Secondary Outcomes: Side Effects
The different side effects reported by the participants and their intensity are reported in . None of the participants reported high-intensity side effects. The result presents the number of times the side effect was reported, out of a possibility of 242, and the number of participants reporting the side effect, out of a possibility of 22. For the number of participants reporting the side effects, there was no significant difference between the 3 forms of treatments for all the side effects measured. For the number of side effects reported, there was a significant and positive association between TG supplement and moderate eructation, moderate dysgeusia, and moderate bloating. Each of these moderate side effects was, however, reported by only 1 participant. The association of eructation, dysgeusia, and bloating with the TG esterified form was significant but with a low magnitude, since the frequency of these side effects was low . Mild abdominal pain/discomfort was reported 8 times by 1 participant when taking the MAG esterified form and once with the TG supplement. There was a significant and positive association between mild abdominal pain/discomfort and the MAG supplement, compared with the EE and TG supplements . There were no significant differences for nausea and flatulence between the treatments.
Side effects and their intensities reported by the adults in the 24 h after taking MAG, EE, and TG n3 FA supplements
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Studies In Healthy Volunteers
In the studies mentioned in the preceding paragraph, consistent data on fatty acid metabolism were reported: After ingestion of purified EPA, blood levels of EPA increased. After ingestion of purified DHA, blood levels of DHA increased. No study using purified EPA found increases in DHA, strongly arguing against EPA being metabolized to DHA in large amounts. However, all studies with DHA supplements found increases in EPA, strongly implying retroconversion of DHA to EPA. After supplementation with EPA, but not with DHA, levels in docosapentaenoic acid increased. Identical data have also been reported from patients .
Fish Oil Triglycerides Vs Ethyl Esters
Omega-3s from fish oil, eicosapantaonic acid and docosahexaenoic acid come to consumers in one of two forms: triglycerides or ethyl esters. One of the most controversial and debated quality issues surrounding fish oil is which form of fish oil is best Triglyceride or Ethyl Ester ?
What form are the long-chain omega 3 fatty acids in when we absorb them from eating fish ? The answer is triglyceride. Over 98% of all fats ingested are in triglyceride form.
Cost vs. Absorption
Ethyl ester forms of omega-3 fatty acid supplements are becoming more prevalent in the market because of the cost: they are cheaper to produce than triglyceride forms. The industry created ethyl ester because they are more malleable form than triglycerides. They have a much higher boiling point, and are easier to work with when processing for supplement distribution.
The main purpose of molecular distillation is to remove the industrial contaminants present ine the commodity fish oils most supplement makers use, and concentrate the omega-3 molecules, EPA and DHA. In this model sterility overshadows efficacy.
Studies have shown that ethyl esters are the least bio-available forms of omega-3s compared to TG forms and/or whole fish. One purification is complete through the micro distillation process why would the manufacturer leave them in an EE form COST.
The process to convert fish oil EEs back to TGs is costly. Bulk oil costs for TG concentrates are typically 30-40% higher than EE concentrates.
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What Is Natural Fish Oil
If you took an oily fish and cold-pressed it what comes out is raw fish oil in its purest form. The oil in this state is known as natural triglyceride fish oil. If you looked at it under a microscope, youd see that each triglyceride is made up of three fatty acids attached to a molecule of glycerol that forms a backbone to hold them all together.
This same structure is identical to virtually all the fats and oils found in nature, including those from plants, animals and human beings. This makes natural triglycerides highly bioavailable to the human body, which is another way of saying we dont have to work too hard to make use of all the nutrients they contain.
The more natural the structure of fish oil and the less processed it is, the more easily we can absorb it. Sounds great, doesnt it? But before you rush out to track down some raw natural triglyceride fish oil supplements, getting your Omega 3 in this way isnt such a good idea.
Because it isnt concentrated, raw fish oil contains very low amounts of the active ingredients EPA and DHA, meaning youd have to swallow vast quantities to receive any therapeutic benefits. And because it hasnt been treated or purified, it could be contaminated with heavy metals, PCBs or dioxins.
Ethyl Esters Vs Triglycerides It May Not Really Matter
When it comes to determining whether the triglyceride form of omega-3 is somehow better or safer than the ethyl ester form, this post provides some food for thought, but at the end of the day it does not take sides. The post suggests that after reviewing the scientific literature in terms of bioavailability, safety or efficacy, that the differences are minor and cannot be considered to be significantly different. It should be noted that Scientific Based Health, where the post appears, sells dietary supplements containing omega-3 fatty acids from both forms.
But back to ethyl ester. There is a third wayin addition to conventional diet and nutritional supplementsto access the benefits of omega-3 fatty acids. And that option is prescription drugs.
There are currently two FDA-approved prescription fish oil medications available, both using ethyl esters. Lovaza combines EPA and DHA , while Vascepa includes EPA only .
This article mentions that a medical food derived from fish oil, Vascazen, is also available. Each 1-g Vascazen capsule contains at least 900 mg of ethyl esters of omega-3 fatty acids sourced from fish oils and includes approximately 680 mg of EPA and approximately 110 mg of DHA.
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How To Use Omega
Read the Patient Information Leaflet if available from your pharmacist before you start taking this medication and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth with food as directed by your doctor, usually once or twice a day. Swallow the capsules whole. Do not crush, chew, or dissolve the capsules.
Do not substitute other omega-3 fatty acids or fish oil products for this product without talking with your doctor first. They may not contain the same amount and type of fatty acids.
The dosage is based on your medical condition and response to treatment. Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. Keep taking this medication even if you feel well. Most people with high triglycerides do not feel sick.
It is very important to continue to follow your doctor’s advice about diet and exercise. It may take up to 2 months to get the full benefits of this drug.
If I Were To Put On My Weasel
Ethyl ester oils are natural they are found in fruits and juices! Weve been consuming them for millennia!
But thats not all!
Concentrated TG Fish Oils that passes for natural well, sheesh, they have 2 to 3 fatty acids per glycerol molecule! Thats unheard of in nature!
But waittheres more!
EE fish oils have a natural number of fatty acids per glycerol backbone. Speaking of backboneask the TG guys what percent of their oil is TG. Youll never get an answer! You know why? Because if you buy one bottle of their stuff, theyll keep sending bottles every month until your grandchildren are eighty!
So call now! Order one. Or a hundred. Heck, I dont care! Youll eventually pay for a hundred. Hurry! Call now! If phones are busy, its because were in trouble with the FTC.
But I jest.
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How Are Concentrated Natural Triglyceride Fish Oils Made
So weve seen how ethyl ester can be useful if we want a clean, concentrated fish oil that actually supplies anywhere near a strong enough dose in a small volume of oil.
Just to recap, ethyl esters are made when fatty acids are removed from their natural glycerol backbone and reattached to a molecule of ethanol to purify and concentrate the oil.
But once youve done this, its then possible to reverse the process and restructure the fat back to its natural triglyceride form, by re-attaching the fatty acids to the glycerol again.
So you get a fish oil thats full of omega-3 and free from toxins, but in a natural form thats easy to absorb.
Fa Extraction And Analysis
FAs were extracted from the plasma samples using the Folch et al. method . For each sample, 11.5 mg of triheptadecanoin was added to 100 L of plasma as an internal standard. The FAs were saponified using KOH-methanol, protonated with HCl, and methylated with BF3-methanol , as previously described in Chevalier and colleagues .
The FA composition of the plasma samples was analyzed by GC equipped with a flame ionization detector . One microliter of the sample was injected in splitless mode at 250°C into a 50-m BPX-70 fused capillary column . The methylated FAs were then carried by helium at a pressure of 107 kPa. A temperature gradient was applied as follows: 50°C maintained for 2 min, followed by an increase of 20°C/min up to 170°C. The temperature was maintained at 170°C for 10 min and thereafter increased by 10°C/min to 195°C. After 35 min at 195°C, the temperature was again raised to 220°C at a rate of 20°C/min and the column was kept at this temperature for 5 min. FAs coming out of the column were detected by the flame ionization detector at 260°C. The total run time was 61.75 min. Nu-Chek-Prep standards were used to identify peaks. The chromatogram analysis was performed using the OpenLab CDS ChemStation.
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Why Are Natural Triglyceride Form Oils Like Bare Biologys More Bioavailable
Its all down to the glycerol molecule. In most fish oils this is removed and replaced by ethanol. But the ethanol molecule is far more resistant to lipase, the pancreatic enzyme needed to break it down.
It also has to be processed by the liver. There the ethanol is separated from the free fatty acids, which need to scavenge for a glycerol molecule to form a triglyceride again. Only when its become a triglyceride can it be taken away by your blood to be absorbed and used by your body. These extra steps slow down the whole process.
By contrast, supplements such as Bare Biologys natural triglyceride form fish oils and capsules still have their glycerol molecule. They arent resistant to lipase and dont contain any ethanol molecules that have to be filtered by the liver.
Studies suggest just 20% of the EPA and DHA in ethyl ester form can be absorbed by your body. To boost bioavailability you can take the supplement with a meal containing fat, which takes it up to 60%. But just contrast this with EPA and DHA in their natural triglyceride form. These were found to have a 69% absorption rate right from the start which increased to a massive 90% when taken with additional dietary fat.
Whats The Bottom Line On Ethyl Esters Fish Oil
At the end of the day, if health outcomes are your goal, where you choose to get your omega-3 ethyl esters should go hand in hand with making sure you are getting the right dose to meet your particular health goals. For healthy people who likely will not need prescription strength omega-3 fatty acids, the first step is to start by calculating how much omega-3 you actually need. And for those with very high triglyceride levels, its also a good idea to know your existing blood levels of omega-3s. Learn more about the Omega-3 Index and how you can manage your Omega-3 goals.
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Ethics Approval And Consent To Participate
The research ethics committee of the CIUSSS de lEstrieCHUS approved our research project . This study was conducted in accordance with the Declaration of Helsinki. Interested individuals were informed of the requested involvement and risks. They were required to read the information and consent form and could ask questions before signing.
How Much Better Are Omega
One study showed that omega-3 in the triglyceride form has 71% greater absorption than EEs . Another study found that free fatty acids were 400% better absorbed than ethyl esters . The ethyl ester omega-3 supplement used in the study was actually Lovaza, which is produced by GSK and is only available on prescription. This unfortunately means that doctors are still currently prescribing the inferior EE omega-3 form of fish oils.
The scientific and medical community has still not fully understood that different types of fish oil produce different effects and results. Omega-3 is one of the most researched substances in medical history, but much of the research so far has only tested the benefits of EE fish oil.
However, more research is starting to be published, looking at the different effects of EE and triglyceride fish oil once they have been absorbed into the body.
For example, one six-month study showed that triglyceride supplements had better bio-availability than EE supplements , and also that triglyceride omega-3 was significantly better at reducing circulating blood triglyceride levels than EE fish oil . Circulating triglyceride levels in the blood are a significant CV risk marker, and one of the criteria used to diagnose metabolic syndrome.
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Intelligent Labs And Pure Omega
At Intelligent Labs, we will only ever sell the highest quality Triglyceride fish oil. We joined the GOED . As a GOED member, all our fish oil must meet the strict quality standards of the GOED Voluntary Monograph. Their mission is to ensure that Omega-3 supplements are safe, pure, and of the highest quality. All the companies that participated in developing the Monograph implemented strict quality standards. Read more about our partnership with GOED and our triglyceride fish oil Omega-3 fatty acids supplement.
References
H Carlier, A Bernard, C Caselli. Digestion and absorption of polyunsaturated fatty acids. Reproduction Nutrition Development, EDP Sciences, 1991, 31 , pp.475-500
Schuchardt, J., & Hahn, A. . Bioavailability of long-chain omega-3 fatty acids. Prostaglandins, Leukotrienes, and Essential Fatty Acids , 89, 1-8.
Dyerberg, J., Madsen, P., Møller, J., Aardestrup, I., & Schmidt, E. . Bioavailability of marine n-3 fatty acid formulations. Prostaglandins, Leukotrienes and Essential Fatty Acids , 83, 137-141.
J Neubronner, J.P. Schchardt, G Kressel, M. Merkel, C von Schacky, Ahahn. Enhanced increase of omega-3 index in response to long term n-3 fatty acid supplementation from triacyglycerides versus ethyl esters, Eur J. Clin Nutr. 65 247 -254.
El Boustani S, Colette C, Monnier L, Descomps B, Crastes de Paulet A, Mendy F. Enteral absorption in man of eicosapentaenoic acid in different chemical forms. Lipids 1987 22:711-4.
Andy Mobbs
Can You Buy A Concentrated Natural Triglyceride Fish Oil
Wouldnt it be great if there was another way of handling fish oil? One that concentrates the active ingredients and removes the contaminants, but still keeps the fish oil in its easy to absorb, natural triglyceride form?
There is and its the one we use here at Bare Biology.
While the conversion of the fish oil in its raw form is necessary to create a clean, concentrated supplement, you dont have to leave the fatty acids as ethyl esters. You can actually convert the fish oil back to its original, natural triglyceride form again.
To do so is more costly and fish oils that use this process are more expensive because of it. But its so worth it, because natural triglyceride fish oils are the most effective supplement money can buy. They contain far more active ingredients than cold pressed oils per dose and are 70% more bioavailable than ethyl ester fish oils.
Fish oils made in this way are quite rare, making up a tiny percentage of the market. But Bare Biology is one of the few manufacturers who go this extra mile. We use this conversion process to make all of our supplements, meaning the omega-3 in our products are in the same natural triglyceride form found in nature.
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Triglycerides Vs Ethyl Ester For Omega
We lean on Cooper Clinic physicians who help formulate our products based on evidence and trends they see from the thousands of preventive exams they conduct each year along with medical research. Combining the evidence and recommendations of Cooper Clinic physicians with recommendations from leading omega-3 researchers, including Bill Harris, PhD, we decided to change to fish oil in the triglyceride form from the previously used ethyl ester form.
Using Epa + Dha To Raise Omega
Knowing an individuals Omega-3 Index is the only way to truly determine what level of supplementation is sufficient. OmegaQuant®, founded by the previously mentioned Bill Harris, PhD, is a lab that specializes in Omega-3 Index testing. The labs research has led to the following advice for increasing an individuals Omega-3 Index:
If your Omega-3 Index is between 4 percent and 8 percent, OmegaQuant would recommend you increase your current EPA+DHA intake by 0.5 -1 gram per day. This can be accomplished in two ways: eating more oily fish and/or taking fish oil supplements. On the other hand, if it is less than 4 percent, our recommendation is to raise your intake by 1-3 g per day. Although this can be accomplished by eating more oily fish, fish oil supplements are usually necessary to achieve this level of EPA+DHA intake.
Raising your Omega-3 Index is achieved by a consistently consuming the recommended level of omega-3 over time. The triglyceride form in our Advanced Omega-3 provides our customers with the ideal form for optimal absorption in comparison to ethyl ester.
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