Fish Oil Dosage – Why You Need It and How Much Omega-3 Should You Take?

Written by Andy Mobbs
Reviewed by Lamia A Kader, MD

This article starts with explaining why standard doses of fish oil are not enough to produce the numerous health benefits omega-3 provides, and then shows why that is from an evolutionary perspective. Learn everything you need to know about the fish oil dosage for every specific need you have.

Fish oil dosage can be a very confusing subject, and it’s one of the most common questions we get here at Intelligent Labs. Officially the amounts recommended by different government bodies vary, but the US Academy of Nutrition and Dietetics recommends 500 mg of EPA and DHA (omega-3 fatty acids) a day, and this is probably the most common guideline that we hear in the industry.

However, we recommend a daily serving of 2250 mg of EPA and DHA (which is supplied in 3g of fish oil) from our Intelligent Labs Ultra Pure Omega-3 fatty acids. So if 500mg is recommended by The Academy of Nutrition and Dietetics, why are we suggesting an omega-3 dosage that’s so much higher?

Table of Contents

Why Do We Suggest a Higher Fish Oil Dosage?

Well, 500 mg fish oil dosage is recommended because it’s generally thought to be enough to prevent an omega-3 deficiency. Research conducted at Harvard in 2009, concluded that up to 96,000 preventable deaths in the USA every year are caused by omega-3 deficiency (1), so even the 500mg recommendation is not being reached by a large number of people. It’s actually estimated that in the USA, the average daily intake of omega-3 is just 100 mg per day (2).

That’s why health experts are desperate to make sure everyone is getting at least this much omega-3. However, we don’t just want to avoid an omega-3 deficiency, we are interested in thriving, becoming the best we can be, and fully benefiting from all the amazing benefits omega-3 can do for our health when it’s available to us in abundance. To understand exactly why higher levels of omega-3 allow us to thrive we need to take a quick look at where we have come from and how omega-3 has shaped our evolution.

Human Beings – We Were Born to Fish

Our evolutionary past is tied to fish and seafood. The first hominids species i.e the first human like species appeared in the fossil records about 2.5 million years ago, that was the same time as the last ice age started (although it’s often called the present ice age as we are currently in what is know as an interglacial warming period).

It marked a time of significant change in the weather patterns of the earth and the previous areas our primate ancestors had inhabited were the forest regions of Northern Africa where they ate a mostly vegetarian diet. The weather became drier and cooler and that led to a reduction in the area of forestry, and the amount of available food as well. Because of this, our ancestors had to move to areas where food was more plentiful or risk extinction. To put our extinction risk in perspective, 177 large mammal species worldwide became extinct during this period (3).

As they moved from the forests of Northern Africa things started to become very interesting. The search for food led to the Great Rift Valley which is a 3,700 mile long trench in Eastern Africa that reaches from Lebanon in the north to Mozambique in the south.  It was here that we started to see in the fossil records the evidence for the increasing size of the human brain. From Homo habilis, to Homo ergaster, Homo erectus, Homo heidelbergensis and Homo sapiens, with each subsequent species found larger bodies and bigger brains are seen. The reason is that the Great Rift valley is filled with lakes, and the abundance of these lakes mean that they had the opportunity to begin a ‘shore-based diet’.

A shore-based diet consists of fish, mollusks, crustaceans, frogs, bird’s eggs, and aquatic plants, and provides the richest known dietary sources of the nutrients needed to power the human brain (4). These nutrients are iodine, iron, zinc, copper, selenium, and most importantly the omega-3 fatty acid DHA.

how much fish oil should i take
The Great Rift Valley

Growing a bigger brain has given our ancestors an advantage in nature. But it only gives them an advantage once they have grown that bigger brain. Whilst it’s still growing it actually puts them, and their parents at greater risk from predators, and extra pressure on them for the extra time required to find food for their children when they are not able to fend for themselves.

So, because initially growing bigger brains would have been an evolutionary disadvantage. We could have only evolved these bigger brains if our environment had allowed access to an abundance of easily available food that provided the vital nutrients needed for brain growth in an environment of relative safety. That was the exact habitat of the Great Rift Valley, with its wetland environment of freshwater and saltwater shores of lakes, riverbanks, marshes, estuaries, and later the coastal regions of east and southern Africa (5).

A key point to understand is that we are still in the wetland stage of our evolution. In other words, we still need to get the abundant supply in our diets of the nutrients that have driven our evolution to be our best, because we can’t yet produce them ourselves. However, in the modern world as we have moved away from this diet and reduced our intake of nutrients like omega-3 we have opened up ourselves to many potential health issues (5). For example, there are many studies that indicate that Alzheimer’s disease is more prevalent in populations consuming low amounts of fish and aquatic invertebrate nutrients (6).

That we were born to fish is now the accepted theory of evolution of paleo-anthropologists, and has replaced the now-debunked theory that we evolved on the plains of Africa that was popularized in the otherwise excellent book ‘Born to Run’ (7). However, despite the evidence for the ‘Born to Fish’ theory, it’s still just a theory. The question is do the scientific studies that have looked at omega-3 benefits and dosages back this up by suggesting a need for higher omega-3 fish oil dosage? That’s what this article will look at next.

Scientific Evidence For a Higher Fish Oil Dosage

What’s the Recommended Fish Oil Dosage to Reduce Inflammation and Pain? Or For General Health?

Inflammation in the body is a cause of a huge number of health problems. For example, coronary heart disease, major depression, ageing and cancer are all characterized by an increase in an inflammatory molecule called interleukin 1 (IL-1), (a proinflammatory cytokine). Whilst autoimmune conditions like arthritis, Crohn’s disease, ulcerative colitis and lupus erythematosus are also linked in interleukin 1 levels and another molecule called leukotriene LTB4, which is produced from omega-6 fatty acids (8). Don’t worry about the names of the molecules, the point is we can reduce them with a high enough dose of a high-quality omega-3 supplement.

A meta-analysis study (which is a review of other published studies) published in arthritis research concluded that people must take 2.7g of omega-3 daily to achieve anti-inflammatory and pain reduction benefits (9). The authors also concluded that the reduction in oxidized LDL (the bad cholesterol) that’s associated with inflammatory conditions such as arthritis was also reduced with a daily fish oil dosage (omega-3 dose) of 2.7g.

The studies were conducted with ethyl ester fish oil which is much less well absorbed than our triglyceride fish oil, so a 3-capsule dose of Intelligent Labs Ultra Pure Omega 3 would be greater than a 2.7g dose of ethyl esters.

Fish Oil Dosage for Crohn’s Disease

As mentioned above Crohn’s disease is an autoimmune condition. The disease is often marked by periods of normality followed by relapses. One study showed that in patients who had a high-risk factor for relapse, 59% stayed Crohn’s free after one year following a daily dose of 2.7g of omega-3 (10). Also in another study, patients who had been hospitalized with severe psoriasis showed a significant improvement with a higher fish oil dosage – 4.2g of omega-3 daily (11).

Omega-3 and Omega-6 – What’s the Proper Balance and Fish Oil Dosage?

There is a test that measures the ratio of omega-6 and omega-3 fatty acids in your red blood cells. It’s sometimes called an AA:EPA ratio (Arachidonic Acid to Eicosapentaenoic Acid). While omega-3 fats reduce inflammation in your body, omega-6 fats promote it.

Inflammation is an essential part of your immune response. But long-term, low-grade (chronic) inflammation can put you at risk of heart disease, cancer, arthritis, and diabetes. So it’s important to have the right balance of omega-6 and omega-3 fats.

Ideally, this ratio should be 2:1. Your omega-6:3 ratio is largely affected by your diet. Most Western diets are too high in omega-6, so the ratio is around 10:1. People suffering from chronic diseases often have a ratio as high as 15:1 or more (12), whilst reducing the ratio to 3:1 or lower is associated with very low levels of inflammation (13). You can lower your omega-6:3 ratio by decreasing your omega-6 intake and increasing your omega-3 intake. To decrease your omega-6 levels, avoid eating a lot of processed vegetable oils — these include vegetable oil, corn oil, safflower oil, soybean oil, and cottonseed oil. You should also avoid processed foods that contain these oils.

To increase your omega-3 levels, eat more foods rich in omega-3 fats. Oily fish, like salmon, trout, mackerel, tuna and sardines, is one of the best sources — aim to eat two portions a week. Although not as rich a source, grass-fed meat and omega-3 enriched eggs can also help to increase your levels.

There are some plant sources of omega-3, like flax seeds, chia seeds, walnuts and hemp seeds. But your body finds it harder to use this type of omega-3 (ALA). If you’re vegan, vegetarian or don’t eat a lot of fish you might need to think about taking a supplement.

A 2010 study found a daily dose of 2.5g of EPA and DHA was sufficient to reduce the AA:EPA ratio to 2.6:1, so under the 3:1 ratio that achieves a very low level of inflammation (14).

Conclusion: A daily fish oil dosage of 2.7g reduces the inflammation associated with autoimmune conditions such as arthritis and 2.5g will reduce the omega 6:3 ratio down to low levels of cellular inflammation. These doses came from ethyl ester fish oil, so taking the 3 capsules daily of Intelligent LabsUltra Pure Omega 3 (in triglyceride form) will surpass these levels.

Triglycerides, Blood Cholesterol and Heart Disease

It has long been known that omega-3 protects against heart disease, and significantly reduces the levels of triglycerides circulating in the blood and can increase levels of HDL (the good cholesterol), but is a standard 500 mg dose of omega-3 going to be enough to make a difference?

What’s the Ideal Fish Oil Dosage to Reduce Triglycerides?

High triglycerides are one of the most common reasons for people taking an omega-3 supplement. Some studies have shown decreases of over 50% in the levels of triglycerides at a dose of 10g of omega-3 per day in patients with high triglycerides (15). However, more usual findings are a reduction of 25-30% with doses of 2-4g of omega-3 (16).

Conclusion: To reduce triglycerides levels we recommend 3 capsules daily serving of Intelligent LabsUltra Pure Omega 3.

What’s the Recommended Fish Oil Dosage to Improve Cholesterol?

When looking at omega-3 effects on cholesterol, we first need to explain exactly what we are looking at. Doctors will talk about good and bad cholesterol, with HDL being the good and LDL being the bad. However, HDL and LDL are not actually cholesterol, they are what are known as lipoproteins, LDL is Low density lipoproteins and HDL is High density lipoprotein. Because cholesterol is fat soluble and our blood is mostly water cholesterol won’t dissolve in water, so it has to be carried around our body by Lipoproteins.

Cholesterol is vital for life, it forms the basis of the membranes of every single one of the body’s 20 trillion cells and forms the basis of many hormones. LDL transports cholesterol to cells, whereas HDL transports excess cholesterol to the liver for disposal into the bile.

So cholesterol in itself doesn’t cause us problems, it’s the lipoproteins, or more specifically LDL that can cause heart disease. Too much LDL in the blood can cause cholesterol to lodge in the artery walls and form plaque, this plaque hardens and narrows arteries which causes heart disease.

HDL

Omega-3 (and more specifically DHA) raises HDL cholesterol (the good one). One study with a 4.5g daily dose of EPA and DHA in a roughly 3:2 ratio (the ratio found in Intelligent Labs Ultra Pure Omega 3) showed a 50% increase in the levels of HDL (so around a 20 mg/dl increase!) (17). Although might be a larger than average increase, another meta-analysis study showed that DHA on average increases HDL by 4.49 mg/dL (18) in doses of 2.3-4g per day.

LDL

When it comes to LDL levels the studies are less clear and the results are somewhat mixed. Some studies have shown a decrease in LDL levels and some an increase. A meta-analysis study has also shown that EPA is likely to slightly decrease LDL and DHA slightly increase it by 4.63 mg/dL (19). So, we could say that EPA is better for our cholesterol than DHA. However, these studies have looked at DHA and EPA in isolation and not together, and most omega-3 supplements come in a combination of EPA and DHA. They are also only measuring one aspect of LDL which is not necessarily an indicator of heart disease risk.

To understand the reason for this, we need to look at what an LDL test result actually shows. When you go to the doctor to get a LDL test,  they give you an LDL-C reading, which is the measurement of the amount of cholesterol inside the LDL particle. However, whilst a high reading is a potential issue, there is a much more effective reading for heart disease risk and that is LDL-P, which is a measurement of the number of LDL particles.

small and large LDL particles

A good an-allergy to understand the difference between LDL-C and LDL-P and why LDL-P is the bigger risk factor is to think of a highway. The walls at the edge of the highway are the endothelium lining of the arteries. The cars on the road are LDL, and the passengers in the car are the cholesterol. The total size of all the cars or the volume would be the LDL-C figure, whereas the number of cars on the road would be the LDL-P figure. The actual risk to cars of crashing off the road is not the size of the cars, but the number on the road. The busier the road the more likely there will be a crash, and this is LDL-P.

LDL particle number (LDL-P) is a much more accurate predictor of heart disease risk than either LDL-C or total cholesterol. So, to understand how omega-3 affects heart disease, we need to look at LDL-P rather than LDL-C (19).

what's the difference between LDL-P and LDL-C

As well as measuring LDL-P we can also measure Apolipoprotein B, which is the major apolipoprotein in LDL. It binds with triglycerides and cholesterol to form LDL, and it is also the receptor that binds with cells so LDL can deliver it’s fats and cholesterol. So in scientific studies Apolipoprotein B levels act as a proxy for LDL-P.

A 2015 study showed that a dose of 3.4g of EPA and DHA per day significantly reduced Apolipoprotein B levels, whereas a dose of 0.85g a day did not change Apolipoprotein B levels (20). Another study with a huge dose of 24g of omega-3 per day (EPA and DHA) showed significant reductions in LDL-C and Apolipoprotein B levels (21). Whilst we don’t recommend a 24g daily fish oil dosage, the studies do indicate that larger doses can reduce LDL particle count more.

Studies have shown that DHA significantly increases LDL particle size in 4g daily servings of Pure DHA (22, 23) and a mixed EPA and DHA omega-3 supplement (23).  Increased particle size, as shown in the image above, is generally an indicator of reduced LDL particles, which is another good reason to have a healthy amount of DHA in your omega-3 supplement.

Conclusion: To increase HDL and reduce LDL-P we recommend 3 capsules daily of IntelligentLabs Ultra Pure Omega 3.

Other Cardiovascular Benefits:

Blood Clotting

A 1997 study showed that a dose of 2.6g per day of omega-3 fatty acids reduced blood platelet aggregation (the ability of blood cells to form a clot) which reduces the risk of thrombosis (24). Another study showed that a daily omega-3 fish oil dosage of 2-3g significantly increased bleeding times and reduced platelet aggregation (25).

Heart Rate Variability

Another study showed that a 5.2g daily dose of omega-3 increased heart rate variability. Decreased heart rate variability is associated with arrhythmia (abnormal patterns of the heart), and higher death rates in patients who have already suffered a heart attack (26).

Stability of Atherosclerotic Plaques

Higher fish oil dosage were also shown to make atherosclerotic plaques more stable (i.e less likely to rupture and cause a heart attack), in patients waiting for a carotid endarterectomy (an operation to unblock a carotid artery) (27).

Artery Widening

Although early trials have shown the ability of high dose omega-3 to widen the arteries in heart disease patients (28), more recent studies have suggested that high fish oil dosage effects are only mild (29, 30), so this may not be a cardio-protective factor of omega-3.

Blood Pressure

A review of 31 studies on blood pressure found that omega-3 could lower blood pressure, and that the amount that it lowered was related to the dose. The higher the fish oil dosage, the more blood pressure was lowered and they estimated the lowering as -0.66/-0.35 systolic/diastolic mm Hg per 1g of omega-3 fatty acids per day (31). Another meta-analysis study found that 3g or more of omega-3 per day can lead to clinically relevant blood pressure reductions (32).

Resting Heart Rate

A study found that 4g of ethyl ester EPA or DHA per day could reduce resting heart rate by 1.9 bpm (EPA) and 2.2 bpm (DHA) (33).

Nitric Oxide Production and Endothelial Function

Endothelial function is the ability of the arteries to contract and relax efficiently. Nitric Oxide is known to relax arteries and increase blood flow, and because of this Nitric Oxide (NO) boosters are very popular sports supplements. A 1997 study found that a 3g a day dose of omega-3 increased endothelial function, and it was concluded that this was likely to be due to increased NO production. They also found the DHA rather than EPA was responsible for this (34).

Heart Attack Risk

So how do all these cardiovascular benefits affect heart attack risk? The best way to look at this is through long-term studies on individuals that have already suffered heart attacks. However, the problem is that there are not many of those, and so far there has been only one study using high fish oil dosage of 4g per day (35). It showed no benefit from using the fish oil, although, as the authors discussed the study was conducted in western Norway where the population already has a very high fish intake through their diet. So, the fish oil was unlikely to be able to add to the cardioprotective benefits they were already receiving from their omega-3 dietary intake.

However, 2 other studies showed a significant benefit of omega-3 for patients who had suffered a heart attack. The (GISSI) trial in Italy on over 11,000 men showed a significant reduction in cardiac events following 1g of omega-3 a day for 3.5 years (36). Also, a 1 year trial of patients who had suffered a heart attack showed that supplementation with fish oil of 1.08g per day reduced cardiac deaths by 50% over placebo (37). Despite this, a further study showed that omega-3 of 900mg twice a week so approximately 260mg a day, showed no benefit on cardiac death rates to men with angina (38), and a final study showed that a daily fish oil dosage of just under 400mg of omega-3 had no significant impact on heart attack risk on patients who had recently suffered a heart attack (39).

So it’s clear that 260mg a day or 400mg a day is a dose far too small to have heart benefits in the body. However, 1g a day will provide a significant reduction in heart attack risk. So it seems very likely considering all of the other cardiac protective effects that higher doses than 1g a day of omega-3 will reduce cardiac death rates even further.

The Omega-3 Index

The one thing that these studies lack is testing higher doses of omega-3, and also the examination of actual omega-3 levels in the blood. Luckily there is a clinical test – The Omega-3 Index that we can look at. The Omega-3 Index is the percentage of omega-3 fatty acids present in the blood. In the USA the average is 4% – 5% (40 – 43). However, the level needed to see a significant reduction in primary cardiac arrest (44), sudden cardiac death (45), coronary atherosclerosis (46), and acute coronary syndrome (47) is over 8% (48).

To increase the average level of omega-3 in your blood from 4%-5% to over 8% requires a daily intake of omega-3 of between 1.8 and 1.9g (49 – 50).

Conclusion: A daily 3 capsules serving of IntelligentLabs Ultra Pure Omega 3 should provide the benefits listed above including a slight reduction in blood pressure, reduced risk of blood clotting and thrombosis, increased nitric oxide production and endothelium function, and an increase in the Omega-3 Index above 8% which is associated with a significant reduction in cardiac risk events.

Cognitive Benefits

The main reason Intelligent Labs includes a high dose of DHA in Ultra Pure Omega 3 supplement is because of DHA’s effects on the brain. DHA is the most prominent of all the fatty acids in the brain. It forms a vital part of cell membranes and gives them fluidity. In brain neurons, this extra fluidity allows them to make effective synapse connections. A lack of DHA for a growing fetus that must make 250,000 new brain cells a minute, can be disastrous. DHA also plays a key role in the ongoing structure of the adult brain.

In the brain, the areas most closely associated with memory show the highest DHA concentrations (51). DHA also has 3 key roles in the brain.

  • DHA protects brain tissue from inflammation

DHA produces anti-inflammatory molecules as well as suppressing pro-inflammatory molecules that can degenerate and age the brain (52- 53).

  • DHA causes physical changes in the brain that stimulate learning and memory

DHA directly promotes neurites growth from neurons, these neurites form the connections between cells as memories form (54). It also promotes rapid signal transduction across synapses, and it also provides fluidity in cell membranes allowing for rapid changes in shape and function that can be recognized as learning and memory (55-56).

  • DHA can heal brain tissue after it has been damaged through injury

After an injury, the brain will release DHA in large amounts that are then converted into molecules called protectins. Protectins provide anti-inflammatory actions and begin healing in brains that have suffered seizure, stroke or a physical injury (52, 57)

So now let’s look how this relates to studies that have used DHA supplementation and assessed cognitive improvements:

A 2012 study showed that a 1g daily serving of DHA led to increased cerebral blood flow during cognitive tasks, whereas no benefit was found with 1g of EPA (58). Another meta-analysis study showed that 1g per day of DHA improved episodic memory (i.e times, places, associated emotions, and other contextual who, what, when, where, why knowledge) and working memory (which is like a mental sticky note we use to keep track of information until we need to use it) (59). Also, a 2013 study showed that 1.16g of DHA per day improved working memory in healthy young adults and memory reaction time (60).

Cognitive Decline

Studies on cognitive decline are key to understanding DHA’s benefits in the brain. So far, studies have shown that DHA supplementation is not effective in late stage Alzheimer’s. However, no pharmaceutical drug is effective in late stage Alzheimer’s, and the best they can do is slow the progress of early onset Alzheimer’s and dementia. It is early onset Alzheimer’s and dementia where DHA shows it’s benefits.

A paper in 2015 by Dr. Emily Chew came to the conclusion that omega-3 supplements were not beneficial in any form of cognitive decline. This conclusion was widely published in the media with headlines suggesting that ‘omega-3 supplements were useless’. However, when you look more closely at the study you see that they used only a 350mg daily serving of DHA (61).

Another paper by Adam Ismail at GOED, titled ‘Omega’s and Cognition, Dosage Matters, published after Dr. Chew’s study also in 2015, reviewed all of the studies on cognitive decline and fish oil DHA supplementation. He looked specifically at whether they provided a successful outcome, and the level of DHA supplementation per day. The results are quite striking, and clearly show a fish oil dosage of less than 500mg per day of DHA is not enough to provide cognitive benefits (62).

how much fish oil should i take

Conclusion: DHA is vitally important for cognitive benefits. Studies show that the more DHA one supplements with the better the outcome. All studies supplementing with above 1000mg a day of DHA show benefits.

A study in The American Society for Clinical Nutrition showed that DHA supplementation reaches a ‘saturation point’ in the blood at 1.2g of DHA a day when taken with EPA in a 3:2 ratio, so 1.8g of EPA and 1.2g of DHA per day for a total of 3g of omega-3 a day. So when you reach that level of supplementation, blood levels of DHA stay constant even when you increase the DHA dose over 1.2g (63).

A 2001 study showed there was a correlation between blood levels of omega-3 and levels in the cerebral cortex (64), so reaching the ‘saturation point’ in blood DHA would suggest we are also reaching the limit of DHA absorption into the brain. So to reach this saturation point we would recommend 4 capsules daily of Intelligent Labs Ultra Pure Omega 3.

Exercise and Sports Performance Benefits

How Much Omega-3 Fish Oil Should I Take For Recovery?

Hard training causes inflammation and pain, as we’ve already seen an omega-3 fish oil dosage of 2.7g a day is needed to reduce this inflammation (9), although this inflammation is associated with training over the longer term. A 2009 study showed that 1.8g of omega-3 per day was needed to significantly reduce the perceived pain and the range of motion of joints following acute exercise sessions known as DOMS – Delayed Onset Muscle Soreness (65).

Increasing Muscle Mass

Several studies have shown that omega-3 supplementation can promote muscle growth and does so by switching on the mTOR pathway, which is the body’s muscle-building ‘switch’. It can also improve Insulin signaling which allows more muscle-building nutrients into cells (66-67). A dose of 3.86g of omega-3 showed a muscle-building (anabolic response) both in older adults for the prevention of sarcopenia (muscle wasting with age) (66), and in young and middle-aged men and women (68).

Increasing Blood Flow to the Muscles During Exercise

A study on trained cyclists using 2.4g of omega-3 fish oil dosage a day found that it significantly lowered heart rates during incremental workloads to exhaustion, as well as displaying lower steady-state submaximal exercise heart rates (so lower heart rates when exercising at a constant workload below maximum), as well as lower whole-body oxygen consumption (so more efficient oxygen use), and lower oxygen consumption by the heart (68).

Conclusion: A 3 capsules daily serving of Intelligent Labs Ultra Pure Omega 3 will help reduce both short and long-term inflammation associated with training. It will also help increase blood flow to the muscles during exercise. Individuals whose goal is increasing muscle mass may need to supplement with 4 capsules daily, if they do not already have a high dietary intake of omega-3 (i.e eating lots of fish).

Pregnancy

As we’ve seen earlier DHA is vital for a developing fetus, so what advice should pregnant women have on omega-3 supplementation?

How Much Omega-3 Fish Oil Should I Take During Pregnancy?

A fascinating study published in the journal of Pediatrics in 2003 showed that mothers who supplemented with 2.5g a day of omega-3 during pregnancy had children who scored higher on IQ tests at 4 years of age than mothers who did not take omega-3 supplements (69).

Preventing Premature Births

A study of women in their third trimester of pregnancy was split into 3 groups. The first group was given 4g of olive oil daily, the second was given 2.7g of omega-3 daily, and the third was given placebo. The results showed that the olive oil group had the shortest pregnancies, and the omega-3 group had the longest pregnancies. No negative side effects of omega-3 supplementation for the mother or child were reported during the study (70).

Conclusion: Take at least 2.5g of omega-3 a day during pregnancy. It’s also important to continue supplementing after giving birth, as a baby’s omega-3 levels will quickly decline unless they get it through their diet (i.e breast milk). A mother’s breast milk omega-3 levels increase directly proportional to omega-3 in their diets, so any supplementation should be continued for at least the entire breastfeeding period (71).

Depression and Mental Health

There are many epidemiological studies showing that in populations with a higher omega-3 dietary intake there is less depression (epidemiological are studies of populations, they can find the correlation between behavior and health, but they can’t prove direct cause). For example, a Norwegian study found that people who took cod liver oil were 30% less likely to suffer from depression.

What’s the Recommended Fish Oil Dosage to Help With Depression?

A recent meta-analysis found success in improving depression symptoms with omega-3 doses from 1000mg to 6.6g daily (72). They also found that omega-3 combined with antidepressant therapy was more effective than antidepressants alone. Interestingly they found that EPA was more successful than DHA for lifting depression and that studies that used DHA only supplements were not effective at reducing depression. However, studies that combined EPA and DHA supplements were successful at reducing depression.

So far, the cutoff point in studies is 60% EPA and 40% DHA for success in treating depression symptoms, which is exactly the 3:2 ratio we use in Intelligent Labs Ultra Pure Omega 3 (73).

The authors suggested that “DHA as a component of neuronal membrane phospholipids affect neurotransmission, whereas EPA may influence mood to a greater extent by acting through eicosanoid (signaling molecules that are predominantly anti-inflammatory when produced from EPA omega-3) mechanisms to increase cerebral brain flow.

However, we’ve previously seen in the section on cognitive benefits that a 1g daily serving of DHA increases cerebral blood flow, whereas a 1g serving of EPA doesn’t (58). What is interesting is, the studies of omega-3 and depression last for a maximum of 12 weeks, with many lasting 8 weeks and some only 3 or 4 weeks. The vast majority of the DHA studies that showed improvements in cognitive abilities lasted for 6 months or longer.

When you compare this to other research that has found that it can actually take up to 10 – 12 weeks of supplementation with DHA for it to fully integrate into the inner cell membranes (74), it seems quite possible that depression studies using DHA for longer than 12 weeks may come to different conclusions. So currently the recommendation is for at least 1g of omega-3 per day in no more than a 3:2 EPA to DHA ratio for depression. We also await longer studies into the effect of DHA on depression symptoms.

Conclusion We recommend the 3 capsules daily serving of Intelligent Labs Ultra Pure Omega 3 to help relieve symptoms of depression, as an addition to treatments recommended by your physician.

How Much Omega-3 Fish Oil Should My Child Take For Depression?

The studies mentioned above were conducted on adults and there are far fewer studies on children. However, depression still affects between 2 – 4% of children (75). A 2006 study conducted on children between the ages of 6 and 12, found that supplementation with 400 mg of EPA and 200mg of DHA (for a total of 600mg of omega-3 per day) for 4 months caused a significant decrease in depression symptoms (76).

Also another contributing factor to depression is poor sleep. A 2014 study found that a 600mg daily dose of DHA in children reduced wake episodes during the night and increased sleep time by an average of 58 minutes a night (77).

Conclusion: Try an omega-3 fish oil dosage of 600mg per day.

PTSD (Post-traumatic stress disorder)

DHA also appears to be more effective than EPA in dealing with PTSD. PTSD is associated with a lowering of brain volume of the amygdala and hippocampus areas of the brain (78, 79). The amygdala and the hippocampus both interact with the prefrontal cortex, which controls the expression of emotions and impulses, the ability to focus, and the storage of memories.

We have already seen that DHA increases blood flow to the prefrontal cortex, and clinical studies have shown that the higher the consumption of omega-3 the greater the volume of the amygdala and hippocampus, and that DHA can cause neurogenesis (the growth of new neurons) in these areas (80).

How Much Omega-3 Fish Oil Should I Take For PTSD?

So far there have not been many clinical studies on the effectiveness of omega-3 on PTSD, however, a 2010 study studied people who had recently been in a motor vehicle accident, and supplemented them with 1470mg of DHA and 147mg of EPA for 12 weeks (81). There was an average of 74 hours between the accident and starting the omega-3 protocol, and the results showed that the omega-3 was effective in preventing PTSD symptoms from appearing. This suggests omega-3 supplementation can be helpful following exposure to traumatic events. We await more studies in this area.

Conclusion: It’s hard to draw a conclusion from the studies so far. Theoretically, omega-3 may be able to help based on its ability to increase the volume of areas of the brain associated with PTSD. So if you want to try taking omega-3 for PTSD, you should use the fish oil dosage recommended above in the cognitive benefits section of the full 3 capsules daily serving of Intelligent Labs Ultra Pure Omega 3.

ADHD (Attention deficit hyperactivity disorder)

ADHD is very common affecting some 3% -5% of children in the US and 4% of adults. ADHD is also associated with lower levels of omega-3 in the brain, and a 1996 study showed that in boys aged from 6 – 12, those with lower levels of omega-3 had higher levels of ADHD (82).

How Much Omega-3 Fish Oil Should I Take For ADHD?

Several studies have shown an improvement in ADHD symptoms with omega-3 fish oil supplementation (83, 84). A 2009 study went on to give very clear guidelines of 20-25  mg/kg/day of EPA and 8.5-10.5 mg/kg/day of DHA. So for a 30kg child, it would be about 660mg of EPA and 270mg of DHA per day (84).

How Much Omega-3 Fish Oil Should I Take For Anxiety?

A study of substance abusers showed that a 3g daily dose of omega-3 reduced anger and anxiety (85). Another study conducted on young healthy medical students found a daily fish oil dose of 2.85g reduced anxiety and inflammation even during stressful exam periods (86).

Conclusion: Based on these studies we suggest trying a dose of 3g of omega-3 a day, about 4 capsules daily of Intelligent Labs Ultra Pure Omega 3.

Eye Health

DHA is at its highest concentration in the eye and is particularly highly concentrated in the retina, and is thought to be very important for healthy retinal function.

Macular Degeneration

Macular degeneration specifically targets the retina, so we would expect to see DHA affect this condition. So far, there are no treatments to cure or reverse macular degeneration, there are only treatments to slow its progress.

How Much Omega-3 Fish Oil Should I Take For Macular Degeneration?

There have been 3 key studies so far looking at different doses of Omega-3 and their effects on macular degeneration. The first, supplemented 1000 mg a day of omega-3, with 650 mg of EPA and 350 mg of DHA. The authors concluded that this dose of omega-3 did not reduce the risk of developing advanced macular degeneration (87).

The second study increased the dose slightly to 1100mg a day, but used a much higher dose of DHA (840 mg of DHA and 270 mg of EPA). The authors found that when they examined the study participants blood levels of DHA, those with the highest levels of DHA had a 68% reduced risk of developing new blood vessels formation, (new blood vessels formation are characterized by vision loss and the development of advanced macular degeneration), although none of the study participants’ vision actually improved (88).

The third study increased the omega-3 fish oil dosage considerably to 5000 mg a day, with 3400 mg of EPA and 1600 mg of DHA. Quite incredibly, they found that 100% of the study’s participants didn’t just slow the rate of their macular degeneration, but actually significantly improved their eyesight. Some of the participants experienced an improvement within a few days of starting the study, and all had experienced a significant improvement within 4.5 months of starting supplementation. The authors concluded that high-dose omega-3 supplementation could actually begin to restore the eyesight of people suffering from macular degeneration! (89).

Conclusion Higher dose omega-3 supplementation is needed to see benefits for macular degeneration. We suggest starting with the recommended 3 capsules per day serving of Intelligent LabsUltra Pure Omega 3 (2250mg of omega-3), then potentially increasing the dose if you do not see benefits by 1 capsule per day every 2-3 weeks.

How Much Omega-3 Fish Oil Should I Take For Dry Eye?

Dry Eye is the one condition discussed in this article that studies show success in treating with lower omega-3 doses (although higher doses will work too). For example, a 2011 study found that 855 mg (427 EPA and 285 DHA, 142 other omega-3’s) per day significantly improved dry eye symptoms (90). Another 2011 study found a 750mg daily serving of Omega-3 (450mg EPA, 300mg DHA), brought significant improvements with 70% of study participants being symptom-free at the end of the 90-day study (91).

Conclusion: Just under 1g of omega-3 per day has been shown to improve symptoms of Dry Eye. However, so far there have not been studies on higher doses. Because dry eye is linked to inflammation and in the inflammation section above we have seen a greater reduction in inflammation from larger dosages, we would expect to see even greater benefits from higher omega-3 fish oil dosage. We therefore recommend the full 3 capsules daily serving of Intelligent Labs Ultra Pure Omega 3.

References

(1) The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors, Goodarz Danaei, Eric L. Ding, Dariush Mozaffarian, Ben Taylor, Jürgen Rehm, Christopher J. L. Murray, Majid Ezzati, Public Library of Science Medicine, April 28, 2009.

(2) USDA Nutrient Intakes From Food: Mean Amounts Consumed per Individual, by Gender and Age, What We Eat in America, NHANES 2009–2010. 2012Washington, D.C.USDA.

(3) Global late Quaternary megafauna extinctions linked to humans, not climate change. Christopher Sandom, Søren Faurby, Brody Sandel and Jens-Christian Svenning, Published:22 July 2014.

(4) Energetic and nutritional constraints on infant brain development: Implications for brain expansion during human evolution, Stephen C. Cunnanea, Michael A. Crawford, Volume 77, December 2014, Pages 88–98.

(5) Human Brain Evolution, The Influence of Freshwater and Marine Influences, Cunnane and Stewart. 2010.

(6) Fish, docosahexaenoic acid and Alzheimer’s disease, Cunnane, Plourde M, Pifferi F, Bégin M, Féart C, Barberger-Gateau P. Prog Lipid Re. 2009 Sep;48(5):239-56.

(7) Born to Run, Christopher McDoughall, 2009.

(8) Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr 2002;21:495–505.

(9) Fish oil: what the prescriber needs to know, Leslie G Cleland, Michael J James and Susanna M Proudman, Arthritis Res Ther. 2006; 8(1): 202.

(10) Effect of an enteric-coated fish-oil preparation on relapses in Crohn’s disease, Belluzzi A, Brignola C, Campieri M, Pera A, Boschi S, Miglioli M, N Engl J Med. 1996 Jun 13;334(24):1557-60.

(11) Omega-3 fatty acid-based lipid infusion in patients with chronic plaque psoriasis: results of a double-blind, randomized, placebo-controlled, multicenter trial. Mayser P1, Mrowietz U, Arenberger P, Bartak P, Buchvald J, Christophers E, Jablonska S, Salmhofer W, Schill WB, Krämer HJ, Schlotzer E, Mayer K, Seeger W, Grimminger F. J Am Acad Dermatol. 1998 Apr;38(4):539-47.

(12) A rapid method for determining arachidonic:eicosapentaenoic acid ratios in whole blood lipids: correlation with erythrocyte membrane ratios and validation in a large Italian population of various ages and pathologies, Rizzo AM, Montorfano G, Negroni M, Adorni L, Berselli P, Corsetto P, Wahle K, and Berra B. Lipids in Health and Disease 9:7 (2010).

(13) Importance of maintaining a low omega–6/omega–3 ratio for reducing inflammation. DiNicolantonio JJ, O’Keefe JH. Open Heart 2018;5:e000946.

(14) Omega-3 fatty acid supplements in women at high risk of breast cancer have dose-dependent effects on breast adipose tissue fatty acid composition,Yee LD, Lester JL, Cole RM, Richardson JR, Hsu JC, Li Y, Lehman A, Belury MA, and Clinton SK, Am J Clin Nutr 91: 1185-1194 (2010).

(15) Post heparin lipolytic activity and plasma lipoprotein response to omega-3 polyunsaturated fatty acids in patients with primary hypertriglyceridemia. Nozaki S1, Garg A, Vega GL, Grundy SM,Am J Clin Nutr. 1991 Mar;53(3):638-42.

(16) n-3 fatty acids and serum lipoproteins: human studies. Harris WS, Am J Clin Nutr. 1997 May;65(5 Suppl):1645S-1654S.

(17) Omega-3 fatty acids selectively raise high-density lipoprotein 2 levels in healthy volunteers. Franceschini G1, Calabresi L, Maderna P, Galli C, Gianfranceschi G, Sirtori CR. Metabolism. 1991 Dec;40(12):1283-6.

(18) Effects of eicosapentaenoic acid versus docosahexaenoic acid on serum lipids: a systematic review and meta-analysis. Wei MY, Jacobson TA, Curr Atheroscler Rep. 2011 Dec;13(6):474-83.

(19) LDL particle subclasses, LDL particle size, and carotid atherosclerosis in the Multi-Ethnic Study of Atherosclerosis (MESA), Samia Mora a, Moyses Szklo b, James D. Otvos c, Philip Greenland d, Bruce M. Psaty e, David C. Goff Jr.f , Daniel H. O’Leary g, Mohammed F. Saad h, Michael Y. Tsaii , A. Richey Sharrett b, Atherosclerosis 192 (2007) 211–217.

(20) Dose-response effects of marine omega-3 fatty acids on apolipoproteins, apolipoprotein-defined lipoprotein subclasses, and Lp-PLA2 in individuals with moderate hypertriglyceridemia, Skulas-Ray AC, Alaupovic P, Kris-Etherton PM, West SG. J Clin Lipidol. 2015;9(3):360–367.

(21) Inhibition of low density lipoprotein synthesis by dietary omega-3 fatty acids in humans. D R Illingworth, W S Harris, W E Connor, Arteriosclerosis, Thrombosis, and Vascular Biology. 1984; 4: 270-275.

(22) Docosahexaenoic Acid But Not Eicosapentaenoic Acid Increases LDL Particle Size in Treated Hypertensive Type 2 Diabetic Patients, Richard J. Woodman, MMedSci1, Trevor A. Mori, PHD1, Valerie Burke, MD1, Ian B. Puddey, MD, Gerald F. Watts, MD, PHD, James D. Best, MD and Lawrence J. Beilin, MD, Diabetes Care 2003 Jan; 26(1): 253-253.

(23) Purified eicosapentaenoic and docosahexaenoic acids have differential effects on serum lipids and lipoproteins, LDL particle size, glucose, and insulin in mildly hyperlipidemic men. Mori TA, Burke V, Puddey IB, Watts GF, O’Neal DN, Best JD, Beilin LJ. Am J Clin Nutr. 2000 May;71(5):1085-94.

(24) Interactions between dietary fat, fish, and fish oils and their effects on platelet function in men at risk of cardiovascular disease, Mori TA, Beilin LJ, Burke V, Morris J, Ritchie J, Arterioscler Thromb Vasc Biol. 1997 Feb;17(2):279-86.

(25) Effects Of 11-week Increase In Dietary Eicosapentaenoic Acid On Bleeding Time, Lipids, And Platelet Aggregation,Margareta Thorngren, Anders Gustafson, The Lancet, Volume 318, No. 8257, P1190–1193, 28 November 1981.

(26) Effect of fish oil on heart rate variability in survivors of myocardial infarction: a double blind randomised controlled trial, J. H. Christensen, P. Gustenhoff, E. Korup, J. Aarøe, E. Toft, J. Møller, K. Rasmussen, J. Dyerberg, and E. B. Schmidt, BMJ. 1996 Mar 16; 312(7032): 677–678.

(27) Association of n-3 polyunsaturated fatty acids with stability of atherosclerotic plaques: a randomised controlled trial, Thies F, Garry JM, Yaqoob P, Rerkasem K, Williams J, Shearman CP, Gallagher PJ, Calder PC, Grimble RF, Lancet. 2003 Feb 8;361(9356):477-85.

(28) Preventing Restenosis With Fish Oils Following Coronary Angioplasty. A Meta-analysis, James P. Gapinski, MD; Jerome V. VanRuiswyk, MD, MS; Gustavo R. Heudebert, MD; Gordon S. Schectman, MD, Arch Intern Med. 1993;153(13):1595-1601.

(29) The Effect of Dietary ω-3 Fatty Acids on Coronary Atherosclerosis: A Randomized, Double-Blind, Placebo-Controlled Trial, Von Schacky C, Angerer P, Kothny W, et al. Ann Intern Med. 1999;130:554–562.

(30) Controlled trial of fish oil for regression of human coronary atherosclerosis, Frank M. Sacks, MD, Peter H. Stone, MD, FACC, C. Michael Gibson, MD, FACC, David I. Silverman, MD, FACC, Bernard Rosner, PhD, Richard C. Pasternak, MD, FACC, Journal of the American College of Cardiology, Volume 25, Issue 7, June 1995, Pages 1492-1498.

(31) Does fish oil lower blood pressure? A meta-analysis of controlled trials. M C Morris, F Sacks and B Rosner, Circulation, August 1, 1993.

(32) Does Supplementation of Diet With ‘Fish Oil’ Reduce Blood Pressure? A Meta-analysis of Controlled Clinical Trials, Lawrence J. Appel, MD, MPH; Edgar R. Miller III, MD, PhD; Alexander J. Seidler, PhD; Paul K. Whelton, MD, MSc,Arch Intern Med. 1993;153(12):1429-1438.

(33) Effects of highly purified eicosapentaenoic acid and docosahexaenoic acid on hemodynamics in humans. S Grimsgaard, K H Bønaa, J B Hansen, and E S Myhre, Am J Clin Nutr July 1998 vol. 68 no. 1 52-59.

(34) n-3 fatty acids and urinary excretion of nitric oxide metabolites in humans, W S Harris, G S Rambjør, S L Windsor, and D Diederich, Am J Clin Nutr February 1997 vol. 65 no. 2 459-464.

(35) Effects of a high-dose concentrate of n−3 fatty acids or corn oil introduced early after an acute myocardial infarction on serum triacylglycerol and HDL cholesterol, Dennis WT Nilsen, Grethe Albrektsen, Knud Landmark, Solfrid Moen, Torbjørn Aarsland, and Leik Woie, The American Journal of Clinical Nutrition, Volume 74, Issue 1, July 2001, Pages 50–56.

(36) Early protection against sudden death by n-3 polyunsaturated fatty acids after myocardial infarction: time-course analysis of the results of the Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico (GISSI)-Prevenzione, Marchioli R, Barzi F, Bomba E, et al. Circulation. 2002; 105: 1897–1903.

(37) Randomized, double-blind, placebo-controlled trial of fish oil and mustard oil in patients with suspected acute myocardial infarction: the Indian experiment of infarct survival—4, Singh RB1, Niaz MA, Sharma JP, Kumar R, Rastogi V, Moshiri M, Cardiovasc Drugs Ther. 1997 Jul;11(3):485-91.

(38) Lack of benefit of dietary advice to men with angina: results of a controlled trial, Burr ML1, Ashfield-Watt PA, Dunstan FD, Fehily AM, Breay P, Ashton T, Zotos PC, Haboubi NA, Elwood PC, Eur J Clin Nutr. 2003 Feb;57(2):193-200.

(39) n–3 Fatty Acids and Cardiovascular Events after Myocardial Infarction, Daan Kromhout, M.P.H., Ph.D., Erik J. Giltay, M.D., Ph.D., and Johanna M. Geleijnse, Ph.D., for the Alpha Omega Trial Group, N Engl J Med 2010; 363:2015-2026.

(40) The impact of age, body mass index, and fish intake on the EPA and DHA content of human erythrocytes, Sands SA, Reid KJ, Windsor SL, Harris WS, Lipids. 2005; 40:343-347. (41) Incorporation and clearance of omega‐3 fatty acids in erythrocyte membranes and plasma phospholipids, Cao J, Schwichtenberg KA, Hanson NQ, Tsai MY, Clin Chem. 2006; 52:2265-2272.

(42) Comparison between plasma and erythrocyte fatty acid content as biomarkers of fatty acid intake in US women, Sun Q, Ma J, Campos H, Hankinson SE, Hu FB. Am J Clin Nutr. 2007; 86:74-81.

(43) Is body size a biomarker for optimizing dosing of omega‐3 polyunsaturated fatty acids in the treatment of patients with IgA nephropathy? Donadio JV, Bergstralh EJ, Bibus DM, Grande JP, Clin J Am Soc Nephrol. 2006; 1:933-939.

(44) Dietary intake and cell membrane levels of long-chain n-3 polyunsaturated fatty acids and the risk of primary cardiac arrest. Siscovick DS, Raghunathan TE, King I, Weinmann S, Wicklund KG, Albright J, Bovbjerg V, Arbogast P, Smith H, Kushi LH JAMA. 1995 Nov 1; 274(17):1363-7.

(45) Blood levels of long-chain n-3 fatty acids and the risk of sudden death, Albert CM, Campos H, Stampfer MJ, Ridker PM, Manson JE, Willett WC, Ma JN Engl, J Med. 2002 Apr 11; 346(15):1113-8.

(46) The effect of dietary omega-3 fatty acids on coronary atherosclerosis. A randomized, double-blind, placebo-controlled trial, von Schacky C, Angerer P, Kothny W, Theisen K, Mudra H, Ann Intern Med. 1999 Apr 6; 130(7):554-62.

(47) EPA and DHA in blood cell membranes from acute coronary syndrome patients and controls, Block RC, Harris WS, Reid KJ, Sands SA, Spertus JA, Atherosclerosis. 2008 Apr; 197(2):821-8.

(48) The Omega-3 Index: a new risk factor for death from coronary heart disease? Harris WS, Von Schacky C, Prev Med. 2004 Jul; 39(1):212-20.

(49) Determinants of Erythrocyte Omega‐3 Fatty Acid Content in Response to Fish Oil Supplementation: A Dose–Response Randomized Controlled Trial, Michael R. Flock, BS, Ann C. Skulas‐Ray, PhD, William S. Harris, PhD, Terry D. Etherton, PhD, Jennifer A. Fleming, MS, RD, and Penny M. Kris‐Etherton, PhD, RD, J Am Heart Assoc. 2013 Dec; 2(6): e000513.

(50) Incorporation of eicosapentaenoic and docosahexaenoic acids into lipid pools when given as supplements providing doses equivalent to typical intakes of oily fish, Browning LM, Walker CG, Mander AP, West AL, Madden J, Gambell JM, Young S, Wang L, Jebb SA, Calder PC, Am J Clin Nutr. 2012 Oct; 96(4):748-58.

(51) Docosahexaenoic acid (DHA): an ancient nutrient for the modern human brain. Nutrients. 2011 May;3(5):529-54, Bradbury J.

(52) Docosahexaenoic acid signal lipidomics in nutrition: significance in aging, neuroinflammation, macular degeneration, Alzheimer’s, and other neurodegenerative diseases. Bazan NG, Molina MF, Gordon WC Annu Rev Nutr 2011 Aug 21;31:321-51.

(53) Inflammatory, apoptotic, and survival gene signaling in Alzheimer’s disease. A review on the bioactivity of neuroprotectin D1 and apoptosis., Lukiw WJ, Bazan NG. Mol Neurobiol. 2010 Aug;42(1):10-6.

(54) Improved spatial learning performance of fat-1 mice is associated with enhanced neurogenesis and neuritogenesis by docosahexaenoic acid. Proc Natl Acad Sci U S A. 2009 Jul 7;106(27):11370-5, He C, Qu X, Cui L, Wang J, Kang JX.

(55). Docosahexaenoic acid-induced protective effect against impaired learning in amyloid beta-infused rats is associated with increased synaptosomal membrane fluidity.Hashimoto M, Hossain S, Shimada T, Shido O, Clin Exp Pharmacol Physiol. 2006 Oct;33(10):934-9.

(56) Putative link of PUFA, GPR40 and adult-born hippocampal neurons for memory,Yamashima T. A Prog Neurobiol.2008 Feb;84(2):105-15.

(57) A DHA-derived mediator that protects brain and retina against cell injury-induced oxidative stress, Bazan NG. Neuroprotectin D Brain Pathol. 2005 Apr;15(2):159-66 . (58) DHA-rich oil modulates the cerebral haemodynamic response to cognitive tasks in healthy young adults: a near IR spectroscopy pilot study, Jackson PA, Reay JL, Scholey AB, Kennedy DO, Br J Nutr. 2012 Apr;107(8):1093-8.

(59) Docosahexaenoic acid and adult memory: a systematic review and meta-analysis. Yurko-Mauro K, Alexander DD, Van Elswyk ME3. PLoS One. 2015 Mar 18.

(60) DHA supplementation improved both memory and reaction time in healthy young adults: a randomized controlled trial, Welma Stonehouse, Cathryn A Conlon, John Podd, Stephen R Hill,Anne M Minihane, Crystal Haskell, and David Kennedy, Am J Clin Nutr, May 2013 vol. 97 no. 5 1134-1143.

(61) Effect of long-chain ω-3 fatty acids and lutein + zeaxanthin supplements on cardiovascular outcomes: results of the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial, Bonds DE, Harrington M, Worrall BB, Bertoni AG, Eaton CB, Hsia J, Robinson J, Clemons TE, Fine LJ, Chew EY, JAMA Intern Med. 2014 May;174(5):763-71.

(62) Omega 3’s and Cognition, Dosage matters, Adam Ismail, GOED, 2015-08-31.

(63) Dose-response effects of fish-oil supplementation in healthy volunteers, Blonk MC, Bilo HJ, Nauta JJ, Popp-Snijders C, Mulder C, Donker AJ, Am J Clin Nutr 1990;52:120–7 (64) The relationship between age and the fatty acid composition of cerebral cortex and erythrocytes in human subjects, Carver JD, Benford VJ, Han B, Cantor AB, Brian Res Bull 2001;56:79–85.

(65) The effects of ingestion of omega-3 fatty acids on perceived pain and external symptoms of delayed onset muscle soreness in untrained men, Tartibian B1, Maleki BH, Abbasi A, Clin J Sport Med. 2009 Mar;19(2):115-9.

(66) Dietary omega-3 fatty acid supplementation increases the rate of muscle protein synthesis in older adults: a randomized controlled trial1,2,3, Gordon I Smith, Philip Atherton, Dominic N Reeds, B Selma Mohammed, Debbie Rankin, Michael J Rennie, and Bettina Mittendorfer, Am J Clin Nutr. 2011 Feb; 93(2): 402–412.

(67) Omega-3 polyunsaturated fatty acids augment the muscle protein anabolic response to hyperinsulinemia-hyperaminoacidemia in healthy young and middle-aged men and women.Smith GI, Atherton P, Reeds DN, Mohammed BS, Rankin D, Rennie MJ, Mittendorfer B,Clin Sci (Lond). 2011 Sep;121(6):267-78.

(68) Fish oil reduces heart rate and oxygen consumption during exercise.Peoples G.E., P.L.McLennan, P.R.Howe, H.Groeller (2008) J.Cardiovasc.Pharm. 52:540-547.

(69) Maternal Supplementation With Very-Long-Chain n-3 Fatty Acids During Pregnancy and Lactation Augments Children’s IQ at 4 Years of Age, Ingrid B. Helland, Lars Smith, Kristin Saarem, Ola D. Saugstad, Christian A. Drevon, Pediatrics, January 2003, VOLUME 111 / ISSUE 1.

(70) Randomised controlled trial of effect of fish-oil supplementation on pregnancy duration. Olsen, S., Srensen, J., Secher, N., Hedegaard, M., Henriksen, T., Hansen, H., & Grant, A. (1992), The Lancet, 1(8800), 1003-1007.

(71) Effect of maternal docosahexaenoic acid (DHA) supplementation on breast milk composition.Makrides M, Neumann MA, Gibson RA, Eur J Clin Nutr1996;50:352–7.

(72) Meta-analysis and meta-regression of omega-3 polyunsaturated fatty acid supplementation for major depressive disorder, R J T Mocking, I Harmsen, J Assies, M W J Koeter, H G Ruhé, and A H Schene, Transl Psychiatry. 2016 Mar; 6(3): e756.

(73) Eicosapentaenoic acid appears to be the key omega-3 fatty acid component associated with efficacy in major depressive disorder: a critique of Bloch and Hannestad and updated meta-analysis, Martins JG, Bentsen H, Puri BK, Mol Psychiatry. 2012 Dec; 17(12):1144-9; discussion 1163-7.

(74) Early modifications of fatty acid composition in plasma phospholipids, platelets and mononucleates of healthy volunteers after low doses of n3 polyunsaturated fatty acids, Stasi DD, Bernasconi R, Marchioli R, et al. 2004, Eur J Clin Pharmacol 60: 183–190.

(75) Practice parameters for the assessment and treatment of children and adolescents with depressive disorders. J Am Acad Child Adolesc Psychiatry 1998; 37(10 Suppl):63S–83S

(76) Omega-3 Treatment of Childhood Depression: A Controlled, Double-Blind Pilot Study, Hanah Nemets Boris Nemets Alan Apter Ziva Bracha R.H. Belmaker, The American Journal Of Psychiatry June 2006 Volume 163 Number 6.

(77) Fatty acids and sleep in UK children: subjective and pilot objective sleep results from the DOLAB study – a randomized controlled trial, Paul Montgomery*, Jennifer R. Burton, Richard P. Sewell, Thees F. Spreckelsen andAlexandra J. Richardson, Journal of Sleep Research, Volume 23, Issue 4, pages 364–388, August 2014.

(78) Amygdala Volume Changes in Posttraumatic Stress Disorder in a Large Case-Controlled Veterans Group. Morey, R., Gold, A., Labar, K., Beall, S., Brown, V., Haswell, C., . . . Workgroup, F. (2012), Arch Gen Psychiatry Archives of General Psychiatry, 69(11), 1169-1169.

(79) Hippocampal volume deficits associated with exposure to psychological trauma and posttraumatic stress disorder in adults: A meta-analysis, Woon, F., Sood, S., & Hedges, D. (2010), Progress in Neuro-Psychopharmacology and Biological Psychiatry, 34(7), 1181-1188.

(80) Long-chain omega-3 fatty acid intake is associated positively with corticolimbic gray matter volume in healthy adults, Conklin SM, Gianaros PJ, Brown SM, Yao JK, Hariri AR, Manuck SB, Muldoon MF, Neuroscience Letters. 2007, 421: 209-212.

(81) Omega-3 Fatty Acids for Secondary Prevention of Posttraumatic Stress Disorder After Accidental Injury: An Open-Label Pilot Study, Matsuoka, Yutaka MD, PhD; Nishi, Daisuke MD; Yonemoto, Naohiro MPH; Hamazaki, Kei MD, PhD; Hashimoto, Kenji PhD; Hamazaki, Tomohito MD, PhD, Journal of Clinical Psychopharmacology, Issue: Volume 30(2), April 2010, pp 217-219

(82) Omega-3 fatty acids in boys with behavior, learning, and health problems,Stevens LJ1, Zentall SS, Abate ML, Kuczek T, Burgess JR, Physiol Behav. 1996 Apr-May;59(4-5):915-20.

(83) Omega-3 fatty acid treatment of children with attention-deficit hyperactivity disorder: A randomized, double-blind, placebo-controlled study, Stacey Ageranioti Bélanger, MD PhD, Michel Vanasse, MD, Schohraya Spahis, MSc, Marie-Pierre Sylvestre, MSc, Sarah Lippé, PhD, François l’Heureux, MSc, Parviz Ghadirian, PhD, Catherine-Marie Vanasse, PhD, and Emile Levy, MD PhD, Paediatr Child Health. 2009 Feb; 14(2): 89–98.

(84) Effect of Supplementation with Polyunsaturated Fatty Acids and Micronutrients on Learning and Behavior Problems Associated with Child ADHD, Natalie Sinn, PhD, Janet Bryan, PhD, J Dev Behav Pediatr 28:82–91, 2007.

(85) Associations between increases in plasma n-3 polyunsaturated fatty acids following supplementation and decreases in anger and anxiety in substance abusers,Buydens-Branchey, L., Branchey, M., & Hibbeln, J. (2008), Progress in Neuro-Psychopharmacology and Biological Psychiatry, 32(2), 568-575.

(86) Omega-3 supplementation lowers inflammation and anxiety in medical students: a randomized controlled trial. Kiecolt-Glaser JK1, Belury MA, Andridge R, Malarkey WB, Glaser R, Brain Behav Immun. 2011 Nov;25(8):1725-34.

(87) Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial, Chew EY, Clemons TE, SanGiovanni JP, Danis R, Ferris FL 3rd, Elman M, Antoszyk A, Ruby A, Orth D, Bressler S, Fish G, Hubbard B, Klein M, Chandra S, Blodi B, Domalpally A, Friberg T, Wong W, Rosenfeld P, Agron E, Toth C, Bernstein P, Sperduto R, JAMA. 2013 May 15;309(19):2005-15.

(88) Oral docosahexaenoic acid in the prevention of exudative age-related macular degeneration: the Nutritional AMD Treatment 2 study, Souied EH1, Delcourt C, Querques G, Bassols A, Merle B, Zourdani A, Smith T, Benlian P; Nutritional AMD Treatment 2 Study Group, Ophthalmology. 2013 Aug;120(8):1619-31.

(89) Pilot study for treating dry age-related macular degeneration (AMD) with high-dose omega-3 fatty acids, Tassos Georgioua, Anastasia Neokleousa, Despina Nicolaoua, Barry Sears, PharmaNutrition, Volume 2, Issue 1, January 2014, Pages 8–11.

(90) A multicentre, double-masked, randomized, controlled trial assessing the effect of oral supplementation of omega-3 and omega-6 fatty acids on a conjunctival inflammatory marker in dry eye patients, Françoise Brignole-Baudouin, Christophe Baudouin, Pasquale Aragona6, Maurizio Rolando, Marc Labetoulle, Pierre Jean Pisella, Stefano Barabino, Raphaele Siou-Mermet, and Catherine Creuzot-Garcher, Acta Ophthalmologica, Volume 89, Issue 7, pages e591–e597, November 2011.

(91) Pilot, prospective, randomized, double-masked, placebo-controlled clinical trial of an omega-3 supplement for dry eye, Wojtowicz JC1, Butovich I, Uchiyama E, Aronowicz J, Agee S, McCulley JP, Cornea. 2011 Mar;30(3):308-14.

Leave a Reply

Your email address will not be published. Required fields are marked *