The Importance of Omega-3 Fish Oil (& The Best Way to Get It)

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If you like to peruse medical journals in your free time (like me!), you may have noticed a lot of conflicting research when it comes to fish oil and Omega-3s. Even if recent studies aren’t your choice for light reading, it’s important to understand the implications of fish oil and omega-3 consumption.

What I take and feel good about giving my family has changed over the years as I’ve read, studied, and learned more. Read on to learn what I’ve found in my research and what I use now.

What are Omega-3s and Fish Oil?

Let’s start at the beginning.

Fish Oil

These terms are often used interchangeably in most literature but they don’t always refer to the same things. Fish oil can refer to any oil that comes from a marine source. This doesn’t differentiate the source, the breakdown of the Omega-3s (EPA and DHA), and doesn’t necessarily require manufacturers to specify the amount.


The group of fats known as Omega-3 fatty acids are well-documented for their health benefits. Sourcing and ratios are controversial, but more on that below. The term omega-3s most often refers to a group of fatty acids. The most well known, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), are found in fish sources. ALA (alpha-linolenic acid) is found in plant sources like nuts and seeds, though evidence suggests that the body can’t efficiently use ALA like it can DHA and EPA.

Why Omega-3?

Now on to the research…

Omega-3 fatty acids are vital for many aspects of health, and many of us are not getting enough of them. But that doesn’t necessarily mean we should just start chugging the fish oil. Source matters and there are some big problems with certain types of fish oil supplements. More on that below, but Omega-3s (from high quality sources) have many benefits.

The University of Maryland Medical Center explains that Omega-3 fatty acids from fish may be useful for:

  • Reducing the risk of heart disease and causes of death associated with heart disease
  • Decreasing severity of symptoms associated with diabetes
  • Alleviating pain associated with rheumatoid arthritis
  • Reducing risk of osteoporosis and bone loss
  • Improving health and reducing symptoms for those with autoimmune disease
  • Helping those with anxiety, depression or bipolar disorder
  • Reducing risk of various types of cancers
  • Improving cognitive function

As I explained before, there are two main types of Omega-3s:

  • Alpha-linolenic acid (ALA), found in certain vegetable oils, walnuts, and some green vegetables.
  • The other type, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), is found in fatty fish.

The body can convert some ALA to EPA & DHA but is not very efficient at this process, so it is important to also consume sources of EPA/DHA. These nutrients are especially recommended during pregnancy and nursing (and are in most prenatal vitamins) because only certain forms of DHA are transferred across the placenta.

Omega-3 vs. Omega-6 = Ratio Matters

Omega-3s are important, but what is even more important, is consuming a healthy ratio of Omega-6 (n-6) and Omega-3 (n-3) fats. In fact, I suspect that we will find over time that this ratio is the confounding factor in fish oil research.

Both Omega-3 and Omega-6 fats are considered polyunsaturated fats because they have many double bonds. In general, we need much smaller amounts of these fats than we do other fats like saturated and monounsaturated fats, but they are still vitally important. Our bodies aren’t able to produce polyunsaturated fats so we must get them from diet (this is the reason they are called “essential fatty acids”).

Omega-6 fats are found in many processed foods, vegetable oils, processed grains, and soy. Omega-6 fats increase inflammation while Omega-3 fats can help reduce inflammation. Since n-6 fats are present in many processed foods, it is easy to understand why most of us get plenty of these in our diets. In fact, many people get way too much in their diets! (source)

The ideal ratio of Omega-6 to Omega-3 fats is thought to be around 1:1 (and not higher than 4:1). Most people are consuming much higher amounts of Omega-6 fats (up to 30:1). Higher amounts of Omega-6 can contribute to inflammation within the body and to disease.

Of course there are two ways to change this ratio: increasing Omega-3 consumption or decreasing Omega-6 consumption.

The Sourcing Matters… A Lot

Omega-3s (like all nutrients) are best obtained from food. In fact, the research documents a strong inverse relationship between fish consumption and heart disease and death. In other words, generally, the more fish a population eats, the lower its rates of heart disease and all causes of death.

The same unfortunately can’t be said about fish oil supplementation. In fact, this is where the controversy starts.

I have read studies that indicate that fish oil reduces heart disease. Other studies show it has no affect or may be harmful to the heart.

Some studies show that fish oil supplementation is good for the brain. Others show a negative effect.

Studies claim that fish oil helps improve insulin sensitivity and reduces diabetes risk. Other meta-analysis results show no benefit over the long term.

Ratio and Source of Fish Oil

In my opinion, the abundance of conflicting info indicates three things:

  1. A strong genetic component to fish oil needs between populations and people
  2. Lack of differentiation among types and qualities of fish oil in studies
  3. Not taking into account the Omega-3 to Omega-6 ratio in the body

I strongly suspect that further research will indicate that the ratio is a critical key in understanding Omega-3. Getting the benefits won’t just be about taking a fish oil supplement, but also reducing Omega-6 consumption. This is one of the reasons I avoid vegetable oils and margarine at all costs. These are very high sources of Omega-6!

Best Fish Oil Source? Fish!

This may be shocking, but the best source of fish oil is fatty fish! Consumption of quality sources of fatty fish (like sardines) is the most well-studied beneficial source of Omega-3.

I’ve always said that food should come before supplements as a priority and never is this more true that with fish. If the budget is tight or you aren’t sure about fish oil supplementation, eating fish is a great way to go.

Our family incorporates fatty fish like sardines at least a couple times a week as a source of Omega-3. I order high-quality sardines in bulk from about once a month. We also order high-quality low-mercury fish and incorporate them into our diet.

That said, some people don’t like or don’t eat seafood. In these cases, fish oil supplementation may be helpful, depending on source, genetics and dose. Fish oil supplements are increasingly popular with concerns about environmental toxins and heavy metals. We still prefer whole-fish sources whenever possible and make sure to order high quality fish where metals and radiation aren’t a concern.

Fish Oil Supplements: What I’ve Used

This is where the waters get murky. I highly recommend doing your own research on any supplements, including fish oil. All fish oil supplements are not created equal. Certain forms of fish oil contain altered forms of Omega-3s and can actually contribute to inflammation in the body.

Here’s why:

Many Omega-3 supplements are in ethyl ester form, which is an altered form created when ethanol is fused with the fish oil. This creates an extremely pure fish oil concentrate, but not one that is very bioavailable. These types of fish oils are often hard to digest and can oxidize easily. The real difference, however, is in the digestion of these different types of fish oils. The natural triglyceride form breaks down in the small intestine and can be easily absorbed. Fish oils in the ethyl ester form are much more difficult for the body to break down and are not absorbed as easily once broken down. (source)

The natural triglyceride (TG) form is purified but still in a form that the body recognizes and can easily digest. It can be taken without food and doesn’t go rancid or smell strongly.

My Fish Oil Criteria

Searching for an Omega-3 supplement should always meet the following criteria:

  • Natural Triglyceride form of Omega-3
  • Concentrated doses of EPA and DHA
  • Sustainably sourced (krill oil populations are declining so I prefer sources like anchovy or sardine which are more sustainable)
  • Free of contaminants and heavy metals
  • At least 2 grams of concentrated Omega-3s without having to swallow a handful of pills

This Omega-3 supplement meets those criteria and doesn’t have a fish aftertaste. This is the one I take when I need extra Omega-3s.

Fish Oils & Omega-3s: Bottom Line

We know fish is healthy. Studies show a strong link between consumption of fish and longer life and reduced heart disease risk. Most doctors have suggested seafood consumption for years and the research backs this up. In the light of recent concerns about heavy metal toxicity and radiation, it is important to choose high quality seafood. Sardines are a great food source of Omega-3 and are inexpensive and easy to eat on the go. In fact, most fish oil supplements use sardines as the source. So skip the pill and eat some real fish! Cod liver oil has traditionally been considered a whole food way to get the benefits of fish oil as well.

It is also important to pay attention to Omega-3 and Omega-6 ratios in the body. Instead of only focusing on consuming more Omega-3, we should pay attention to the amount of Omega-6 we consume and work to get those numbers to a healthy ratio.

At the end of the day, more fish, more veggies, and less processed foods (with vegetable oils) are the way to go!

Do you take supplemental Omega-3s? Have they helped you? Share below!

Katie Wells Avatar

About Katie Wells

Katie Wells, CTNC, MCHC, Founder of Wellness Mama and Co-founder of Wellnesse, has a background in research, journalism, and nutrition. As a mom of six, she turned to research and took health into her own hands to find answers to her health problems. is the culmination of her thousands of hours of research and all posts are medically reviewed and verified by the Wellness Mama research team. Katie is also the author of the bestselling books The Wellness Mama Cookbook and The Wellness Mama 5-Step Lifestyle Detox.


154 responses to “The Importance of Omega-3 Fish Oil (& The Best Way to Get It)”

  1. Christi Avatar

    I believe with the way of eating I do now, (Bright Line Eating) my equalizing of omega 3 and 6 ratio has been achieved.
    Just from the good food choices I make each day the depression I have experienced for a number of years has completely gone away.

  2. Kelly Hardy Avatar
    Kelly Hardy

    I just switched from the Nordiac Naturals to the Fermented Cod Liver oil. Should I switch back. Currently 33 weeks pregnant.

    1. Katie - Wellness Mama Avatar

      I definitely think this is an area where everyone needs to do their own research and figure out what option feels best to them as there is so much conflicting info out there and I think both can be good options.

  3. Wendy Brown Avatar
    Wendy Brown

    Hello Katie,
    I was wondering if you are familiar with the Omega Cure brand by Omeag3 Innovations? They ship their bottles fresh and frozen. They do not sell any that are encapsulated and the taste is mild and fresh. I was wondering if you have any knowledge on their quality.

  4. Didi Avatar

    I have been giving my son this since he was one. He is now four, and the eye doctor told me he his eyesight is exceptionally good for a 4yr old. I think it’s due to the fish oil 😉

  5. Abha Alexandre Avatar
    Abha Alexandre

    Which fish oil would you recommend instead of green pasture due to its controversy

  6. Selansia Crawford Avatar
    Selansia Crawford

    Hi Katie, which Sardines would you recommend, the one in extra virgin olive oil or the on in water and sea salt?

    Also, im currently pregnant and im taking the Nordic Natural Cod Liver oil. Would you recommend that?

    Thank you!

    1. Katie - Wellness Mama Avatar

      I like both of those sardines… some people prefer the ones in olive oil if they are new to the taste. And I always took cod liver oil or Omega 3 while pregnant but definitely check with a midwife or doc to be sure.

  7. Becky Avatar

    Katie, Thanks for all your research and for sharing this info!! When I click the highlighted “this is what I take” it shows the Nordic Naturals brand. In the comments above, however, it seems that you’re recommending the Realdose brand. Which of these brands do you recommend for a daily supplement?

  8. Debra Schramm Avatar
    Debra Schramm

    I need sardine serving suggestions please. How do you eat yours?

  9. Hena Avatar

    I have been taking Omega 3 TG form for a couple years and was about to start taking Rosita Cod Liver Oil instead but just got supper confuse when I read “Cod Liver Oil, which is an excellent source of fat-soluble vitamins not present in many Omega-3 supplements but is not a great source of Omega-3s.”
    As for now DHA and EPA from CLO and supplements were the same. What am I missing? Thanks

  10. Bri Avatar

    I would like to see their ingredient list, but do not see it listed anywhere on their website. Can you help please?

  11. rebi Avatar

    What about Vital Choice salmon oil or krill oil?Has anyone tried these?

    1. Elysia Avatar

      Yep! I did a TON of reading on omega 3s and decided that a combo of all 3 – salmon, krill & high omega fish – was the best for me. For about 2/3 of the month I take 1 Vital Choice salmon oil cap and 1 Dr. Tobias omega 3 cap per day. If I’m feeling more inflamed I’ll take 2 of the DT. Then in the few days before my period and during it, I switch to Life-Flo krill oil – 2 per day. If I’m having a tougher time I’ll add 1 DT. I don’t go crazy with the dosing. Honestly I can’t afford it! But this feels like a good way to go for me. The VC salmon oil has some great benefits that the DT fish oil doesn’t – and vice versa. Which is why I take them together. And the krill has great benefits of its own too – esp menstrual!
      Good luck! 🙂

  12. Lisa Avatar

    Hi Katie! i love all your recommendations and always default to your advice with supplements and such… however this one i simply can’t afford at the moment 🙁 .. ($49 a month), i have been using ocean mom’s dha but recently realized that the EE form that it comes in is not as bioavailable as the TG type(which might explain why i still have a little brain fog going on)… HELP! i want to continue taking an omega-3 supplement as i am 9 months pregnant and know how beneficial it is, do you have any other recommendations that are a little more affordable?
    Also, is there any reason i shouldn’t take an omega 3 supplement for the last few weeks of pregnancy? (i feel like i heard somewhere to stop just for the last month?)
    Thank you!

    1. Elysia Avatar

      Hi Lisa! Congrats on your pregnancy! I can’t answer your pregnancy-specific question – hopefully Katie will be able to reply – but just wanted to add my 2 cents re omega 3s in general. I also had a financial concern, because of my Lyme disease my ND wanted me on a megadose and it was just too expensive! I did a TON of reading on the subject and one of the things I learned is that studies have shown that triglyceride form was only more bioavailable/beneficial when used short term – with long term use the benefits of ethyl ester form and triglyceride form were evenly matched. I also compared a bunch of different products based on purity testing, source, potency and cost. For my needs, I ended up choosing Dr. Tobias brand which was rated #1 by Labdoor and has tons of positive reviews on Amazon. No, I don’t work for them or anyone in the fish oil industry lol! Theirs just stood out because of their stellar purity, high potency, reasonable cost, etc. I’ve been taking it for a couple weeks and so far so good!

      Sending positive thoughts for the remaining few weeks of your pregnancy and birth!!

      1. Lisa Avatar

        Thank you Elysia! any day now 😉 i so appreciate your input, i hope Katie chimes in too, but i’m definitely going to look into Dr Tobias’ brand. All the medical jargon can be difficult to translate and make sense of so i appreciate your clearing up the EE vs TG goodness. 🙂 Cheers!

  13. Nicole Avatar

    I am TTC. Taking whole food organic prenatals and looking for my DHA source. I was taking green pasture cod liver oil after reading about it on this site. Didn’t know it didn’t have the recommended dose of Omega 3’s. Especially for a prenatal.
    Please advise if Real Dose is a good option for my prenatal along with FCLO. Also how many capsules?
    If not, what do you recommend ?

  14. Katie Avatar

    Hi Katie – thank you for your post!
    I am healing my Hashimotos Hypothyroidism with the Autoimmune Paleo diet. I want to take omega 3 supplements but here are my issues: I can’t stand fish or shellfish. The smell makes me gag. Taking fish oil in capsules or liquid makes me hurl. I can’t do it. I have never liked fish or been able to stomach it. Are there any alternatives for the DHA and ALA I need besides getting sun?

    Any help would be amazing!

    Blessings on your work,

    Katie 😉

  15. Kim Avatar

    I’ve been using Real Dose Omega 3 for just over a month now. I’ve also been giving it to my children – my son has autism and started having seizures since he became a teen. Here has been my experience to date:

    Over 6 months ago I started doubling my omega 3 intake ( I was taking either Barleans or Carlsons at the time) because of a recommendation from my doctor due to high cholesterol. Very shortly afterwards I noticed the hand/joint pain I had been living with went away. Not immediately making the connection to the Omega 3s – I was talking to a different doctor about my arthritis and using glucosamine – and he indicated that it isn’t always effective – but should definitely be taking omega 3s! I was and it worked.

    Now since I’ve been on Real Dose – hand/joint pain has returned. I’ve also for the last couple weeks been experiencing dry eye discomfort – and just recently read that that can also be attributed to no or low quality omega 3s. Also, although no one will ever claim to know what exactly causes seizures – my son is at the hospital right now getting stitches over his eye. He had his second seizure in over a year!! We were just about to have his follow up EEG and his neurologist was expecting he would be weaning off seizure meds. Sometimes you can’t really notice a difference from one brand of a supplement versus another. And I can’t be certain that all these issues – that can usually be helped by high quality omega 3 supplementation – aren’t being caused by other dietary or environmental issues – although I can think of none that have been drastic.

    I will not be taking this product any longer – and I will be contacting Real Dose to see if I can get a refund for the 3 unopened bottles I have remaining.

  16. Nicole Avatar

    Hello! I have read somewhere in the past that fish oils in capsule form are usually pasteurized, at high temperatures, causing the fatty acid chains to be damaged (or something to that effect). Do you know if this is the case with these fish oils? I see they test for levels of mercury and lead, but how are you gauranteed the quality of the oil? I take the Green Pasture FCLO and FSLO, and I know they do not heat their oils. I really would like to include an omega 3 supplement. I am also curious, as another person commented, about the ingredient derived from soy. I have thryoid issues, which has brought on lots of other problems, and am trying to avoid soy. Do you feel that it is a small enough amount to not be an issue? Thanks so much!

  17. Molly Huang Avatar
    Molly Huang

    What do you think about New Chapter Wholemega Whole Fish Oil?

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