Are omega-3 absorbed best when taken at the same time as a high-fat meal?

Why is it better to take your omega-3 at the same time as eating a high-fat meal? Is it a way of minimising any side-effects or does it improve their efficacy?

2019-10-04

Heart & Circulation Q&As

It’s true that omega-3 fatty acids, particularly those contained in fish oil supplements, are best absorbed by the body when taken alongside a high-fat meal (1). It’s also better to take them at the start of the meal, to prevent any potential gastric problems.

Why does a high-fat meal make it easier for the body to absorb omega-3?

A lipid-rich meal stimulates the production of bile acids: produced by the liver, these help to emulsify essential long-chain fatty acids such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). These are the main omega-3 fatty acids found in the various omega-3 supplements available (fish oil, krill oil, calanus oil...).

Once emulsified in this way, the long-chain fatty acids are easier to digest by lipases, pancreatic enzymes which act at the upper level of the intestine (2) and which facilitate their absorption.

What should you choose in order to prevent any unwelcome gastric side-effects?

Some marine-source omega-3 supplements can produce adverse effects such as burping, acid reflux, bad breath, and a fishy after-taste … Such effects are mainly due to undue oxidation (3) of the fatty acids. To some degree, oxidation is normal, but it can become excessive during the various production and preservation stages of fish oil-based supplements.

To avoid these effects, be sure to choose supplements of EPA and DHA fatty acids in their natural form (triglycerides). It’s more expensive than the synthetic form (ethylic esters), but studies show that it’s easier to digest (there’s no release of ethanol) and twice as bioavailable. It’s a good idea to choose supplements that contain antioxidants too, especially tocopherols (ie, vitamin E), to minimise oxidation and maximise preservation.

In addition, taking these supplements at the start of a meal reduces the time they take to pass through the stomach and thus minimises the risk of unwelcome gastric effects.

Why take marine-source omega-3 supplements?

EPA and DHA have proven beneficial effects:

a decrease in levels of triglycerides (4), a form of fatty acid which at excessive levels in the blood, increase cardiovascular risk;
a reduction in blood pressure(5) ;
a decrease in mortality risk in individuals at risk for cardiovascular disease (6) ;
relief of inflammatory diseases (7) (arthritis, ulcerative colitis…).

In the case of therapeutic use, it’s essential to seek advice from your pharmacist in order to take the right dose for your particular situation.

References

Dyerberg J, Madsen P, Møller JM, Aardestrup I, Schmidt EB : Bioavailability of marine n-3 fatty acid formulations. Prostaglandins Leukotrienes And Essential Fatty Acids. 2010, Vol. 83(3), pp 137-41.
Kevin C Maki : Long-Chain Omega-3 Fatty Acid Bioavailability: Implications for Understanding the Effects of Supplementation on Heart Disease Risk. The Journal of Nutrition. 2018, Vol. 148(11), pp 1701–1703.
Adam Ismail, Gerard Bannenberg, Harry B. Rice, Ellen Schutt, Douglas MacKay : Oxidation in EPA- and DHA-rich oils: an overview. Lipid Technology. 2016, Vol. 28(3–4), pp. 55-59.
Durrington PN, Bhatnagar D, Mackness MI, et al : An omega-3 polyunsaturated fatty acid concentrate administered for one year decreased triglycerides in simv. treated patients with coronary heart disease and persisting hypertriglyceridaemia. Heart. 2001, Vol. 85, pp 544-548.
Toshinori Hoshi, Bianka Wissuwa, Yutao Tian, Nobuyoshi Tajima, Rong Xu, Michael Bauer, Stefan H. Heinemann, and Shangwei Hou : Omega-3 fatty acids lower blood pressure by directly activating large-conductance Ca2+-dependent K+ channels. PNAS. 2013, Vol. 110(12), pp 4816-4821.
Del Gobbo LC, Imamura F, Aslibekyan S, et al. ω-3 Polyunsaturated Fatty Acid Biomarkers and Coronary Heart Disease: Pooling Project of 19 Cohort Studies. JAMA Intern Med. 2016, Vol. 176(8), pp 1155–1166.
Artemis P. Simopoulos : Omega-3 Fatty Acids in Inflammation and Autoimmune Diseases. Journal of the American College of Nutrition. 2002, Vol. 21(6), pp 495-505.