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Citadel Nutrition Fish Oil Review

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These days, Fish Oil is seen as something of a commodity. Most people assume “Fish Oil is Fish Oil” and they should just go with the cheapest brand. To be clear, this is a huge misconception…[Skip to the Bottom Line]

WHAT IS FISH OIL?

Fish Oil, as the name implies, refers to the oils of fish which contain (among other things) two omega-3 fatty acids: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Generally, Omega-3 supplements are standardized for these two fatty acids in particular, because the vast majority of health benefits associated with such supplements can be attributed to these two compounds.

Because the list of health claims associated with Fish Oil supplementation is extensive, for the purpose of this review we will focus on three in particular: Cognition/Learning, Cardiovascular Health, and Joint Pain. While we acknowledge that Fish Oil supplementation may convey more health benefits then these three alone, these are the areas where a significant amount of research has been conducted, making it easier to draw conclusion. Let’s begin…

COGNITION/LEARNING:

A 2010 study, published in the “Journal of Nutrition”, found that higher levels of DHA (but not EPA) were associated with better performance on cognitive tests assessing nonverbal reasoning, mental flexibility, working memory, and vocabulary in humans (ages 35-54).

These findings were in-line with those of an earlier (1999) study in which DHA supplementation was associated with significant improvements in memory related learning ability in rats.

Furthermore, a 2012 study using 2 grams of DHA/EPA found that 6 months of supplementation resulted in enhanced working memory in otherwise healthy individuals (ages 18-25). While Omega-3 supplementation has shown much promise in several studies, it is worth mentioning that some studies have found no such benefit.

A 2008 study, the subjects of which were older (but healthy) individuals, found there was no effect on cognitive performance measures after 26 weeks of DHA/EPA supplementation. Similar results were noted in two separate studies from the “Journal of Psychopharmacology” and the “British Journal of Nutrition”. Based on the research, it appears those who are likely to derive the most cognitive benefit are those with low levels of DHA/EPA to begin with.

CARDIOVASCULAR HEALTH:

Triglycerides are formed from a glycerol molecule attached to three fatty acids and are the major constituents of fats, both plant and animal. High Triglyceride levels generally occur as a result of excessive fat intake, and are considered a major risk factor in the development of cardiovascular disease.

A 2011 meta-analysis, comparing several randomized, placebo controlled studies, concluded that both DHA and EPA significantly reduce triglycerides after several weeks of supplementation. Logically, individuals with higher triglycerides tend to see a greater reduction.

Fish Oil supplementation has also been noted, in three other meta-analysis (each consisting of several randomized, double-blind placebo controlled studies), to significantly reduce triglyceride levels in individuals with hyperlipidemia (abnormally high fat in the blood). Ultimately, Fish Oil supplementation is an effective way to reduce cardiovascular risk by lowering triglycerides and keeping them within the normal range.

JOINT PAIN & INFLAMMATION:

A 2007 meta-analysis consisting of 17 different trials, which sought to determine if fish oil supplementation may be beneficial for joint pain (associated with rheumatoid arthritis and other inflammatory diseases), found a significant decrease in subject-reported joint pain (intensity, stiffness, tenderness, etc.).

The alleged mechanism of action here is through suppression of the cytokine (cell-signaling protein) TNF-alpha which stimulates inflammation. Overall, Fish Oil is effective at reducing inflammation, so the benefits seen with arthritis patients likely pertain to various inflammatory conditions, both mild and severe.

FORMS OF FISH OIL:

Just as there are multiple sources of Omega-3 fatty acids, both dietary and supplemental, there are multiple types of fish oil, the most common of which are the ‘ethyl ester’ form and the ‘triglyceride’ form. The triglyceride form tends to be the better absorbed of the two, as demonstrated in a 2010 study in which the ethyl-ester form achieved only 73% bioavailability compared to the triglyceride form.

Citadel uses the triglyceride form, conveying an obvious advantage of various brands which use the ethyl ester form. Beyond this distinction, Fish Oil can be further examined based on the type of fish the oil is extracted from. Generally speaking, the larger the fish, the more mercury may be present in the oil. Mercury, in high doses, is extremely detrimental to health and extreme cases of mercury poisoning may result in death. For that reason, it is generally recommended to consume Fish Oil that is extracted from small fish.

Citadel’s Fish Oil is derived from anchovies and sardines, and is tested for mercury (these test results are available on their website).

THE BOTTOM LINE:

Overall, Citadel’s Fish Oil is one of the best Omega-3 supplements we’ve analyzed. Fish Oil, as opposed to supplements that contain a combination of ingredients, may seem like a commodity to the average individual. On the contrary, the quality of such products tends to vary significantly from brand to brand. Compared to the industry average, Citadel’s Fish Oil has a high concentration of EPA/DHA relative to other Omega-3 fatty acid content. Given that the triglyceride form is superior to the ethyl-ester form found in so many competing products, yet the price is in the average range, we strongly recommend Citadel’s Fish Oil to anyone looking for a-quality Omega-3 supplement.

REFERENCES
  1. Dyerberg, Jørn, et al. “Bioavailability of marine n-3 fatty acid formulations.”Prostaglandins, Leukotrienes and Essential Fatty Acids 83.3 (2010): 137-141.
  2. Goldberg, Robert J., and Joel Katz. “A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain.” Pain 129.1 (2007): 210-223.
  3. Xu, Zhen-Zhong, et al. “Resolvins RvE1 and RvD1 attenuate inflammatory pain via central and peripheral actions.” Nature medicine 16.5 (2010): 592-597.
  4. Hokanson, John E., and Melissa A. Austin. “Plasma triglyceride level is a risk factor for cardiovascular disease independent of high-density lipoprotein cholesterol level: a metaanalysis of population-based prospective studies.”Journal of cardiovascular risk 3.2 (1996): 213-219.
  5. Harjai, Kishore J. “Potential new cardiovascular risk factors: left ventricular hypertrophy, homocysteine, lipoprotein (a), triglycerides, oxidative stress, and fibrinogen.” Annals of internal medicine 131.5 (1999): 376-386.
  6. Sarwar, Nadeem, et al. “Triglycerides and the risk of coronary heart disease 10 158 incident cases among 262 525 participants in 29 western prospective studies.” Circulation 115.4 (2007): 450-458.
  7. Wei, Melissa Y., and Terry A. Jacobson. “Effects of eicosapentaenoic acid versus docosahexaenoic acid on serum lipids: a systematic review and meta-analysis.” Current atherosclerosis reports 13.6 (2011): 474-483.
  8. Stradling, Clare, et al. “The effects of dietary intervention on HIV dyslipidaemia: a systematic review and meta-analysis.” PloS one 7.6 (2012): e38121.
  9. Pei, Jiao, et al. “The Effect of n-3 Polyunsaturated Fatty Acids on Plasma Lipids and Lipoproteins in Patients With Chronic Renal Failure—A Meta-Analysis of Randomized Controlled Trials.” Journal of Renal Nutrition 22.6 (2012): 525-532.
  10. Eslick, Guy D., et al. “Benefits of fish oil supplementation in hyperlipidemia: a systematic review and meta-analysis.” International journal of cardiology 136.1 (2009): 4-16.
  11. Muldoon, Matthew F., et al. “Serum phospholipid docosahexaenonic acid is associated with cognitive functioning during middle adulthood.” The Journal of nutrition 140.4 (2010): 848-853.
  12. Gamoh, Shuji, et al. “Chronic administration of docosahexaenoic acid improves reference memory-related learning ability in young rats.” Neuroscience 93.1 (1999): 237-241.
  13. Narendran, Rajesh, et al. “Improved working memory but no effect on striatal vesicular monoamine transporter type 2 after omega-3 polyunsaturated fatty acid supplementation.” PloS one 7.10 (2012): e46832.
  14. Chiu, Chih-Chiang, et al. “The effects of omega-3 fatty acids monotherapy in Alzheimer’s disease and mild cognitive impairment: a preliminary randomized double-blind placebo-controlled study.” Progress in Neuro-Psychopharmacology and Biological Psychiatry 32.6 (2008): 1538-1544.
  15. Van de Rest, O., et al. “Effect of fish oil on cognitive performance in older subjects A randomized, controlled trial.” Neurology 71.6 (2008): 430-438.
  16. Antypa, N., et al. “Omega-3 fatty acids (fish-oil) and depression-related cognition in healthy volunteers.” Journal of Psychopharmacology 23.7 (2009): 831-840.
  17. Jackson, Philippa A., et al. “No effect of 12 weeks’ supplementation with 1 g DHA-rich or EPA-rich fish oil on cognitive function or mood in healthy young adults aged 18–35 years.” British Journal of Nutrition 107.08 (2012): 1232-1243.

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