It is well established that eating fatty fish like salmon, mackerel and tuna, helps to reduce the risk of heart disease. However, there are many people who don't like to eat fish but want the heart-health benefit so they take fish oil.

"The American Heart Association says fish oil supplements should only be considered by individuals with heart disease or high triglyceride levels," said Tammy Roberts, nutrition and health education specialist, University of Missouri Extension.

It is recommended that people with documented coronary heart disease take one gram per day of fish oils that contain both DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid) if they are not consuming fatty fish. People with high triglyceride levels are often prescribed up to 4 grams of fish oil per day.

"High doses of fish oil (three grams or more) can cause excessive bleeding in some people so self prescribing is definitely not recommended. Supplements should be taken only after consulting with your physician," said Roberts.

There are fish oil supplements that are in a form called ALA. They are from a plant base such as flaxseed. Only a minimal amount of ALA is actually converted to DHA and EPA in the body so they may not be as effective, according to Roberts. When purchasing fish oil, Roberts says it is important to note that a one gram capsule (1,000 milligrams) may only contain 300 milligrams of DHA and EPA combined so you may need to take three capsules per day.

Side effects of fish oil supplements include belching, bad breath, heartburn, nausea, large stools, rash and nosebleeds.

"Taking these supplements with food and freezing or refrigerating them can help reduce side effects. Taking them with food may increase absorption," said Roberts.

Be sure to purchase fish oil supplements from established companies who certify that their products are free from heavy metals such as mercury, lead and cadmium.

"Since there is so much to remember about fish oil supplements, it might be easier to just eat fish, especially the fatty kind, twice a week," said Roberts.

For more information on nutrition issues, contact one of the nutrition and health education specialists working in the Ozarks: Tammy Roberts, (417) 682-3579; Christeena Haynes, (417) 345-7551; or Dr. Pam Duitsman, (417) 886-2059.

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