Should I Take a Fish Oil Supplement?

August 24, 2018 by  
Filed under Supplements

Omega-3 fatty acids are substances that your body requires in order to carry out various daily functions. Unfortunately, the body cannot make omega-3 fatty acids by itself, and therefore, we must ingest these healthy fats from food. Two important types of omega-3 fatty acids are docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Docosahexaenoic acid and EPA can be found in animal-based food sources including fatty fish and shellfish like salmon, mackerel, tuna, mussels, oysters, and crabs.

Research has shown that consuming omega-3 fatty acids can positively impact your health. EPA, specifically, has shown to reduce inflammation, which helps keep metabolic processes in the body balanced and properly functioning. Research suggests that consuming EPA can help improve symptoms of people with depressive disorders.


DHA fatty acids provide a key structural role in many cell membranes, especially in the eyes, brain, and sperm. These fatty acids are also used to form eicosanoids. Eicosanoids are signaling molecules used throughout the body to elicit specific responses from other cells. They are primarily used when regulating responses related to inflammation, allergies, fever, or blood pressure.


Adequate intake of omega-3 fatty acids for adults over 18 years old is 1.6 g for males and 1.1 g for females daily. The American Heart Association recommends eating fish at least 2 times per week to obtain sufficient amounts of these healthy fats. For those who do not consume fish, one easy way to get enough omega-3 fatty acids is by taking fish oil supplements. Fish oil capsules contain both DHA and EPA omega-3 fatty acids. These supplements are a great option as they are generally low cost and can be easily added into your daily diet.

To prevent a fishy aftertaste, try taking them with the largest meal of the day. Another way to avoid fishy burps and aftertaste is by purchasing enteric-coated capsules. The coating on these capsules delay the point in time in which the capsule is digested in the digestive tract. However, expert from the Food and Drug Administration, Siobhan Delancey, advises that absorption of supplements might not reach its fullest potential when coated as some of these supplements are best absorbed and utilized in the stomach. Overall, fish oil capsules can be an easy way to supplement healthy fats into your diet, especially for those who do not consume fish.


1. Boston 677 Huntington Avenue, Ma 02115 +1495‑1000. Omega-3 Fatty Acids: An Essential Contribution [Internet]. The Nutrition Source. 2012 [cited 2018 Aug 28]. Available from:

Thank you to dietetic intern Molly Lowery for her contributions to and creation of this post.

Can Vitamins Help Your Hair, Skin and Nails?

Sounds pretty simple: take a “high potency” vitamin cocktail and your hair, skin and nails will magically start to shine.

But is there any truth to the claims that dietary supplements can help improve hair, skin and nail health?

In short: no.

You see, the B vitamin biotin is associated with nail (and even a bit of hair and skin) health. But that’s when a diet includes an ample amount of biotin.

Having a sub-par diet and then topping it off with a biotin pill chase, isn’t going to do the trick.

A diet that is inadequate in biotin will result in poor hair, skin and nail health (as will a diet that has inadequate dietary fat).

But bulking up on biotin supplements will not make your hair, skin and nail health better.

Your best bet is to round out your diet with foods that are natural sources of biotin like nuts, eggs, avocados, vegetables, meat and fish.

Let the food based source of biotin work its magic, and save your money from those supplements, which in this case don’t do any good!

Vital Stats on Vitamin Needs

December 11, 2014 by  
Filed under Consumer awareness, Supplements


Have you ever wondered if you should take a multivitamin? A vitamin D supplement? Fish oil? The list of vitamins marketed to consumers goes on and on.

There’s no shortage of information about vitamins on the internet, but here’s a basic rundown of what you may and may not need.

Foods First

  • Foods should be your first source of nutrients – not pills!
  • Eating a wide variety of nutrient-rich foods from all five food groups is the best way to make sure you are getting all of your necessary vitamins and minerals.
  • For tips on achieving balance in your diet across the food groups, check out the USDA’s Myplate guidelines at:

Realize When You’re at Risk

Most adults are not at risk for developing nutrient deficiencies. In fact, you are more likely to be eating more nutrients than you need (due in part that many N. Americans consume too much food!) There are, however, certain populations who may be at risk for micronutrient deficiencies, including:

  • Pregnant women who have elevated folic acid needs
  • Elderly people and vegans who may be at risk for vitamin B12 deficiency
  • Females and vegetarians who may be at risk for iron deficiency
  • Those with lactose intolerance or dairy allergy who may be at risk for calcium and vitamin D deficiency

Choosing a Multivitamin Wisely

Your best bet if you want to fill in gaps in your diet is to consider a multivitamin:

  • Look for multivitamin preparations with as close to 100% of the daily value for vitamins and minerals as possible
  • Choose generic brands or popular brand you have heard of; beware of “prescription strength” and “high potency” which don’t mean anything

Wherever you fall with regards to wants or needs with vitamins, keep in mind that taking a supplement is not a free pass to eat poorly. Supplements are just that – they “supplement” the diet, they don’t reverse poor diet choices!

Special thanks to Dietetic Intern Jenny Legrand for her contributions to this post.

What’s In Your Supplement?

October 22, 2014 by  
Filed under Consumer awareness, Supplements

Dietary supplements are a multi-billion dollar industry in the United States. Surprisingly, however, supplement manufacturing is not regulated by the Food and Drug Administration, which oversees foods consumed by humans and various drugs used to treat a variety of disease. You might ask yourself then, who does regulate the supplement industry? Great question! It turns out that the individual manufacturers are responsible for the safety of the products they produce and sell. Sounds pretty scary, if you ask me. What then happens if a particular supplement is associated with adverse reactions in users? The FDA then steps in at this point and essentially does an investigation. In some cases, the FDA may issue a recall of the supplement. What happens next? Another excellent question. This is exactly what was considered by the authors of a recent study published in the Journal of the American Medical Association (Medical News Today Article). The JAMA study involved an examination of products that were recalled by the FDA from US markets for being composed of ingredients that could have serious adverse health consequences, even leading to death. It turns out that almost 50% of FDA recalled class 1 drugs since 2004 have been for dietary supplements. The authors of the JAMA paper note that many of the banned substances were still commercially available 6 months or more after the FDA recall. The study authors obtained the recalled supplements and did thorough chemical analyses (using fancy scientific techniques such as gas chromatography and mass spectrometry). What they found is actually quite disturbing! One or more pharmaceutical adulterant (i.e. a potentially toxic or banned substance) was found in two-thirds of the recalled products that remained for sale on store shelves. This included 11 of 13 supplements for sports enhancement, 6 of 9 for weight loss, 1 of 5 for sexual enhancement, and 13 of 20 which were produced by American Manufacturers. In many cases the substance that originally led to the FDA recall remained in the product and in other cases, other adulterants were found. So, what does this mean for me and you? Among us, perhaps 50% take some kind of dietary supplements. If this is you, the best advice is to be very careful. This article outlines some of the unexpected hazards with these products. One way to protect yourself is to look for the US Pharmacopeia Verified Mark. This ensures that the products with this seal have undergone independent testing. Another alternative is to obtain all the nutrients and other dietary products you need from whole natural foods, an approach that many with scientific knowledge of nutrition have taken.

Not All Fish Are Created Equal

You have probably heard that we all should eat more fish and seafood, right? What you probably haven’t heard as much about is how the source and the type of fish you eat can influence not only nutrient intake levels but also the levels of certain contaminants you consume. This is a particular concern as some fish contain antibiotics, pesticides, or other chemicals, including mercury, polychlorinated biphenyls (PCBs) and dioxins. For some individuals, for example pregnant women, this is an issue of real importance as these substances can cause harm to the developing fetus.

Despite these potential risks, it is generally accepted in the nutrition community that fish is a healthy dietary choice and regular consumption can have a positive impact on overall health. For example, the American Heart Association recommends eating fatty fish at least two times a week (AHA Omega-3 FAs), and diets such as the Mediterranean and DASH diet also promote fish consumption. Certain fish (e.g. salmon) contain high levels of omega-3 fatty acids which have anti-inflammatory properties, and may decrease risk of heart arrhythmias and blood clotting, and thus be protective against heart disease. Fish is also high in protein yet low in saturated fats.

This then leaves us in a quandary. How are we to eat more fish and other seafood, yet avoid exposing ourselves to dangerous environmental contaminants? The answer lies in the type of fish we consume, whether it was farm raised or caught in the wild and the frequency with which we consume the fish. Let’s look at species first. Contaminants are most likely to be present in older, larger predatory fish, such as shark, swordfish, king Mackerel and tilefish (Mayo Clinic Fish Info). The U.S. Food and Drug Administration (FDA) thus recommends that young children and pregnant and lactating women avoid eating these fish. It is also important to keep in mind, that not all fish and other seafood are high in omega-3 fatty acids. Some however, contain significant levels of omega-3 fatty acids and also have lower levels of environmental contaminants. These include salmon, canned light tuna, shrimp, pollock and catfish, which then are the best choice for consumers.

Two other issues to consider are the source of the fish and whether taking fish oil supplements is a good alternative. As you may or may not know, many fish such as tilapia are raised in “fish farms”. These aquaculture facilities raise large numbers of fish in relatively tight quarters. This leads to an increase in the risk for infection and other illnesses; antibiotics are thus routinely used in this setting. It is also important to consider whether the fish was imported into the U.S. from another country, as the inspection process may not be so robust. Moreover, there is some evidence that the nutrient content of wild caught fish is higher, but the price may also be higher. And lastly, there is emerging evidence in the nutritional sciences world that fish oil supplements do NOT provide the same health benefits that regular consumption of certain fish.

In summary, eating fish is good for us, but we have to be educated to realize the greatest health benefits. This general rationale also applies to many other aspects of healthy eating, such as choosing fruits and vegetables with the lowest levels of contaminating pesticides. So, learn, procure, cook and enjoy!

(written with the creative assistance of Avery Bramnik and Nicole Solomon, both University of Florida undergraduate students)

Antioxidant Supplementation: Health Insurance or Health Risk?

Scenario: A 58 year-old man named Mike has just been diagnosed with prostate cancer. He is wondering how this could be since there is no family history of the disease, and he exercises regularly, is a vegan, and takes antioxidant supplements. Mike assumed that his healthy lifestyle would decrease his chances of developing cancer, but apparently not. After talking to his doctor, he wonders if the supplements played a causal role in his recent diagnosis.

Antioxidants are substances that protect against the detrimental effects of oxygen free-radicals. These radicals, with reactive, unpaired electrons, are produced during normal metabolism and can damage cell membranes and biological molecules such as protein or DNA. Diets high in fruits and vegetables are rich in antioxidants, such as vitamin C, vitamin E, β-carotene and selenium, which can neutralize these reactive oxygen species. Many people, however, do not consume adequate amounts of these foods. This explains why the dietary supplement industry promotes antioxidant supplements to consumers, with promises of decreasing aging and preventing cancer along with other health-promoting properties. This sounds great, of course, but is there any scientific proof to back up these claims?

According to the National Institutes of Health (NIH), supplements with high doses of β-carotene may increase the risk of lung cancer in smokers and vitamin E supplements may increase the risk of hemorrhagic stroke and prostate cancer. In 2011, a study of >35,000 men, known as The Selenium and Vitamin E Cancer Prevention Trial (SELECT), discovered that selenium and vitamin E supplements did not decrease the risk of prostate cancer, and that vitamin E supplements (taken alone) increased the risk by 17% (NCCAM Supplements). Multiple other studies echo these findings (Harvard University). Nonetheless, many people in the USA continue to regularly use antioxidant supplements, according to experts at Stanford University (Stanford University).

One possible reason for antioxidant supplements doing more harm than good relates to the fact that high levels of antioxidants can potentially convert to proxidants. Moreover, oxidant molecules are used in the body to get rid of damaged cells, including those that are precancerous or cancerous, so supplements could disrupt an important oxidant/antioxidant balance. So as the saying goes, more is not always better.

The best option for obtaining adequate amounts of antioxidants is adding fruits, vegetables, and whole grains to your diet. The typical American diet already provides 120% of the RDAs for many antioxidant nutrients (JNCI Paper), so supplementation should not be necessary for most healthy people.  Furthermore, the health-promoting benefits of consuming antioxidant-rich foods may actually be caused by other substances present in the same foods, or relate to lifestyle choices of individuals who most often consume these foods.

Conclusion to Scenario: In the end, Mike realizes that not every claim about dietary supplements is true. Mike does not want what happened to him to also happen to his little brother. He thus intends to warn his little brother about the truth behind antioxidant supplementation. What will you do? We suggest you get the facts, and only the facts, before using any dietary supplement.

(Written with the creative assistance of Nehemie Laguerre, a University of Florida undergraduate student)

Does Taking a Daily Multivitamin Support Health?

November 1, 2013 by  
Filed under Supplements

You may have seen headlines recently that provide confusing messages about taking a daily multivitamin. Observational studies performed by researchers at the Mayo Clinic found that taking multivitamins increased risk of premature death in older Midwestern women. Furthermore, the Iowa Woman’s Health study reported that those taking a daily multivitamin were 6 percent more likely to die over the 19 year study period than those that did not take one. Not all studies however support these observations.

 Do multivitamins protect against disease?

Although the above referenced studies suggest increased risk of death when taking a daily multivitamin, others do not support this contention.  For example, a placebo-controlled clinical trial, the Physician’s Health study, found that taking a multi did not increase (or decrease) risk for heart attack or stroke. This study asked participants to either take a multivitamin or not for a period of 11 years. Of note, prostate cancer development was slightly lower (~8%) in those taking the multi, but risk of other cancers was not different between study groups. Importantly, this study was able to link cause and effect, unlike the epidemiological studies cited above. It’s thus safe to say that the data from large-scale clinical trials and observational studies are not convincing on either side at this time. So, what’s a person to do and what should be the take home message?

Who should take a multivitamin and why?

For those who do not obtain enough of several critical nutrients, taking a multi is a good idea. The nutrients of concern, as identified by nutrition experts, are as follows: vitamin B12, vitamin D, folic acid, iron, calcium, potassium and fiber. Fiber, potassium and calcium are too bulky to fit into a pill, so these should be obtained from the diet. A daily multi however, can provide amounts of the other 4 to make up for dietary deficiencies. Many consider multivitamins as insurance against disease development, but if you consume adequate levels of these nutrients of concern, the multi will have little added benefit.

What type of product is recommended?

If you do choose to take a daily multivitamin, choose one that has no more than 100% the DV for the added nutrients. Avoid products that contain more than RDA for iron for adults (which varies depending upon gender and eating patterns).  Furthermore, since the calcium content of most multivitamins is low, you might consider taking calcium supplements, particularly if you don’t consume dairy products. Also keep in mind that more expensive does not necessarily mean better. You should be able to find a suitable product for less than $10/month.

So, what do you think, do multivitamins promote health and protect against disease development? Are you going to rethink this situation for yourself and keep abreast of the latest scientific developments on this issue? What is most important is that each of us gets the daily nutrients we require for good health, and if a multivitamin allows you to accomplish this, it’s certainly not a bad idea.

Dietary Supplements

September 24, 2013 by  
Filed under Consumer awareness, Supplements

I hope that you enjoyed Jamie’s post about protein supplementation last week. As a follow up, I thought it would be helpful to share some information about dietary supplements in general. Do some dietary supplements work? Yes. Are some dietary supplements dangerous? Yes. How should you proceed? Well, it depends. Here’s some food for thought.

Dietary supplements vs. drugs

Dietary supplements include vitamins, minerals, amino acids, enzymes, herbs, animal extracts, and probiotics. Similar to drugs, they come in the form of pills, gel capsules, liquids, and powders. But unlike drugs, dietary supplements are NOT regulated for safety or effectiveness by the Food and Drug Administration (FDA) before they go to market. Thanks to the Dietary Supplement Health and Safety Education Act (DSHEA) passed in 1994, the FDA is only responsible for taking action against unsafe dietary supplements after they reach the market.1

Remember Fen-Phen? Ever heard of Metablolife 356, Lipokinetix, or Hydroxycut?  These are all dietary supplements that were banned by the FDA because they contained dangerous ingredients. Banned, yes, but only after confirmed cases of liver failure, seizures, cardiovascular problems, and deaths.

How can I find a safe dietary supplement?

The first step is to look for the United States Pharmacopoeial Convention (USP) seal of approval. The USP is a non-government organization that tests dietary supplements for authenticity, strength, dissolvability, weight, and packaging. USP verification is a voluntary process for supplement manufactures, but may provide peace of mind for concerned consumers.

Consumer Labs is another organization to consider. They test dietary supplements similar to the USP, then post their results to a subscription-based website:

Figure 1. USP and Consumer Labs labels.

USP and CL jpeg

The second step regarding safe dietary supplement usage is to limit your expectations. If a supplement claim sounds too good to be true, it likely is. Don’t expect a magic pill to make you faster, stronger, bigger, smaller, longer, thinner, smarter, etc.  A daily multivitamin/mineral supplement can never replace the benefits of a healthy diet and lifestyle.

The third step is to dismiss the well-known adage “If one pill is good, then two are better, and three must great”. Look for vitamin and mineral supplements that provide no more than 100-200% of the Recommended Dietary Allowance (RDA). It’s an indisputable fact that chronic nutrient deficiencies negatively affect health, but 5000% of the RDA of a given nutrient will not make you 5000% healthier.  Besides, if you eat any amount of real food you are bound to consume some percentage of the RDA.  Combine this with a daily multivitamin/mineral supplement containing 100% of the RDA and you are assured of getting your needs met. Another idea to take a multivitamin/mineral supplement only every other day.

Take home message

First, ask yourself if you truly need a dietary supplement. What does it depend on for you (diet, lifestyle, finances, etc.)? If you do decide that a supplement is in your best interest, then the take home message  is “buyer beware”. Or at least be aware. Look for the USP seal of approval and avoid supplements containing more than 200% of the RDA. Also, if you are pregnant, lactating, or taking prescription medications, please consult with your physician before consuming any type of dietary supplement.