Fish Oil

Fish oil contains the omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). There are several omega-3 fatty acids, and each has a different metabolic fate in the body and different actions. Therefore, the term "omega-3" can be somewhat misleading.

EPA and DHA are the two fatty acids that have been studied extensively for their ability to decrease certain cardiovascular risk factors, notably blood pressure and triglycerides. Though other omega-3 fats have some beneficial effects in the body, it makes sense to get the most bang for your buck.

The American Heart Association recommends fatty fish, which is rich in EPA and DHA. EPA and DHA have several beneficial effects in the body, including decreasing certain kinds of inflammation.

The table below shows the different omega-3 fatty acids and how many steps it takes to break down other types of omega-3 fatty acids into EPA and DHA.

Studies show that just 8-21 percent of the omega-3 fatty acid ALA (found in flaxseeds, walnuts, canola oil and fortified in some functional foods) is broken down to EPA (men are at the low end of this range) and 4-9 percent is broken down to DHA (again, men are at the low end of the range). Why are the levels so low? This process is inefficient and hampered by some of the other fats we eat (which compete for certain enzymes in the body).


Fatty Acid Sources Breaks Down To Steps To EPA Steps To DHA
Alpha Linolenic Acid (ALA) Flaxseed oil, walnuts, canola oil and some functional foods Stearidonic Acid (SDA) 3 5
Stearidonic Acid (SDA) SDA-rich soybean oil from GMO soybeans Eicosatetraenoic Acid 2 4
Eicosapentaenoic Acid (EPA) Fatty fish, fish oil supplements Clupanodonic Acid N/A 2
Clupanodonic Acid N/A Docosahexaenoic Acid (DHA) N/A 1
Docosahexaenoic Acid (DHA) Fatty fish, fish oil supplements N/A N/A N/A
Intake of the fish oil omega-3 fatty acids EPA and DHA is inversely related to fatal coronary heart disease, blood pressure (especially in older, hypertensive patients) and triglycerides. Some research has also shown that EPA and DHA may decrease the symptoms associated with depression and certain inflammatory diseases in addition to enhancing joint mobility.

There are several factors that contribute to healthy joints. Omega-3s enhance joint mobility through a few different mechanisms.

EPA and DHA may decrease inflammation. Studies show that EPA and DHA are more effective than ALA for decreasing several inflammatory markers. EPA and DHA also increase some anti-inflammatory markers such as IL-10, TGF beta.

Omega-3 fatty acids may decrease the progression of osteoarthritis. EPA and DHA inhibit the expression of various proteins that contribute to osteoarthritis. In addition, petri dish studies indicate that ALA and EPA decrease both the destruction and inflammatory aspects of cartilage cell metabolism.

Omega-3 fatty acids are incorporated into cartilage cell (chondrocyte) membranes. In a dose-dependent manner, they decrease enzymes that degrade cartilage and inflammatory cytokines (IL-1alpha, TNF alpha, COX-2,) thereby affecting cartilage cell gene transcription.

Studies show that EPA and DHA are more effective than ALA for decreasing several inflammatory markers.
Omega-3s may decrease risk of bone marrow lesions. A study in 293 adults without osteoarthritis, some with and some without knee pain, found that higher intakes of monounsaturated fatty acids or omega-6 polyunsaturated fatty acids were associated with an increased risk of bone marrow lesions.

This study lends further support to the recommendation to balance fat intake and shift toward foods rich in omega-3 fatty acids while decreasing intake of omega-6 fatty acids.

Omega-3s help other aspects of joint health. Omega-3 fatty acids may decrease symptoms of morning stiffness, tender or swollen joints, and joint pain. They can also help increase blood flow during exercise.

Consider glucosamine and chondroitin sulfate.

If you have moderate or severe osteoarthritis that doesn't respond to other treatment modalities, ask your physician about Synvisc injections.

Eat an anti-inflammatory diet loaded in colorful fruits and vegetables.

Try tart cherry juice.

Go to a physical therapist for help with your range of motion, and to determine what muscles you need to stretch and strengthen.

Try low-impact activity (swimming, running in the water, water aerobics, stationary cycling) until your joints feel better.


Joint pain can limit your activity and cause distress. Luckily, how you train and eat can help. In addition to stretching and strengthening the surrounding muscles (while not overloading them too soon), you can also take omega-3 fatty acids.

Omega-3 fatty acids can potentially enhance joint mobility through several biochemical processes such as altering eicosanoid biosynthesis, signal transduction, and influencing gene expression. In addition, fish oil in particular can decrease some cardiovascular disease risk factors at the same time.

As always, tell your physician about all supplements you are taking (including over-the-counter drugs such as ibuprofen or allergy medicine).

Curr Opin Clin Nutr Metab Care 2004;7(2):137-144.
J Nutr 2009; 139(4):804S-19S.
AHRQ Publication Number 04-E010-1.
Curr Pharm Des. 2009;15(36):4165-72.
Osteoarthritis Cartilage 2009;17(7):896-905.
J Clin Endocrinol Metab 2006;91(2):439-46.
Arthritis Rheum 2002;46(6):1544-53.
Proc Nutr Soc 2002;61(3):381-9.
Arthritis Rheum 2002;46(6):1544-53.
Exp Biol Med (Maywood) 2001;226(6):485-97.
Arthritis Rheum 33:305-315, 1990.
Am J Clin Nutr 2006;83(6): S1505-1519S.
FASEB, #688.8, San Diego, CA, April, 2005.
Biol Chem 2000;275(2):721-4.

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