More than 60 percent of the Dutch population does not meet the Health Council's guideline of eating fish once a week. In addition, our own research (blood tests among more than 350 people) shows that about 95 percent are deficient in omega-3. This is worrisome. It poses a major problem for the health of our population. Because the omega-3 fatty acids EPA and DHA from fish and seafood are essential for good health. Not for nothing do the fatty acids EPA and DHA have recognized health claims.


The recognized European health claims are:

  • Good for your heart: daily intake of 250 mg of EPA and DHA contributes to normal heart function.
  • Good for your brain: Daily intake of 250 mg DHA contributes to normal brain function. For pregnant and breastfeeding women, 200 mg DHA on top of daily intake of 250 mg EPA + DHA contributes to normal brain development of the fetus/infant.
  • Good for your vision: daily intake of 250 mg of DHA helps maintain normal vision. For children up to 1 year of age, it is 100 mg of DHA.
  • Good for the immune system: daily intake contributes to the normal functioning of the immune system.
  • Good for blood pressure and triglyceride levels: daily intake of 2,000 - 5,000 mg EPA + DHA helps maintain normal blood pressure and triglyceride levels.
  • Good for muscle function: daily intake contributes to normal muscle function.


Previously, the Health Council's advice was to eat fish twice a week, but recently that was changed to once a week. According to a research report by the Health Council, only 15 percent of all Dutch people managed to eat fish twice a week. In my opinion, eating fish once a week is not nearly enough for good health. Especially not if you have been deficient in eating fish and seafood for years and/or if your fat digestion does not work well. With poor fat digestion, omega-3 fatty acids are not absorbed properly and end up in the toilet bowl. Characteristics of poor fat digestion include: sticky poop (lots of toilet paper / toilet brush needed) and floating stools. Chances are you too can't manage to eat fish once a week and/or your fat digestion is not working properly. A good omega-3 fish oil supplement is then recommended. Since there are many bad fish oil supplements for sale, it is wise to watch out for a few things. Because the intake of a bad (oxidized) omega-3 oil does your health more harm than good.

100% natural

First of all, fish oil must be 100 percent natural. Synthetic additives are not necessary for anything.

Antioxidants

The omega-3 fatty acids EPA and DHA from fish oil are very sensitive to oxidation. This means that they are rapidly affected by contact with oxygen. Examples of oxidation processes are rusting and combustion reactions. Through contact with oxygen, the omega-3 fatty acids are affected and become rancid. Oxidized fish oil can be recognized by its foul "fish smell" and foul "fish boils. Research among fish oil users shows that fish oil burping is a major reason why people stop using a fish oil supplement. It is also a major reason why people don't take it. Old fish smells and is gross, but fresh fish hardly smells at all. A good fish oil does not cause "fish burps. To prevent damage to the fish oil, antioxidants must be added to the fish oil. Examples of antioxidants are tocopherols (vitamin E), polyphenols, herbal extracts (such as rosemary extract), ascorbates (vitamin C) and citric acid. Good manufacturers add these types of antioxidants, but by no means all manufacturers do. Therefore, pay close attention to whether your fish oil contains antioxidants such as vitamin E or polyphenols. Does the fish oil contain no antioxidants? Then chances are the fish oil is oxidized and thus rancid. Oxidized omega-3 fatty acids are less useful to your body. Be especially careful with cheap fish oil supplements. Rather invest a little more money. Good health is the best investment.

Low TOTOX value

In addition to perceiving a foul "fish smell" and foul "fish boils," you can also measure the oxidation rate of fish oil using a scientific standard, which is the TOTOX value. This stands for total oxidation value. Two values are used to calculate the TOTOX value, the peroxide value and the anisidine value. The peroxide value consists of the content of fatty acid peroxides and the anisidine value represents the content of aldehydes. Standards have been established for these values by the Global Organization for EPA and DHA Omega-3s (GOED).

  • Peroxide value: Not more than 5 meq/kg
  • Anisidine value: 20 max


The TOTOX value is the most commonly used quality measurement maintained for omega-3 supplements. The TOTOX value is calculated as follows: (2 x peroxide value) + anisidine value. A good fish oil supplement has a low TOTOX value. The maximum TOTOX value that GOED maintains is 26. The lower the TOTOX value, the better. In our clinic, we now only use fish oil with a TOTOX value below 4. You can request the TOTOX value from the manufacturer or supplier. Then ask for an official report.

Purified of heavy metals, PCBs and dioxins

De zee raakt steeds meer vervuild met zware metalen, PCB’s, dioxinen, en andere giftige stoffen. Deze stoffen komen uiteindelijk ook in de vissen terecht. Grote roofvissen zijn het meest vervuild. Goede producenten zuiveren hun visolie nauwkeurig van gifstoffen, zoals zware metalen, PCB’s en dioxinen. Als je over de zuiverhuid van jouw visolie twijfelt kun je altijd een onderzoeksrapport opvragen bij de producent of leverancier. Indien zij hier niet transparant over zijn, zijn jouw twijfels over de zuiverheid waarschijnlijk terecht.

BPA-free packaging

Fish oil is often packaged in plastic. Many types of plastic contain the plasticizer Bisphenol A (BPA). BPA is a hormone disruptor. Not all types of plastic contain BPA. Ideally, choose a fish oil in a BPA-free package. Especially liquid fish oil (i.e., not the capsules) gets a lot of exposure to the plastic packaging. So BPA-free packaging is especially important for liquid fish oil supplements.

Good Manufacturing Practice (GMP)

Good Manufacturing Practise literally means "good manufacturing practice. GMP is a quality assurance system for the pharmaceutical and food industries, among others. With GMP, it is accurately recorded how and under what conditions a product is made. All raw materials, intermediate products and end products are checked and the process is precisely recorded on the so-called preparation protocol. If, in retrospect, something turns out to be wrong with a particular batch of drugs or foodstuffs, one can always find out how it was made, who tested it, where and what raw materials were used, and so on.

Sustainable (MSC certified)

The sea is the basis of life, so we must treat it with care. If we destroy marine life, we indirectly demolish life on land. Therefore, it is important that we do not deplete the sea. Sustainable fish oil is therefore preferred. You can recognize it by the 'Marine Stewardship Council' (MSC) label.

Sustainable fish oil

To get the MSC label, a fishery must meet the MSC standard for sustainably caught fish. This is the most stringent and comprehensive environmental standard for wild-caught fisheries available. And three principles must be met:

  • the fish stock should be healthy and not overfished
  • fishing must not have significant negative effects on the ecosystem
  • fisheries must be properly managed.


Every company in the fish oil production chain must hold an MSC Chain of Custody (CoC) certificate. This ensures that the fish oil is traceable from catch to supplement.

To measure is to know

Many people are deficient in the omega-3 fatty acids EPA and DHA and have far too high an omega-6/omega-3 ratio and far too low an omega-3 index. A good omega-6/omega-3 index is 3:1 and a good omega-3 ratio is above 8 percent. In practice, most people are more likely to have a ratio of 10-25:1 and an index below 8 percent. A good omega-6/omega-3 ratio is a requirement for good health and recovery. The omega-3 index is the most important predictor of cardiovascular disease. An omega-3 index above 8 percent significantly reduces the risk of cardiovascular disease. Cardiovascular disease is one of the top killer diseases. Many people die from them every year. The good news is that you can greatly reduce your risk of cardiovascular disease through a healthy lifestyle and a good omega-3 index. I myself had my omega-6/omega-3 ratio and omega-3 index measured last year. My ratio and index were bad, namely a ratio of 17:1 and an index of 1.3. Now I am eating fish twice a week and also supplementing that with a daily dose of about 2,000 mg of EPA and DHA from a fish oil supplement.

Omega-3 index

These types of omega-3 tests are offered by several vendors at a price of about 65 euros. Recovering your omega-3 ratio and index takes at least 4 months The omega-6/omega-3 ratio and omega-3 index are measured in the cell membrane (outside of the cell) of red blood cells. Red blood cells renew themselves in about 4 months. Therefore, it takes at least 4 months before you can measure the result of your altered omega-3 intake. Fish oil supplementation only makes sense if you do it long-term, since your cells need time to load up with the omega-3 fatty acids EPA and DHA. Taking fish oil for one or two months therefore makes no sense.

What is your omega-3 ratio and omega-3 index?

Have you ever had your omega-6/omega-3 ratio and omega-3 index measured? If not, this is highly recommended. It gives you insight into your health and the opportunity to adjust your omega-3 intake in a targeted way, so you can optimize your ratio and index. Your overall health will benefit from this. You can measure your omega-6/omega-3 ratio and omega-3 index with a simple finger prick test at home.

In short

The omega-3 fatty acids EPA and DHA are essential for good health and recovery. More than 60 percent of the Dutch population does not meet the Health Council's guideline of eating fish once a week. And as many as 85 percent do not manage to eat fish twice a week. In addition, our own research shows that about 95 percent are deficient in omega 3. This is worrisome. Cardiovascular disease causes many deaths (unnecessarily) every year. We have the knowledge to greatly reduce the risk of Western affluent diseases such as cardiovascular disease through lifestyle modifications. Optimizing your omega-3 index is an important factor that can significantly reduce the risk of cardiovascular disease. Let's use this knowledge. Let's stop mopping up while the tap is open. Let's turn off the tap and get to the root cause. Only in this way can we dramatically improve the health of the population. Because it is so incredibly important that you get enough of the omega-3 fatty acids EPA and DHA, supplementation with a fish oil supplement is recommended if you do not eat enough fish, seaweed and seafood. Pay close attention to which fish oil you buy. There are many different brands and the quality varies widely. Therefore, pay attention to the characteristics of a good omega-3 fish oil, which I have written about in this article. Measuring your omega-6/omega-3 ratio and omega-3 index gives you insight into an important measure of your health. It allows you to make targeted adjustments to your omega-3 intake so you can optimize your ratio and index. Your overall health will benefit from this. You can measure your omega-6/omega-3 ratio and omega-3 index with a simple finger prick test at home.

So

Do you want optimal health and reduce the risk of Western affluent diseases such as cardiovascular disease? Then measure your omega-3 status (omega-6/omega-3 ratio, omega-3 index) and adjust your omega-3 intake accordingly. 

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