Research Spotlight on Omega Oils
Natural Triglyceride Form Fish Oil vs. Ethyl Ester Form
No matter what the nutrition, it's always about absorption!
Natural Triglyceride Form Fish Oil vs. Ethyl Ester Form
In response to the well-established benefits of the long chain omega-3 essential fatty acids, EPA and DHA, and the widespread deficiency of omega-3s in the American diet, health care professionals are increasingly recommending purified fish oil as a dietary supplement. But few consumers know that there are two different molecular forms of fish oil supplements on the market: the synthetic ethyl ester form, and the natural triglyceride form.
EPA and DHA naturally occur in the triglyceride form in fish. A triglyceride consists of a glycerol “backbone” linked to three fatty acids. To manufacture a fish oil concentrate, the fatty acids are removed from the backbone and undergo processing. The manufacturer must then choose to either 1) use enzymes to reassemble the fatty acids into the natural triglyceride structure or 2) react the free fatty acids with ethanol, resulting in an ethyl ester fatty acid, which is the less costly option. The majority of concentrated EPA and DHA products on the market are in the ethyl ester form.
Although current research does not reveal scientific consensus on the distinction between these two forms of fish oil supplements, it has been established that several differences exist in how the body utilizes ethyl ester versus triglyceride EPA and DHA. The ethyl ester fatty acid does not naturally occur anywhere in the human diet and may not mimic the physiologic activity of triglycerides. Many clinical studies on bioavailability, stability, and other comparative issues suggest that the triglyceride form is both better absorbed and assimilated as well as more molecularly stable than ethyl esters1–9. In addition, the established therapeutic value of EPA and DHA is based on data from several large-scale epidemiological studies, all of which are based on natural triglyceride fish oils10–15. Thus, although the scarcity of the data does not allow for definitive conclusions, evaluating these issues before relying on a synthetic form of EPA and DHA seems advisable.
1 Lawson LD, Hughes BG. Human absorption of fish oil fatty acids as triacylglycerols, free acids, or ethyl esters. Biochem Biophys Res Commun 1988;152:328–335.
2 Lawson LD, Hughes BG. Absorption of eicosapentaenoic acid and docosahexaenoic acid from fish oil triacylglycerols or fish oil ethyl esters co-ingested with a high-fat meal. Biochem Biophys Research Comm 1988;156:960–963.
3 el Boustani S, Colette C, Monnier L, et al. Enteral absorption in man of eicosapentaenoic acid in different chemical forms. Lipids 1987;22:711–714.
4 Beckermann B, Beneke M, Seitz I. Comparative bioavailability of eicosapentaenoic acid and docasahexaenoic acid from triglycerides, free fatty acids
and ethyl esters in volunteers. Arzneimittelforschung 1990;40:700–704. [German]
5 Visioli F, Rise P, Barassi MC, et al. Dietary intake of fish vs. formulations leads to higher plasma concentrations of n-3 fatty acids. Lipids 2003;38:415–418.
6 Hong DD, Takahashi Y, Kushiro M, et al. Divergent effects of eicosapentaenoic and docosahexaenoic acid ethyl esters, and fish oil on hepatic fatty acid
oxidation in the rat. Biochim Biophys Acta 2003;1635:29–36.
7 Nordoy A, Barstad L, Connor WE, et al. Absorption of the n-3 eicosapentaenoic and docosahexaenoic acids as ethyl esters and triglycerides by humans.
Am J Clin Nutr 1991;53:1185–1190.
8 Krokan HE, Bjerve KS, Mork E. The enteral bioavailability of eicosapentaenoic acid and docosahexaenoic acid is as good from ethyl esters as from
glyceryl esters in spite of lower hydrolytic rates by pancreatic lipase in vitro. Biochim Biophys Acta 1993;1168:59–67.
9 Website USPTO Patent Full-Text and image database. Accessed June 2007 [http://patft.uspto.gov/netacgi/nph-Parser?u=%2Fnetahtml%2Fsrchnum.
htm&Sect1=PTO1&Sect2=HITOFF&p=1&r=1&l=50&f=G&d=PALL&s1=5502077.PN.&OS=PN/5502077&RS=PN/5502077]
10 Bang HO, Dyerberg J. Plasma lipids and lipoproteins in Greenland Eskimos. Acta Med Scan 1972;192:85–94.
11 Bang HO, Dyerberg J. Lipid metabolism and ischemic heart disease in Greenland Eskimos. Adv Nutr Res 1980;3:1–22.
12 Hirai A, Hamazaki R, Terano T, et al. Eicosapentaenoic acid and platelet function in Japanese. Lancet 1980;1132–1133.
13 Yotakis LDO. The preventive effects of polyunsaturated fats on thrombosis. Thromb Haemostasis 1981;46:65–68.
14 Kromhout D, Bosschieter EB, Coulander CL. The inverse relationship between fish consumption and 20-year mortality from coronary heart disease.
N Engl J Med 1985;312:1205–1209.
15 Bang HO, Dyerberg J. Personal Reflections on the incidence of ischemic heart disease in Oslo during the Second World War. Acta Med Scand 1981;210:245–248.