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Fish Oil: With Food or Empty Stomach?

by Vin Kutty, MS on June 8, 2011

Should you eat fish oil pills with meals or on an empty stomach? Which is better?

Quick quiz:

Which of these foods help increase fish oil absorption?

  1. Fat-free yogurt and glass of orange juice
  2. Breakfast cereal with skim milk
  3. Scrambled eggs and bacon
  4. Fruit cup with granola

The answer is: scrambled eggs and bacon.


Eating fish oil supplements with meals that contain fat is MUCH better for absorption. More of the Omega-3 gets into your ‘system’ and more stays there over time when you eat your fish oil pills with food.

Some foods helps absorption better than others.

The fat present in your food is what helps Omega-3 get absorbed into your body.

Many of you probably are on low-fat diets, so keep this in mind. Taking your fish oil pills with just fruits or skim milk is wasting a lot of Omega-3.

New Prescription Fish Oil and Facts About Fats

In an recent study conducted by Om Thera Pharmaceuticals, they compared the absorption of prescription fish oil (Lovaza) when taken with a high-fat versus low-fat diet.

The results showed that there is, not two or three-fold increase when eaten with fatty foods, but almost EIGHT-FOLD increase in absorption of Omega-3 when Lovaza pills are eaten with a big hearty meal that contains fat.

‘Waitaminit!’ you say, ‘It’s eating fat that got me into all this trouble in the first place! Now you tell me to eat more fat so the fish oil can get absorbed? You’re nuts!

Umm, yeah, I am a little nuts. But it’s hard to argue with facts. And the facts say, no, it’s not the fats that got you into trouble. It’s the juices, sodas, donuts, beer, bagel, chips, whole wheat bread and pasta. What’s nuts is that most doctors won’t tell you this!

Besides, you don’t have to eat any of that scary fats like trans fat or Omega-6-rich oils like corn oil or soy bean (vegetable) oils or canola oil. If you’re afraid of fats, just stick with olive oil. And pour it on generously.

Olive oil is a fat that most people, even nutritionists and doctors, can agree on. So go ahead, be generous with olive oil.

Don’t be afraid of fat – not all fats are bad for you.

The right kind of fat (and fewer donuts) would have kept you out of trouble.

The oils in your foods will help the fish oil get absorbed better, especially EPA Omega-3, the primary component in OmegaVia. EPA absorption is very dependent on the amount of oils and fats. DHA is a tiny bit less so.

What About Different Types of Fish Oil?

Occasionally, you’ll hear fish oil marketers say ‘Ours is the best because it is the best absorbed triglyceride form.’ They are partially correct. But all forms of fish oil, be it the triglyceride form, reconstituted triglyceride form, phospholipid form, ethyl ester form, free fatty acid, they all are better absorbed when eaten with a big, heavy meal that contains lots of oils and fat.

Just keep it simple: find a pharmaceutical grade fish oil pill with the most Omega-3 you can afford and eat with with a healthy, fatty meal. And you’re done.

Why Pharmaceutical Grade Fish Oil?

Omega-3 content of pharmaceutical grade fish oil supplements
Well, highly purified fish oils (pharmaceutical grade) show greater reduction in triglyceride and VLDL (the bad cholesterol) than regular fish oils with lower Omega-3 content. Pharma-grade fish oil also show higher levels of EPA and DHA in serum phospholipids.

Science Alert!

Omega-3 EPA and DHA in ethyl esters and triacylglycerols (TAGs) form, after you eat them, go through a process called hyrolysis via gastric lipase enzyme in the stomach.

chyclomicrons, triglycerides and fish oil

This process breaks down the Omega-3 into monoglycerides and free fatty acids. Once this gets into the small intestines, in cells that line the small intestines called enterocytes, another step called re-acylation takes place. This recreates triacylglycerols (TAGs). The TAGs are then assembled with phospholipids, cholesterol and apoproteins to form chylomicrons.

Stick me me now! Science 101 is almost done.

These chylomicrons are fat-protein combo molecules. Their job is to mop up fat from the intestines to other part of the body. Chylomicrons are then released into the lymphatic system to transport to the whole body. Once in circulation, the chylomicrons are broken down by lipoprotein lipase, and EPA and DHA Omega-3 are transported by the circulation to various tissues of the body where they are used mainly for the synthesis of phospholipids.

This is also how Omega-3s help reduce your triglyceride levels. Omega-3 speeds up the triglyceride-mopping effect of chylomicrons.

Exactly how or why eating fish or fish oil provides this benefit is not yet clear.

More on how fish oil reduces triglycerides here.

Oh, in case science nerds are preparing to shoot me hate mail, yes, EPA and DHA Omega-3 are also absorbed preduodenally and via the portal vein to the liver. And these absorption routes are not mutually exclusive. So there! Whew!

DISCLAIMER: This information is for your education only. The contents of this blog do not constitute medical advice. This is merely an open discussion of the science behind health and nutrition. Please consult your physician for medical advice.

Author Vin Kutty is an expert on fish oil About the Author: Vin Kutty is OmegaVia’s Scientific Advisor and Chief Blogger. He is a nutritionist, author, and Omega-3 expert with over 20 years of experience. Email him.

pharmaceutical grade fish oil

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