VOLUME 11 NUMBER 1 • MARCH 2014
45
SA JOURNAL OF DIABETES & VASCULAR DISEASE
DRUG TRENDS
S
cientific research and media exposure
have led to a substantial rise in fish oil
supplementation over the past five years.
Even though omega-3 (n-3) fatty acid
supplements capture only 13% of the US
n-3 product market, the highest retail dollar
value of the supplements is in the fish oil
as opposed to packaged food, beverages
and infant formulas where the n-3 content
is relatively small. The South African market
for fish oil capsules is estimated to be worth
about R65 million.
A group from the Cape Peninsula
University of Technology led by Maretha
Opperman and Spinnler Benade conducted
a survey in 2009 on 45 fish oil supplements
commercially available on the South African
market. The aim of the study was to
determine the fatty acid composition and
content of supplements for comparison
with the claimed contents on the product
labels. The survey was repeated in 2012
on 63 supplements. Their findings were
published in the
Cardiovascular Journal of
Africa
in 2013.
1
The n-3 fatty acids of particular interest
are eicosapentaenoic acid (EPA) and
docosahexaenoic acid (DHA).The more
recent analysis showed an improvement in
the accuracy of EPA content declared on
supplement labels – 52% in 2012 versus
Follow-up study reveals an encouraging, though small, improvement
in accuracy of labelling of omega-3 fish oil supplements
44% in 2009. A higher percentage of
supplements (35% in 2012 vs 13% in 2009)
contained DHA levels higher than declared.
In 2009, 64% of supplements cost R2.01 to
R5.00 or more to achieve a daily intake of
500 mg EPA + DHA, compared to 81% in
2012.
Forty-four per cent of supplements were
found to be in the early stages of rancidity
compared to 73% in 2009. More than
80% of supplements had peroxide levels
higher than the recommended content as
specified by the Global Organisation for EPA
and DHA Omega-3 (GOED). The majority
(81%;
n
= 51) of the supplements studied
in 2012 had a 1.1–1.5:1 EPA-to-DHA ratio
or less, compared to 56% in 2009. Almost
one-third (32%) of the supplements in the
2012 survey contained ethyl esters (EEs) or
a combination of EEs and triglycerides.
The authors concluded that while fish oil
supplementation is a useful tool to increase
the dietary intake of n-3 essential fatty
acids, the absence of a food supplement
regulatory structure in South Africa
makes the safety, purity and quality of
the fish oil supplements surveyed a cause
for concern. On the positive side, their
analysis showed a small improvement in
the accuracy of EPA content declared on
supplement labels compared to the 2009
survey. It was also evident that more of the
supplements contained DHA levels higher
than declared.
A relatively large number of supplements
were found to be in the early stages of
rancidity. Of greater concern was the
peroxide (rancidity) level of more than 80%
of supplements, which was higher than
the recommended content as specified
by GOED. The authors warn that dietary
intakes of oxidised fatty acids may pose
deleterious health effects.
Compared to the previous survey, it
seems that manufacturers have increased
the DHA-to-EPA ratio as well as the
concentration of these two components.
Some of the surveyed supplements had EPA
and DHA contents much higher than the
standard 180 mg EPA and 120 mg DHA per
1 000 mg fish oil. This can be attributed to
the EE and/or triglyceride content of these
preparations. The safety of these has not
been confirmed in humans, however.
P Wagenaar
Reference
1.
Opperman M, Benade S. Analysis of the omega-3
fatty acid content of South African fish oil
supplements: a follow-up study.
Cardiovasc J Afr
2013;
24
: 297–302.
Drug Trends
