The absorption of fish oils and concentrates.

Both preventive and curative therapies have created a considerable demand for eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids. The most common sources for omega 3 fatty acids are fish oil. The concentrations of EPA and DHA in commercial oils, after modest enrichment, reach about 300 mg/g; alternative technologies can produce reasonably priced fish oils containing 400 or even 500 mg/g of omega 3 acids. When the acids are liberated from the glycerides, concentrates of ethyl esters or free acids with 65 to 70% total omega 3 fatty acids (at least 50% EPA + DHA) are readily prepared. Difficulties have arisen because most clinical trials have used fish oils of unspecified composition, and some trials are now based on either ethyl esters or free acids. There are at least three different, but not mutually exclusive, absorption routes in humans, namely the preduodenal route, the lymphatic route via chylomicrons, and the route via the portal vein to the liver. This makes it difficult to compare results. The difficulty in obtaining dose-related clinical data may in part be due to the form in which the omega 3 acids are offered and due in part to the natural presence of these fatty acids in the body. The nontriglyceride forms, especially the free acids, have been advocated for standardization of trials to facilitate interlaboratory comparisons.