Natural Triglyceride vs Ethyl Ester Form Fish Oil – Technical Papers

Written by on March 23, 2011

Fish Oil Forms: Triglycerides better for omega-3 index increase

By Stephen Daniells, 18-Nov-2010

Fish oil omega-3s in the triglyceride form are better for boosting the omega-3 index than the ethyl ester form, says a new study from Germany, a result which echoes recent Danish findings.

Scientists from Leibniz Universitat Hannover and Ludwig Maximilians University in Munich report that the omega-3 index – a quantification of the fatty acid status of a person – increased “faster and higher” when supplementation used omega-3s in the triglyceride form, compared with the ethyl ester form.

Writing in the European Journal of Clinical Nutrition, the scientists report that six months of supplementation with EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) in the triglyceride form increased the omega-3 index by 197 percent, compared with 171 percent following supplements of EPA and DHA in their ethyl ester form.

“As the resulting omega-3 index was significantly higher after n-3 fatty acid- re-esterified triglycerides (FA-rTG) administration compared with n-3 fatty acid-ethyl ester (FA-EE), the results indicate that n-3 FA-rTG is superior to n-3 FA-EE in view of the EPA + DHA tissues incorporation following a long-term administration,” wrote the researchers, led by Leibniz’s Juliane Neubronner.

Heart health and beyond

The heart health benefits of consuming oily fish, and the omega-3 fatty acids they contain, are well-documented, being first reported in the early 1970s by Dr Jorn Dyerberg and his co-workers in The Lancet and The American Journal of Clinical Nutrition. To date, the polyunsaturated fatty acids (PUFAs) have been linked to improvements in blood lipid levels, a reduced tendency of thrombosis, blood pressure and heart rate improvements, and improved vascular function.

Beyond heart health, omega-3 fatty acids, most notably EPA and DHA, have been linked to a wide-range of health benefits, including reduced risk of certain cancers, good development of a baby during pregnancy, joint health, and improved behaviour and mood.

Despite such benefits there are still problems with ensuring adequate omega-3 intakes from fatty fish. This has led to a fleet of omega-3-rich concentrates becoming available. Projections by Frost & Sullivan set annual growth for the omega-3 market at an impressive 24 per cent, and the market is estimated to be worth $1.6bn by 2014.

Omega-3 forms

Various forms of concentrated omega-3 fatty acids are available on the market, and these include free fatty acids (FFA), ethyl esters (EE) or as re-esterified triglycerides (rTG).

Only recently, Dr. Dyerberg his Danish co-workers reported that the bioavailability of omega-3s in the re-esterified triglyceride was 50 percent higher than omega-3 in the form of free fatty acids or ethyl esters (Prostaglandins, Leukotrienes and Essential Fatty Acids, Vol. 83, pp. 137-141).

The new study also found that the re-esterified triglycerides form of omega-3s performed better than their ethyl ester form. The German researchers recruited 150 volunteers ad randomly assigned them to one of three groups: One group received fish oil concentrate as reesterified triglycerides (1.01g EPA + 0.67g DHA); the same doses of fish oil concentrate but as ethyl ester; or placebo (corn oil).

Results of the double-blinded placebo-controlled trial showed that EPA and DHA increases were both quicker and more when omega-3 was supplemented in its triglyceride form.

“However, whether this difference would result in differences in clinical outcomes (that is, reduction in serum TG levels, reductions in coronary heart disease events) is unclear and needs further investigations,” wrote the researchers.

“Nevertheless, these obvious differences between rTGs and EEs should be considered in the n-3 fatty acid intake recommendations,” they concluded.


Source: European Journal of Clinical Nutrition
Published online ahead of print, doi: 10.1038/ejcn.2010.239
“Enhanced increase of omega-3 index in response to long-term n-3 fatty acid supplementation from triacylglycerides versus ethyl esters”
Authors: J. Neubronner, J.P. Schuchardt, G. Kressel, M. Merkel, C. von Schacky, A. Hahn



Fish oil: The natural triglyceride form is better

Original publication at The Heart Scan Blog – Wednesday, February 02, 2011

Fortifeye Super Omega-3 Fish Oil, a high quality triglyceride form fish oil.If you have a choice, the triglyceride form of fish oil is preferable. The triglyceride form, i.e., 3 omega-3 fatty acids on a glycerol “backbone,” is the form found in the body of fish that protects them from cold temperatures (i.e., they remain liquid at low ambient temperatures).

Most fish oils on the market are the ethyl ester form. This means that the omega-3 fatty acids have been removed from the glycerol backbone; the fatty acids are then reacted with ethanol to form the ethyl ester.

If the form is not specified on your fish oil bottle, it is likely ethyl ester, since the triglyceride form is more costly to process and most manufacturers therefore boast about it. Also, prescription Lovaza–nearly 20 times more costly than the most expensive fish oil triglyceride liquid on a milligram for milligram basis–is the ethyl ester form. That’s not even factoring in reduced absorption of ethyl esters compared to triglyceride forms. Remember: FDA approval is not necessarily a stamp of superiority. It just means somebody had the money and ambition to pursue FDA approval. Period.

Taking any kind of fish oil, provided it is not overly oxidized (and thereby yields a smelly fish odor), is better than taking none at all. All fish oil will reduce triglycerides, accelerate clearance of postprandial (after-eating) lipoprotein byproducts of a meal (via activation of lipoprotein lipase), enhance endothelial responsiveness, reduce small LDL particles, and provide a physical stabilizing effect on atherosclerotic plaque.

But if you desire enhanced absorption and potentially lower dose to achieve equivalent RBC omega-3 levels, then triglyceride forms are better.

Here are cut-and-pasted abstracts of two of the studies comparing forms of fish oil.



Bioavailability of marine n-3 fatty acid formulations.

Dyerberg J, Madsen P, Møller JM, Aardestrup I, Schmidt EB.

Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Copenhagen, Denmark.


The use of marine n-3 polyunsaturated fatty acids (n-3 PUFA) as supplements has prompted the development of concentrated formulations to overcome compliance problems. The present study compares three concentrated preparations – ethyl esters, free fatty acids and re-esterified triglycerides – with placebo oil in a double-blinded design, and with fish body oil and cod liver oil in single-blinded arms. Seventy-two volunteers were given approximately 3.3g of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) daily for 2 weeks. Increases in absolute amounts of EPA and DHA in fasting serum triglycerides, cholesterol esters and phospholipids were examined. Bioavailability of EPA+DHA from re-esterified triglycerides was superior (124%) compared with natural fish oil, whereas the bioavailability from ethyl esters was inferior (73%). Free fatty acid bioavailability (91%) did not differ significantly from natural triglycerides. The stereochemistry of fatty acid in acylglycerols did not influence the bioavailability of EPA and DHA.

Original publication at PubMed



Eur J Clin Nutr 2010 Nov 10.

Enhanced increase of omega-3 index in response to long-term n-3 fatty acid supplementation from triacylglycerides versus ethyl esters.

Neubronner J, Schuchardt JP, Kressel G et al.

Institute of Food Science and Human Nutrition, Leibniz Universität Hannover, Am Kleinen Felde 30, Hannover, Germany.


BACKGROUND: There is a debate currently about whether different chemical forms of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are absorbed in an identical way. The objective of this study was to investigate the response of the omega-3 index, the percentage of EPA+DHA in red blood cell membranes, to supplementation with two different omega-3 fatty acid (n-3 FA) formulations in humans.

DESIGN: The study was conducted as a double-blinded placebo-controlled trial. A total of 150 volunteers was randomly assigned to one of the three groups: (1) fish oil concentrate with EPA+DHA (1.01 g+0.67 g) given as reesterified triacylglycerides (rTAG group); (2) corn oil (placebo group) or (3) fish oil concentrate with EPA+DHA (1.01 g+0.67 g) given as ethyl ester (EE group). Volunteers consumed four gelatine-coated soft capsules daily over a period of six months. The omega-3 index was determined at baseline (t(0)) after three months (t(3)) and at the end of the intervention period (t(6)).

RESULTS: The omega-3 index increased significantly in both groups treated with n-3 FAs from baseline to t(3) and t(6) (P<0.001). The omega-3 index increased to a greater extent in the rTAG group than in the EE group (t(3): 186 versus 161% (P<0.001); t(6): 197 versus 171% (P<0.01)).

CONCLUSION: A six-month supplementation of identical doses of EPA+DHA led to a faster and higher increase in the omega-3 index when consumed as triacylglycerides than when consumed as ethyl esters.

Original publication at PubMed



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