South Asians frequently have elevated triglycerides (a form of cholesterol) and a high rate of death from heart attacks. Fortunately, omega-3 fatty acids found in fish and fish oil supplements can help reduce triglycerides and decrease heart attack risk. Recent evidence also suggests that omega-3s lower blood pressure.

What are omega-3s?

Omega-3 fatty acids are the healthy oils found in fatty fish, such as salmon, sardines, herring, trout and mackerel. The two main omega-3s are abbreviated as DHA and EPA. Research links both DHA and EPA with triglyceride-lowering properties and heart protection.

Alpha-linolenic acid (ALA) is a plant-based omega-3 found in flaxseed, canola oil, walnuts and green leafy vegetables such as spinach. However, your body converts less than 5 percent of ALA into DHA and EPA, so it shouldn’t be your sole source of omega-3s in the diet, especially if you are looking for heart-protective benefits. Some supplements contain DHA from algae, a vegetarian source of omega-3 fatty acids, but no long-term studies of these DHA products exist.

How much fish should I eat?

The American Heart Association recommends eating at least two servings of fish per week. Predatory fish, such as ahi tuna, shark, swordfish, tilefish and king mackerel are high in mercury, so eat those in moderation, especially if you’re pregnant. Refer to the EPA website for specific recommendations.

What about fish oil capsules?

Fish oil capsules are an excellent way to get omega-3s’ heart-healthy benefits. Most over-the-counter fish oil capsules contain about 30 percent heart-healthy DHA and EPA, and 70 percent other fish oils. That means a typical capsule containing 1,000 milligrams of fish oil provides 300 milligrams of DHA and EPA.

For heart protection, a typical dose of 250-300 mg of DHA and EPA is sufficient. Read the label to verify the amount of DHA and EPA in each capsule. As always, talk to your doctor before starting fish oil supplements; studies on the health benefits are ongoing and subject to change.

Do fish oil capsules have any side effects?

The most common side effects are nausea, stomach upset and a “fishy burp.” Slowly build up to the recommended doses. For example: Start with one capsule at your largest meals (two per day). If you don’t experience any side effects after a couple of weeks, increase by one capsule at your largest meals (four per day) for a few weeks. If labs indicate you need higher doses and you can tolerate more, increase again by one capsule per day.

To reduce burping and improve adherence, take capsules at bedtime or with meals, keep capsules in the freezer or use enteric-coated products.