Minyak Ikan & Omega-3: Khasiat, Dos & Semasa Mengandung

Minyak ikan (fish oil) contains two omega-3 fats, EPA and DHA, that your body cannot easily make on its own. Its clearest benefit is lowering triglycerides, by about 15%. In pregnancy, omega-3 supplements lowered the risk of early preterm birth in a large review, and omega-3 helps the baby’s nervous system develop. For most healthy adults, eating fish at least twice a week, including one oily fish such as ikan kembung, sardin or salmon, is a good start. A typical 1,000 mg capsule gives only about 300 mg of EPA plus DHA, so read the label. Pregnant women should avoid fish liver oil (cod liver oil) and high-mercury fish such as shark.

Apa itu omega-3 dan minyak ikan?

Omega-3s (omega-3 fatty acids) are a kind of fat found in foods and in the human body (NCCIH). There are three main types:

• ALA (alpha-linolenic acid), found in plant foods such as flaxseed, chia seeds, walnuts, and soybean and canola oils (NCCIH);
• EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), found in seafood, especially oily fish, and in fish oil supplements (NCCIH).

Your body must get ALA from food, because it cannot make it (NIH ODS). It can turn some ALA into EPA and DHA, but only a little, with reported rates of less than 15%. So eating EPA and DHA directly from food or supplements is the only practical way to raise their levels in the body (NIH ODS). Most research on the health effects of omega-3s has focused on EPA and DHA (NCCIH).

Several types of supplements contain omega-3s (NCCIH):

In Malaysia, many people do not get enough omega-3. A Malaysian review found that daily omega-3 intake was well below the Malaysian Recommended Nutrient Intake (RNI) in the groups studied, and in a Seremban health clinic study of pregnant and breastfeeding women, 92% did not meet the RNI for omega-3 (Ng 2012). The authors noted that local foods are not especially rich in EPA and DHA (Ng 2012).

Khasiat minyak ikan: apa kata kajian

Fish oil is one of the most studied supplements. Some benefits are well supported, while others are still uncertain:

Fish oil and heart health in more detail. In the REDUCE-IT trial, people with heart disease, or with diabetes and other risk factors, who were already on a statin and had raised triglycerides took 4 g a day of a purified prescription form of EPA called icosapent ethyl. Over about 5 years, 17.2% had a major heart or blood vessel event, compared with 22.0% on placebo (Bhatt 2019). This is a prescription medicine at a high dose, so its effects may not be the same as those of ordinary fish oil capsules (NCCIH). If you have high triglycerides or heart disease, ask your doctor whether an omega-3 medicine is right for you. Read more in our guides to kolesterol tinggi (high cholesterol) and serangan jantung (heart attack).

Some of the benefits of eating seafood may come from other nutrients in fish, or from eating fish in place of less healthy foods (NCCIH). This is one reason food is usually the first step. For mental health, omega-3 is not a replacement for treatment; see our guides to kemurungan (depression) and ADHD.

Makanan tinggi omega-3

Oily fish are the richest source of the long-chain omega-3s EPA and DHA (NHS). Oily fish include salmon, sardines, mackerel, herring, trout and pilchards; fresh and canned tuna do not count as oily fish (NHS). Some shellfish, such as oysters and crab, also contain omega-3, but less than oily fish (NHS).

The table below shows how much omega-3 is in common foods. The fish values are for the types listed; local fish such as ikan kembung (Indian mackerel) are oily fish too, but their exact content may differ.

Source: NIH Office of Dietary Supplements, based on USDA data.

How much fish to eat. The Malaysian Food Pyramid 2020 suggests 1 serving of fish a day as part of a balanced diet (KKM). The NHS recommends at least 2 portions of fish a week, including 1 of oily fish, where a portion is about 140 g. In everyday Malaysian meals, that could be ikan kembung bakar or asam pedas, sardin on bread, or steamed salmon. Fish also contains other nutrients, such as vitamin D; see our guide to kekurangan vitamin D.

Dos omega-3 sehari

There is no single official daily amount for EPA and DHA. The US Institute of Medicine set adequate intakes for ALA only, and did not set specific amounts for EPA or DHA (NIH ODS). Here is what different sources suggest for women:

Read the label carefully. A typical fish oil supplement provides about 1,000 mg of fish oil, which contains about 180 mg of EPA and 120 mg of DHA, but doses vary widely (NIH ODS). So a “1,000 mg” capsule gives about 300 mg of EPA plus DHA, not 1,000 mg. Add up the EPA and DHA on the label to know what you are really taking.

How much is too much? The European Food Safety Authority says long-term use of EPA plus DHA supplements at up to about 5 g a day appears safe, and the US FDA has concluded that supplements giving no more than 5 g a day of EPA and DHA are safe when used as recommended (NIH ODS). However, the risk of atrial fibrillation rose at doses above 1 g a day in large trials (Gencer 2021), so higher doses are best taken only on a doctor’s advice.

Omega-3 semasa mengandung dan menyusu

Long-chain omega-3 is important during pregnancy and breastfeeding because it helps the baby’s nervous system develop (NHS). Here is what the evidence shows:

• Preterm birth. A Cochrane review of 70 trials with almost 20,000 women found that omega-3 lowered preterm birth before 37 weeks (13.4% vs 11.9%) and early preterm birth before 34 weeks (4.6% vs 2.7%). It also lowered the risk of a low-birthweight baby (Middleton 2018).
• A small trade-off. In the same review, pregnancies lasting beyond 42 weeks were probably slightly more common with omega-3 (2.6% vs 1.6%), and there was no clear effect on depression after birth (Middleton 2018).
• The baby’s development. There is limited evidence that omega-3 supplements in pregnancy improve a child’s thinking skills, and not enough evidence for effects on language, behaviour or ADHD risk (NCCIH).

How much in pregnancy? A 2024 guideline supported by several medical organisations advises pregnant women to get an extra 100 to 200 mg of DHA a day on top of the usual 250 mg of EPA plus DHA. Women with a low DHA intake, for example those who rarely eat oily fish, have a higher risk of preterm birth and should get about 600 to 1,000 mg of EPA plus DHA a day. This extra supply should preferably start in the second trimester, no later than about 20 weeks, and continue until about 37 weeks (Cetin 2024). Ask your doctor or the klinik kesihatan whether this applies to you.

Important pregnancy rules:

• Avoid fish liver oil (such as cod liver oil) while pregnant or trying for a baby, unless your doctor advises otherwise. It is high in vitamin A (retinol), which can harm your unborn baby (NHS).
• Eat oily fish, but not more than 2 portions a week, because oily fish can contain pollutants that build up in the body (NHS). This applies to all women who have not reached menopause.
• Do not eat shark (ikan yu), swordfish or marlin if you are pregnant or trying to get pregnant, because they contain more mercury (NHS).
• Limit tuna to no more than 4 medium cans or 2 tuna steaks a week if you are trying for a baby or are pregnant (NHS).
• Keep taking folic acid. Omega-3 does not replace folic acid; see our guide to folic acid for pregnancy.

Breastfeeding. The US FDA and EPA advise pregnant and breastfeeding women to eat 8 to 12 ounces (about 225 to 340 g) of a variety of lower-mercury fish each week, which is 2 to 3 servings from the “Best Choices” list (FDA). When breastfeeding, there is no limit on tuna, but the limit of 2 portions of oily fish a week still applies (NHS). If you are planning a pregnancy, read our guide to cara cepat hamil, and if you think you may be pregnant, see tanda-tanda mengandung.

Ikan dan merkuri: apa yang selamat

Some fish contain methylmercury, which can harm the brain and nervous system if a person is exposed to too much (NCCIH). This matters most for pregnant and breastfeeding women and young children. The US FDA sorts fish into three groups:

Source: FDA/EPA advice about eating fish. Malay names are common equivalents; check with the seller if you are unsure of the species.

Do fish oil supplements contain mercury? Omega-3 supplements have not been found to contain methylmercury, because it is removed during processing and purification (NIH ODS).

Kesan sampingan dan siapa perlu berhati-hati

Side effects of omega-3 supplements are usually mild (NCCIH; NIH ODS):

• an unpleasant taste or fishy breath;
• bad-smelling sweat;
• headache;
• heartburn, nausea, stomach discomfort or diarrhoea.

Talk to your doctor or pharmacist before taking fish oil if you:

• take a blood thinner such as warfarin. Fish oil can reduce blood clotting at high doses and might raise the INR with warfarin, although most research found that 3 to 6 g a day did not significantly change warfarin control (NIH ODS). Your INR may need checking.
• have heart rhythm problems. In large trials, omega-3 supplements raised the risk of atrial fibrillation by about 25%, and the risk was higher at doses above 1 g a day (Gencer 2021).
• are pregnant, trying for a baby or breastfeeding, especially before taking fish liver oil or a high-dose product (NHS).
• have a fish or shellfish allergy, or take other regular medicines.
• have high triglycerides or liver problems. A supplement is not a substitute for medical care; see our guide to hati berlemak (fatty liver).

Very high doses of EPA plus DHA, at 4 g a day, also raised LDL cholesterol in people with very high triglycerides (Skulas-Ray 2019), which is another reason to take high doses only with medical advice.

Cara pilih suplemen minyak ikan di Malaysia

1. Check that it is registered. In Malaysia, registered products carry a number in the format MAL followed by digits and a letter. The letter N means a health supplement, and T means a natural or traditional product (NPRA). Registered products also carry a serialised NPRA security hologram (NPRA). You can search the registration number on the NPRA website.
2. Look at EPA and DHA, not just “fish oil”. A 1,000 mg fish oil capsule usually gives about 300 mg of EPA plus DHA (NIH ODS). A more concentrated product may let you take fewer capsules.
3. Choose the right type for you. Pregnant women should choose fish oil rather than fish liver oil (NHS). Vegetarians can choose algal oil (NCCIH).
4. Check the total dose. Add up all your supplements, and keep below 5 g a day of EPA plus DHA unless your doctor advises otherwise (NIH ODS).
5. Be wary of big promises. No supplement cures heart disease, depression or ADHD. Treat claims that sound too good to be true with caution, and ask a pharmacist if you are unsure.

Remember that food comes first. If you already eat oily fish two or three times a week, you may not need a supplement at all. If you rarely eat fish, are pregnant or have high triglycerides, a supplement may help; discuss it with your doctor, pharmacist or dietitian.

Frequently asked questions (FAQ)

Apa khasiat minyak ikan (what are the benefits of fish oil)?

The clearest benefit is lowering triglycerides: EPA and DHA from fish oil reduce triglycerides by about 15% (NCCIH). In pregnancy, omega-3 supplements lowered the risk of early preterm birth (before 34 weeks) by 42% in a large Cochrane review (Middleton 2018). For heart health, increasing EPA and DHA slightly reduced coronary events and coronary deaths in a review of 86 studies (NCCIH). Evidence is weaker or mixed for depression, ADHD, dry eye and memory.

Berapa dos omega-3 sehari (how much omega-3 should I take a day)?

There is no single official daily amount for EPA and DHA. A 2024 guideline advises women of childbearing age to get at least 250 mg of EPA plus DHA a day from food or supplements, plus another 100 to 200 mg of DHA a day in pregnancy (Cetin 2024). For the plant omega-3 ALA, the US adequate intake for women is 1.1 g a day, 1.4 g in pregnancy and 1.3 g when breastfeeding (NIH ODS). Higher doses for high triglycerides should be guided by a doctor.

Minyak ikan untuk ibu mengandung selamat ke (is fish oil safe in pregnancy)?

Ordinary fish oil can be used in pregnancy, and omega-3 supplements have not been found to contain mercury because it is removed during processing (NIH ODS). A 2024 guideline recommends extra DHA in pregnancy and suggests pregnant women with a low DHA intake take about 600 to 1,000 mg of DHA plus EPA a day, ideally from no later than about 20 weeks until about 37 weeks (Cetin 2024). Avoid fish liver oil such as cod liver oil, which is high in vitamin A (NHS). Check any supplement with your doctor or pharmacist.

Apa beza minyak ikan dan minyak hati ikan kod (fish oil vs cod liver oil)?

Fish oil is made from the flesh of oily fish and contains EPA and DHA. Fish liver oil, such as cod liver oil, also contains EPA and DHA, but it adds vitamins A and D in amounts that vary between products, and these vitamins can be harmful in excess (NCCIH). If you are pregnant or trying for a baby, avoid fish liver oil unless your doctor advises otherwise, because vitamin A (retinol) can harm the baby (NHS).

Ikan apa yang tinggi omega-3 (which fish are high in omega-3)?

Oily fish are the richest sources, including salmon, sardines, mackerel, herring, trout and pilchards (NHS). In Malaysia this includes ikan kembung (a type of mackerel), sardin and salmon. A 3-ounce (85 g) serving of cooked farmed salmon has about 1.8 g of EPA plus DHA, and canned sardines about 1.2 g, while canned light tuna has only about 0.2 g (NIH ODS). Fresh and canned tuna do not count as oily fish (NHS).

Apa kesan sampingan minyak ikan (what are the side effects of fish oil)?

Side effects are usually mild: an unpleasant taste, fishy breath, bad-smelling sweat, headache, heartburn, nausea, stomach discomfort and diarrhoea (NCCIH; NIH ODS). In large trials, taking omega-3 supplements was linked with a higher risk of atrial fibrillation, an irregular heartbeat, and the risk was greater at doses above 1 g a day (Gencer 2021). Tell your doctor if you have heart rhythm problems.

Boleh makan minyak ikan dengan ubat cair darah (can I take fish oil with blood thinners)?

Talk to your doctor first. Fish oil can reduce blood clotting at high doses, and it might raise the INR when taken with warfarin, although most research found that 3 to 6 g a day did not significantly change warfarin control (NIH ODS). Prescription omega-3 product leaflets advise checking the INR regularly in people taking anticoagulants (NIH ODS).

Minyak ikan boleh turunkan kolesterol ke (does fish oil lower cholesterol)?

Fish oil mainly lowers triglycerides, not LDL cholesterol. A review of 23 studies found that EPA and DHA reduce triglycerides by about 15% but do not affect other blood fats (NCCIH). At prescription doses of 4 g a day, EPA plus DHA products lowered very high triglycerides by 30% or more but could raise LDL cholesterol (Skulas-Ray 2019). If your LDL cholesterol is high, ask your doctor about diet, exercise and cholesterol-lowering medicine.

Apa sumber omega-3 untuk vegetarian (what are vegetarian sources of omega-3)?

Plant foods such as flaxseed (biji rami), chia seeds, walnuts, and soybean and canola oils contain ALA (NCCIH). The body turns only a small amount of ALA into EPA and DHA, with reported rates of less than 15% (NIH ODS). Algal oil supplements, made from algae, are a vegetarian source of DHA, and some also contain EPA (NCCIH).

Bagaimana pilih minyak ikan yang baik di Malaysia (how do I choose a fish oil supplement in Malaysia)?

Choose a product registered with the National Pharmaceutical Regulatory Agency (NPRA). Health supplements carry a registration number starting with MAL and including the letter N, and registered products carry an NPRA security hologram (NPRA). Then check how much EPA and DHA each capsule gives, not just the fish oil amount: a typical 1,000 mg fish oil capsule provides about 180 mg EPA and 120 mg DHA (NIH ODS). If you are pregnant, avoid fish liver oil (NHS).

Disclaimer

This article is for general information only and is not a substitute for advice from a doctor, pharmacist or dietitian. Check with a health professional before taking a supplement, especially if you are pregnant, planning a pregnancy, breastfeeding, have a medical condition or take regular medicines such as blood thinners.

References

• Omega-3 Fatty Acids: Fact Sheet for Health Professionals — NIH Office of Dietary Supplements (NIH ODS)
• Omega-3 Supplements: What You Need To Know — National Center for Complementary and Integrative Health (NCCIH)
• Fish and shellfish — NHS
• Foods to avoid in pregnancy — NHS
• Advice about Eating Fish — U.S. Food and Drug Administration (FDA)
• General Conditions for Registration of Drug Products (registration number and product authentication) — National Pharmaceutical Regulatory Agency (NPRA), Malaysia
• Malaysian Food Pyramid 2020 — Ministry of Health Malaysia (KKM)
• Ng TKW, Nalliah S, Hamid A, et al. Omega-6 and omega-3 fatty acid nutrition amongst Malaysians are far from desirable. IeJSME. 2012;6(2):4-9.
• Middleton P, Gomersall JC, Gould JF, et al. Omega-3 fatty acid addition during pregnancy. Cochrane Database Syst Rev. 2018;11(11):CD003402.
• Cetin I, Carlson SE, Burden C, et al. Omega-3 fatty acid supply in pregnancy for risk reduction of preterm and early preterm birth. Am J Obstet Gynecol MFM. 2024;6(2):101251.
• Manson JE, Cook NR, Lee IM, et al. Marine n-3 fatty acids and prevention of cardiovascular disease and cancer (VITAL). N Engl J Med. 2019;380(1):23-32.
• Bhatt DL, Steg PG, Miller M, et al. Cardiovascular risk reduction with icosapent ethyl for hypertriglyceridemia (REDUCE-IT). N Engl J Med. 2019;380(1):11-22.
• Gencer B, Djousse L, Al-Ramady OT, et al. Effect of long-term marine omega-3 fatty acids supplementation on the risk of atrial fibrillation in randomized controlled trials of cardiovascular outcomes: a systematic review and meta-analysis. Circulation. 2021;144(25):1981-1990.
• Skulas-Ray AC, Wilson PWF, Harris WS, et al. Omega-3 fatty acids for the management of hypertriglyceridemia: a science advisory from the American Heart Association. Circulation. 2019;140(12):e673-e691.
• Dry Eye Assessment and Management Study Research Group. n-3 fatty acid supplementation for the treatment of dry eye disease (DREAM). N Engl J Med. 2018;378(18):1681-1690.
• Appleton KM, Voyias PD, Sallis HM, et al. Omega-3 fatty acids for depression in adults. Cochrane Database Syst Rev. 2021;11(11):CD004692.