In a study by Rapaport et al., on the use of EPA in major depression there is this sentence in the abstract, ‘While overall treatment group differences were negligible (ES=−0.13 to +0.04), subjects with any “high” inflammation improved more on EPA than placebo…’ That is a very tepid positive take.
EPA enteric coated softgels do not work. EPA + DHA softgels must be bitten, the contents swallowed and then softgel capsules thrown away for EPA + DHA to work against major depression
ProEPAxtra was the EPA product used in the Rapoport study. Here is an ad for ProEPAxtraon Amazon. The ad does not explicitly state that the softgel is enteric coated, however, the ad states ‘no fishy aftertaste’ and ‘better absorbed’ both of which are warnings than the soft gel could have some sort of enteric coat. Enteric coated fish oil soft gel capsules appear to be frosty or dull. The softgels in the ad appear to be dull in appearance. The quality of the fish oils themselves is not being questioned.
If supplements are not available in the gastrointestinal tract this cannot but affect gut microbiota differently compared to supplements that are available in the gastrointestinal tract. I am open to the possibility that differences in gut microbiota can play a big role in mental states, however, the gut could also be set up so the gut has to use nutrients when nutients first pass through the gut. Use of nutrients by the gut could be a necessary first step in the use of nutrients systematically.
There is a lot of talk about how the diet of our very distant ancestors is the diet that is appropriate for us. One thing is certain about the diet of our very distant ancestors. Our very distant ancestors did not take nutrients than were formulated not to be available in the gut.
Only taking supplements that are available in the gut, when taking supplements, is one way to address to address gut microbiota positively. As an example EPA + DHA combinations are frequently supplied in enteric coated softgels to avoid ‘fishy smells’. However, biting on the softgels, swallowing the contents and then throwing the softgels away works much better for depression. And what is more even given EPA + DHA work in clinical trials EPA + DHA will not work in the field as EPA + DHA supplements sold in stores are very frequently enteric coated.