Fish oil. It is one of the most commonly used supplements these days, estimated to be taken by 19 million adults in the U.S. alone. In the media, claims of its health benefits are broad and ubiquitous, ranging from heart disease and cancer prevention to treatment of ADHD. However, while there is little doubt that a diet rich in omega-3 foods is beneficial, do fish oil supplements—which also provide omega-3 fats—confer the same benefits for your health? And what if you are currently on one or thinking about starting—what are the ‘right’ reasons for doing so and the potential risks to consider? And finally, what should you look for in a product?
In answering these questions today, I hope to equip you with the confidence to make the best decisions in regards to your health. If you haven’t yet and would like an introduction to omega-3 fats and their natural food sources, take a look at the first part of this article.
Heart Attacks and Strokes
Scientific bottom line: This is where some of the confusion lies, but as of now, there is no clear evidence that fish oil supplements help prevent heart attacks or strokes. Diets rich in omega-3 fats do, however.
Studies have shown that high doses of fish oil supplements (up to 4 grams/day) can significantly reduce triglyceride levels (high levels of which can lead to pancreatitis and heart disease) and is currently used as a prescribed treatment for this purpose. (Note: Such doses of fish oil should never be taken without the supervision of a physician.)
Both omega-3’s from food and fish oil supplementation can improve good HDL cholesterol. However, it has little effect on bad LDL cholesterol (and high supplement doses may actually increase LDL). Therefore, given its ‘neutral’ effect on cholesterol, fish oil supplements should not be taken solely for this purpose. If you are looking to naturally lower your cholesterol, this article will help.
Both dietary omega-3’s and fish oil supplementation have been shown to slightly improve blood pressure in people with high blood pressure.
A few studies suggest that in people who are at risk of having abnormal heart rhythms, both omega-3 from food and fish oil supplementation may reduce the risk of an fatal event.
There is evidence that the omega-3’s in fish as well as fish oil supplements may be modestly helpful in relieving symptoms of rheumatoid arthritis. In these studies, subjects reported briefer morning stiffness, less joint swelling and pain, and less need for anti-inflammatory drugs to control their symptoms.
Breast cancer: There is growing evidence that omega-3’s from diet as well as fish oil supplements may help slightly reduce the risk of breast cancer, but more studies are needed for this to be confirmed.
Colon cancer: A few studies show that the omega-3’s from fish intake and fish oil supplements are associated with a slightly lower risk of colon cancer in men…but not in women. Research, however, is still ongoing.
Prostate cancer: Studies are widely conflicting, with a few suggesting that increased omega-3 intake may actually increase the risk of prostate cancer, while others do not. As of now, this is inconclusive, and research is currently ongoing.
It is a well-establish fact that getting enough omega-3 fats during pregnancy and lactation is crucial for the developmental health of the fetus, and both omega-3’s from diet and fish oil supplements may improve the infant’s visual development and motor skills. There is also limited evidence suggesting that fish oil supplementation during pregnancy and breastfeeding may reduce the risk of childhood asthma and allergies.
While diets rich in omega-3 fats have been observed to reduce the risk of cognitive decline in older adults, the evidence for fish oil supplements is not as robust. Overall, findings indicate that fish oil supplementation does not affect cognitive function in healthy older adults or in people with Alzheimer’s disease. However, in people with mild cognitive impairment, fish oil supplementation may slightly improve cognitive functioning.
A limited number of studies suggest that omega-3 fats from food sources and fish oil supplements—especially those rich in EPA—may help improve some of the symptoms of anxiety and depression, but the evidence is currently weak. The data on the effect of fish oil on children with ADHD is similarly limited, although some suggest that it may help reduce symptoms of hyperactivity and inattention.
A few studies suggest that people who maintain diets rich in fatty fish are less likely to develop the advanced stages of age-related macular degeneration, while studies on fish oil supplements have not. However, it is still too early to tell, and research is ongoing.
Both diets rich in omega-3 fats and fish oil supplementation may be helpful in maintaining skin health and in improving psoriasis and certain types of dermatitis, but more studies are needed.
Fish oil (as well as fatty fish in extremely large amounts) can have an antiplatelet effect (like aspirin), prolonging the time it takes for your blood to clot. Therefore, if you are already taking aspirin, warfarin (Coumadin), clopidogrel (Plavix), or nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen or naproxen on a regular basis, taking fish oil supplements in combination technically may increase your risk of bleeding. The same goes for herbal supplements—some that are known to have ‘blood-thinning’ properties are ginkgo biloba, garlic, and saw palmetto.
With that said, the actual risk of a bleeding event depends largely on the dose of medications/supplements and fish oil you take. Although most research suggest that fairly large doses of fish oil (2-3 grams or more daily) are required before this effect becomes significant, if you take any of these medications or supplements, it is crucial that you let your doctor know, as he or she can help you weigh the potential health risks and benefits to decide what you should take and to adjust the dosages if necessary.
Other issues to consider:
If you find that you cannot incorporate enough fish into your diet to meet the daily goal (500 mg/day for adults), a fish oil supplement may be helpful. Things to consider when shopping for one:
Other types of omega-3 supplements:
Once purchased, store your supplements away from light, in a cool, dry place or a refrigerator. To ensure best absorption, take the supplement with your largest meal. As fish oil will eventually oxidize and go rancid, open a capsule once in a while to check the odor.
If you take several different daily supplements, the chart below can help you plan your regimen:
There is no question that a balanced diet consisting of seafood rich in omega-3 fats is beneficial. The question remains, though, whether omega-3 supplements are beneficial to the same degree. Therefore, the decision to use fish oil should always be made with your physician who can take into account your overall health, medical conditions, current medications, and potential risks. This is especially important if you are someone who is pregnant or breastfeeding, are on blood-thinning medications, or are allergic to seafood.
With that said, here’s to better health for better days!
*Like always, the information presented in this article is only for educational purposes and is not to be used in place of medical advice. Always have a discussion with your physician before starting any supplements, including fish oil.