You have undoubtedly heard about the benefits of fish oil for heart health and longevity of life. No other supplements have recently attracted as much attention as fish oil. The global fish oil supplement market is rising and is expected to reach $4 billion (about $12 per person in the US) by 2022. It is estimated that Americans spend more than $1 billion (about $3 per person in the US) a year on fish oil supplements. So, what is this hype on fish oil, and does it live up to all the health benefit claims touted by the fish oil industry?
The benefits of fish oil were first discovered in the 1970s when a group of Danish scientists was studying the Inuit in Greenland. These scientists were intrigued by how healthy Intuits were despite their fatty diet. The scientists analyzed the Intuits’ blood for 2 years and found that it contained two fatty acids. They visited a U.S. Lipidologist (doctor who studies fatty substances, called lipids, in the blood). They were told that the fatty acids were eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
EPA and DHA are omega-3 polyunsaturated fatty acids. The seafood diet they ate was rich in EPA and DHA, which contributed meaningful health benefits. These 2 fatty acids are major components of fish oil supplements. Other common terms for EPA and DHA are “seafood-derived omega-3 fatty acids,” “marine omega-3 fatty acids”, and “long-chain omega-3 fatty acids”.
Fish oil supplements vs. food sources of fish oil
Omega-3 fatty acids, in both dietary and supplement forms, have numerous benefits for the heart and body metabolism. However, ingesting fish oil from dietary sources is always a healthier choice than taking supplements. Even though the two omega fatty acids, EPA and DHA, play a role in the benefits, it is the combination of these fatty acids along with vitamins, minerals and other molecules found in food sources that are needed to keep the heart, body metabolism, and overall immune system healthy. Fish, seafood, flax seeds, flaxseed oil, chia seeds, walnuts, canola oil and soy oil are food sources with omega-3 fatty acids. Fatty fish such as salmon, mackerel and trout, plus shellfish, such as mussels, oysters and crabs are all rich in omega-3 fatty acids.
Fish oil supplements are derived from small pelagic fish used for fish feed, from formulations produced by algae, or krill oil. They come in liquid, capsule and pill form. Different fish oil formulations contain variable amounts of EPA and DHA. These supplements are better taken with meals high in fat to reduce side effects such as nausea, “fishy taste and “upset stomach.
Benefits on heart and blood vessels
One of the major benefits of omega-3 fatty acids is a reduction in the blood triglyceride level and increase in the good cholesterol, known as high density lipoprotein cholesterol.
High triglycerides and low levels of good cholesterol contribute to an increased risk of heart attack and stroke.
Omega-3 fatty acids can modestly lower the systolic blood pressure (upper number) as well as diastolic blood pressure (lower number). This can be beneficial with hypertension, especially in people with moderate to severe high blood pressure.
Studies have shown that fish oil reduces the symptoms of Rheumatoid Arthritis, such as pain, morning stiffness and tenderness due to their anti-inflammatory properties. Rheumatoid arthritis is a chronic inflammatory condition that can cause joint pain, swelling and damage to the joints.
Benefits for cognition
High intake of food sources rich in omega-3 fatty acids, such as fish (salmon, mackerel), have shown to lower the risk of cognitive decline (declining ability to understand or memory). This benefit is not similarly seen with omega-3 supplements.
Less proven beneficial claims of fish oil
Fish oil and blood glucose levels
The claim that fish oil lowers the blood glucose level is uncertain. Although trials show a small reduction in HbA1C, fish oil supplements have not been proven to produce significant clinical benefits in people with type 2 Diabetes Mellitus.
Fish oil and eye disease
The evidence does not indicate that omega-3 fatty acids slow the progression of eye disease, called age-related macular degeneration. Age-related macular degeneration is an eye disease that worsens over time as you age, and causes loss in the center field of vision.
Fish oil and cancer
Earlier claims stated that fish oil reduces the risk of cancer. The evidence in a recent study shows that fish oil has not shown any decrease in the risk of cancer.
Fish oil and depression
It is still uncertain, based on the studies conducted so far, whether omega-3 fatty acids are beneficial for depression.
Fish oil and attention deficit hyperactivity disorder (ADHD)
There are conflicting results on the benefits of omega-3 fatty acids on ADHD, and it is uncertain whether there is any benefit.
How much is too much fish oil?
The Food and Drug Administration (FDA) advises that people should not exceed 3g per day of EPA and DHA combined, with up to 2g per day from dietary supplements. If you plan to take high dose, check with your doctor. High doses of fish oil may raise the risk of bleeding and stroke.
Interactions with fish oil
- Fish oil taken with blood thinners (anticoagulant and antiplatelet drugs) may increase the risk of bleeding.
- Fish oil can reduce vitamin E levels in the blood if consumed together.
- Some contraceptives may interfere with the triglyceride-lowering ability of fish oil.
Overall, supplements are not a better option than eating fish – baked or broiled. Other than omega-3 fatty acids, fish also contain good amounts of other nutrients, such as protein, iodine and vitamin D. Substituting a healthy diet with a handful of supplements does not always end up with the desired benefits. Eating a heart-healthy diet, engaging in regular physical activity, using good sleep hygiene, and pursuing other healthy lifestyle changes have more proven benefits.
You might incorporate these simple changes, to make sure you start eating healthily:
- Use smaller plates when eating for smaller portions.
- Avoid grocery stores’ center isles, which are mostly filled with processed foods and foods containing preservatives (chemicals or additives).
- Shop the outside perimeters of grocery stores where the freshest foods are displayed.
- Display your healthy foods in a prominent place.
“Let food be thy medicine, and medicine be thy food.”– Hippocrates
“You don’t have to cook fancy or complicated masterpieces – just good food from fresh ingredients.”– Julia Child