Questions regarding the hype over fish-oil supplements have started trickling into my Inbox lately, so many that I feel it’s time to take a concentrated look at these supposed miracle pills. In a nutshell, the capsules claim to replicate the heart-healthy benefits of a diet rich in omega-3 fatty acids, like one that includes two servings of fatty fish (like salmon or halibut) each week.
Fish Oil Basics
There are two kinds of omega-3 fatty acids found in fish that are directly linked to improving heart health: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). The clinical studies and guidelines from the American Heart Association suggest that the combination of omega-3s naturally found in fish can decrease VLDL (bad cholesterol) and triglycerides and possibly increase HDL (good cholesterol). According to the American Heart Association, some people diagnosed with Coronary Heart Disease may benefit from 1 gram of EPA+DHA per day. For someone needing to lower high triglyceride levels, 2 to 4 grams of EPA+DHA per day, taken in capsule form and under a physician’s supervision, may be prescribed. These amounts of EPA+DHA are higher than what is typically found in the average fish oil supplement on store shelves.
And note, megadosing fish oil may not be a good idea - just like it's not a good idea with vitamins and minerals. Any person taking more than 3 grams of omega-3's per day needs to be careful. Part of the reason fish oil reduces heart attack and stroke risk is that the fats have a mild blood thinning effect. In some people, megadosing can potentially thin the blood too much.
Did You Know? The body can metabolize omega-3 fatty acids from plant sources (soybeans, canola, walnut and flaxseed, and their oils) out of another kind of fat, -linolenic acid (LNA). However, in my opinion, the heart-health benefits of LNA-based omega-3 fatty acids require further research before we can say that plant- and fish-based omega-3 fatty acids are interchangeable. If you're a vegetarian or vegan, however, LNA is an important source of fatty acids.
To Supplement or Not?
As the sports dietitian at CTS, the facts above don’t change my stance: You’re better off getting these fats from two servings a week of a fatty fish such as salmon, mackerel, lake trout, herring, sardines, or albacore tuna. In addition to the omega-3 fatty acids, you’ll also consume an excellent source of protein. If you're in good health and eat this much fish, a fish oil supplement won't hurt you, but may not be necessary.
However, I will be the first to admit that I don’t always get around to eating two servings of fish each week. I’m sure many of you are in the same boat, and others who just don't like fish. If you don't eat enough fish, a low-dose supplement of EPA + DHA via fish-oil capsules is a good idea. And vegetarians should consider EPA + DHA supplements (as fish oil or from plant sources if you're vegan), as it can be difficult to get enough of these fatty acids from a vegetable-based diet.
Note: Although there was a widely-publicized attempt to increase the weekly fish consumption guidelines in 2007, several groups, including the FDA, opposed the change. It turned out the fishing industry had played a role in the research supporting the proposed new guidelines. From the standpoint of safety from mercury and heavy metals, the FDA still recommends limiting consumption to 12 ounces a week. From the standpoint of preventing heart disease, the American Heart Association still recommends consuming at least 8 ounces a week. Hence, the overall guideline of 8-12 ounces of fish per week.
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