Fish oil supplements are the third most popular nutritional supplement. But just how firm is the evidence to support their use?
The idea that fish oil and omega-3s are good for your heart has been nutrition orthodoxy for decades. A few dissonant voices have argued that this particular emperor has no clothes. But they have largely been drowned out by the crowd. The American Heart Association recommends a fish oil supplement for those who don’t eat the recommended two 0r more servings of fish per week. And that’s basically everyone.
Fish oil supplements are now the third most popular nutritional supplement. There have been concerns about possible contaminants in commercial fish oil supplements, as well as the negative effects of over-fishing in order to produce enough fish oil to meet the demand. But the presumed benefits have largely overshadowed these concerns. But just how firm is the evidence to support their use?
What's the Evidence on Fish Oil?
Epidemiological studies have found that people who eat more fish and/or take in more omega-3s have lower rates of death from cardiovascular and other diseases. Randomized trials have established that fish oil supplements reduce inflammation and lower triglycerides. But as recently as 2010, authors of a scholarly article on “Fish oil for the Treatment of Cardiovascular Disease” conceded that “The role of omega-3 fatty acids in reducing mortality, sudden death, arrhythmias, myocardial infarction, and heart failure has not yet been established.”
That was 2010. Over the years following, trials showing that fish oil supplements did not, in fact, reduce the risk of heart attacks or death began to pile up. And just this month, researchers published the results of a large meta-analysis looking at ten different clinical trials in which people with heart disease (or at high risk of developing it) took either fish oil supplements or a placebo. Overall, they could detect “no significant association with fatal or nonfatal coronary heart disease or any major vascular events” and concluded that there is “no support for current recommendations for the use of such supplements in people with a history of coronary heart disease.”
But what about people without a history or risk factors for heart disease? Could taking fish oil supplements keep them from developing heart disease? Unfortunately, that is a question that has not been well studied, in part because a trial to test this hypothesis would have to be very long and, therefore, extremely expensive.
The potential benefits of omega-3s are not limited to preventing heart disease. Omega-3s may also play a role in reducing the risk of depression and cognitive decline and can reduce pain and stiffness for people with arthritis and other inflammatory conditions.
A Whole Foods Approach
Personally, I don’t think we’ve overestimated the value of omega-3 fats. But we may have underestimated the benefits of getting our omega-3 from whole foods instead of supplements.