There have been some grumblings among various health bloggers that the almighty fish oil might not be as good for you as once thought and in fact may be BAD for you. How dare they talk that way about my beloved fishy elixir of life. Of course I needed to take a look at what they are saying because new information is gained every day and staying on top of it all is tough business – especially as a physician.
What the fish oil naysayers are pushing
- Fish oil is no wonder supplement
- Fish oil is unstable and can cause damage in our body
- There aren’t really any benefits in ill or healthy folks
Let me address these one by one
Fish oil is no wonder supplement
Of course it isn’t. Did you think it was going to make you super human? As the director of Examine.com, the most well-known evidence-based website on supplements in the world, I want to emphasize that supplements are literally just supplements. They are never to replace a healthy lifestyle of diet, exercise, sleep, and stress management. However, if you are deficient in something due to a diet lacking in that nutrient, then supplementation may be necessary.
Forget the crazy claims that mega-dosing fish oil will make you lose fat and build muscle like crazy. That is nonsense and not backed by science.
Fish oil is unstable and can cause damage in our body
The molecular structure of fish oil does make it more unstable yes. Is this clinically relevant? I don’t know. There have been multiple experiments trying to test this theory. Here is one and here is another – there are many more. Without getting into the details of how they test this, let’s just say that the science isn’t perfect. Some studies go one way, others go another. I think it is reasonable to make the conclusion that mega-dosing as mentioned before is likely not a good idea.
There aren’t really any benefits in ill or healthy folks
It is true that in recent trials we haven’t seen a huge (or any) cardiovascular benefit in patients who already had heart disease. HOWEVER, many of them were already on potent pharmaceutical drugs, which may dampen the effect. There really hasn’t been a long-term study showing any heart health benefits in healthy folks, but this doesn’t mean that there are no benefits. This just means we don’t know.
Here is what we do know – Those who have the highest amount of the fatty acids in fish oil (EPA/DHA) floating around in their blood tend to have less heart disease amongst other things. Maybe those studies that didn’t show benefit should have looked at whether repleting the fish oil fatty acids (EPA/DHA) made a difference as opposed to just picking people based on risk factors. For example, vitamin D supplementation doesn’t do much unless you are deficient in the first place. Maybe fish oil is the same? Here is an awesome review that goes over this possibility. There was also JUST a big systematic review that showed similar findings.
So what is the take away?
If you want to know if you need more fish oil (EPA/DHA) in your life, why not just get tested? The Omega 3 Index is what I use and what is used in many studies. If you are still worried about fish oil supplements, then just eat wild fatty fish like salmon a couple times a week like my nephew does (he is 2 years old and a little fish eating fiend!). For more information on the various doses of fish oil and its benefits, checkout the Examine.com Fish Oil page.
