If you are confused about fish oil supplements these days, it’s not surprising. Recent news stories suggest that these popular supplements may not be all they’re cracked up to be.
Large groups of people, such as those living in Japan who eat high levels of omega-3 fatty acids (the type of fats found in fish oil supplements) over long periods of time, have a lower risk of heart disease than people on a typical American diet. Capsules containing important omega-3 fatty acids called eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been used to lower inflammation and improve heart health for many years. These fats, which are found in fish and other seafood, play important roles in the heart, blood vessels, and brain and may also help your body fight cancer.
Research has shown that omega-3 supplements help lower the risk of heart attacks, reduce heart rhythm problems, and reduce the risk of dying from heart failure. They are particularly good at lowering levels of triglycerides—a type of “bad” fat in your blood.
But several recent review studies—ones that combine the results of other older studies—seem to show supplements don’t have much, if any, effect on the risk of heart attacks and strokes, or death from heart disease.
How can you make sense of the new information?
The National Lipid Association has looked at the quality of the previous studies being reviewed and found some flaws that raise serious questions. A review study is only as good as the quality of the research studies being reviewed. Studies, for example, that last only 6-12 weeks, can show short term benefits, such as triglyceride lowering. But it takes years to show long term benefits. Also, many of those that showed no strong benefits for the heart used much lower doses of EPA and DHA than some of the more positive studies.
There are 2 studies now in progress that are using higher doses of omega-3 fatty acids. One is called REDUCE-IT and the other the STRENGTH trial. Remember it is the dose of omega-3 fatty acids, how long the study lasts (years rather than weeks) and the stage of heart disease present that will affect the results. For example, the STRENGTH trial will monitor the effects of 4 grams of omega-3 fatty acids in 13,000 people over 3-5 years.
There’s probably no harm in taking omega-3 supplements and they may be good. As always, talk to your healthcare provider about whether a fish oil supplement containing EPA and DHA is right for you, keeping in mind that eating fish can provide these healthy fats naturally. The Federal Government’s Dietary Guidelines for Americans recommends that all adults eat at least 8 or more ounces of a variety of seafood (fish or shellfish) every week. Fish with high levels of these good fats include Atlantic salmon, mackerel, sardines, and trout.
Cleveland HeartLab’s OmegaCheck™ test can help tell you where you stand on the heart-healthy EPA and DHA omega-3 fats. It can be particularly helpful if your triglyceride levels are high.