Fish Oil & Omega 3

Omega 3 supplements and cod liver oil are taken by millions of people every day as it has been suggested they are good for the heart, brain and joints, and the capsules are thought to work by improving the health of blood vessels, lowering cholesterol and reducing inflammation. Fish oil is the third most widely used supplement in the United States, with around 10 percent of Americans taking it regularly — often for the perceived benefit to cardiovascular health. Sales were about $1 billion in 2012.

A study by a team at Cambridge University and elsewhere took at 38 studies of varying designs and found that consumption of fish was associated with a reduced risk of stroke. Those eating two to four servings a week were six per cent less likely to suffer a stroke compared to those eating less, and those eating five or more portions of oily fish had a 12 per cent lower risk.

The researchers also looked at levels of omega 3 fatty acids in the blood and found there was no significant difference in stroke risk of those with the highest levels compared with the lowest.

The Health Effects Of Fish

Research into the protective health effects of oily fish began around the 1970s, when scientists homed in on polyunsaturated fat intake. That’s when a landmark study from Denmark revealed low rates of coronary artery disease and diabetes among indigenous Greenlanders with a fish-rich diet.

From that point on, the scientific community quickly began building a case for the link between fish consumption and good health. Later research identified the polyunsaturated omega-3 fatty acids (EPA and DHA, primarily) as the beneficial silver bullet; these are found in high concentrations in such oily fish as sardines, mackerel, and herring. The findings implied that omega-3s from fish lowered blood levels of triglycerides, potentially reducing the risk of conditions like heart disease and cancer.

Additional data over the ensuing decades appeared to support these claims, and by the mid-1990s, the American Heart Association was all in. In 1994, it staged a conference about the therapeutic benefits of omega-3 fatty acids. Supplement companies took notice.

The Omega-3 Capsule

Americans really don’t do oily fish. Average intake of omega-3-rich fish among U.S. men is a measly 1.4 ounces a week (a 2014 Nutrition Journal study found). Some guys may not like the taste; others might think fish is too expensive, too smelly, or too complicated to cook.

So the supplement industry, sensing an untapped market, decided to address those concerns. The result: a convenient capsule that delivered the goods in one easy swallow. Later the formula was refined to eliminate the fish burps of early omega-3 supplements.

Supplement producers started sending out fleets of warship-size trawlers to harvest omega-3-rich fish. They brought in lobbyists to push legislation that would codify the benefits of fish oil into federal product labeling guidance. Those efforts proved so successful that by 2004, the FDA allowed dietary fish oil supplement labels to state that the capsules may reduce coronary heart disease risk.

The government’s optimism remained guarded, however; the FDA stated that the research was “not conclusive.” But that disclaimer did little to stem the tide of American consumers hungry for omega-3s in a capsule—or companies that were eager to deliver it to them.

Over-the-counter supplements

One concern is that over-the-counter supplements may not deliver the fish oil dosage promised on the label. In fact, of 32 commercially available supplements analyzed by researchers in Australia and New Zealand in 2014, only three had levels of EPA and DHA equal to or greater than those advertised on the label. What’s more, two-thirds of the research samples contained less than 67 percent of the EPA and DHA advertised.

Labdoor analyzed 52 best-selling fish oil supplements in the United States, measuring total omega-3 content, EPA and DHA quantities, vitamin D and CLA amounts, methylmercury concentration, and total oxidation values. 357 analytical chemistry assays on the 52 best-selling fish oil supplements in the United States.

Label accuracy was a major issue for fish oil supplements. Total omega-3 content ranged from -60.0% to +62.5% versus their stated label claims.

So how does this happen? Scientists speculate that in the production process, fish oil may become exposed to the air. This exposure can result in oxidization, reducing the total EPA and DHA concentration of the oil. In fact, some liquid gels contain additional flavorings meant to mask the telltale rancid odor of oxidized fish oil, according to a 2014 report published by Consumer Lab.

Fish oils, like any nutritional supplement, are not regulated by the FDA the way prescription drugs are, so you can never be quite sure of what you’re getting. That doesn’t necessarily mean they’re dangerous; it just means you might not be getting all you’ve paid for.

These labels can be confusing, They make it sound as though dietary fish oil supplements are some sort of approved omega-3 fatty acid medication, but they’re not. They’re not intended to prevent or treat disease.

Prescription Omega-3 Fatty Acids

The FDA has approved high-dose prescription omega-3 fatty acid products for reducing very high triglyceride levels in adults. Dietary supplement fish oils are not equivalent to nor should they be used in lieu of prescription omega-3 fatty acid products.

And even if your supplement does deliver the right dose, you may not be receiving all the promised health benefits.

Yes, some smaller studies have revealed heart health benefits, but the bulk of the research has yet to prove that nonprescription supplements can reduce the risk of cardiovascular-related death, delay cognitive decline, ease depression, or prevent prostate cancer—four of the most promising claims regarding omega-3s.

Many of fish oil’s earlier touted benefits have not been replicated in large randomized controlled clinical trials. The hype exceeds the science.

What the Original Research Missed

When you look at the entirety of omega-3 research, one thing sticks out: Most of the data on the benefits of omega-3s came from studies that looked at consumption of fish, not fish oil supplements. Only recently have the supplements been studied in a more comprehensive way, and the results raise worrisome questions.

Eating fish not fish oil capsules linked to lower risk of stroke.

Fish oil supplements taken by millions for their health benefits do not reduce the risk of a suffering a stroke, a study has found . However eating oily fish at least twice a week may have a significant impact, they found.

Or eating large quantities of fish each week means people eat less red meat and other foods that are relatively unhealthy as far as vascular health is concerned and lastly that people who eat a lot of fish are generally healthier than those who eat less or take supplements.

The research looked at people who had established heart disease and healthy people without.

The apparent health benefits of oily fish over white fish may simply be down to the way it is cooked, the researchers wrote in the British Medical Journal, as white flesh fish tends to be battered a fried, making it less healthy.

In an accompanying editorial, authors from the Division of Human Nutrition at Wageningen University suggest that although it is “reasonable” to advise patients that eating one or two portions of fish per week could reduce the risk of coronary heart disease and stroke, any benefit of long chain omega 3 fatty acid supplementation is likely to be small.

They say it is possible, however, that patients with additional risk factors such as diabetes may benefit.

Dr. Peter Coleman, Deputy Director of Research at the Stroke Association said: “From past research we know that eating plenty of fish is good for our general health. This research shows that it could also help to protect us against stroke. However, it’s interesting to see that taking fish oil supplements doesn’t have the same beneficial effect.”

“People who eat lots of fish may have healthier diets in general which could go some way to explain the results. However a lot more research is needed in this area before we decide to eat fish every day of the week.

“Everyone can reduce their risk of stroke by exercising regularly, consuming a healthy, balanced diet and getting your blood pressure checked.”

What Should You Do Now?

More long-term research is needed to see if over-the-counter omega-3 supplementation can live up to the buzz. For now, if you want the preventive benefits of omega-3s, especially for your heart, your best bet is to eat real fish.

Studies show that generally healthy people who eat more fish and have good blood levels of omega-3s have a lower risk of fatal heart disease. Omega-3 effects in controlled trials include several benefits: improved heart rate, enhanced blood vessel function, and greater oxygen flow to the heart itself.

Plus, fish is an excellent source of protein, vitamins, and minerals, and it’s lower in calories than many other protein-rich foods. Fish is more than just omega-3s, it also contains zinc, important amino acids, and vitamin D.

If you regularly eat fatty fish, supplementation isn’t necessary.

Still not biting because of the taste or smell? The good news is that you don’t have to subsist entirely on anchovies and sardines. A variety of fish species, with diverse flavor profiles, pack a wallop of omega-3s.

And don’t let concerns about mercury in seafood dissuade you from eating it. A JAMA review found that the heart health benefits of fish outweigh the risks associated with consuming toxins found in some fish. If you’re still worried, eat smaller seafood (try shrimp or sardines), which don’t carry the toxin load of larger swimmers (like swordfish).

So here’s the bottom line for the average guy: Eat at least two servings of fish that are high in omega-3s each week and cook them in a healthy way to avoid loading up on excess calories.

If you just can’t stomach a fish-forward diet, ask your doctor if you might need a prescription for omega-3s to make up for the lack of seafood on your plate. But that should be a last resort.