Do you take fish oil supplements? If the answer is yes, you should read this article!
What if you could take one pill and suddenly have better skin, more energy, and a healthier heart? That’s the promise that beckons us all every time we walk by the supplement aisle in a drugstore—packed with fish oil capsules, magnesium chews, jugs of collagen powder, and every letter of vitamin under the sun.
Yes, it’s tempting, so it’s no wonder that supplements are projected to turn into a $200 billion global industry by 2025.
As a superstar of the supplement aisle, fish oil is believed to have plenty of benefits for your heart health. But does it actually live up to the hype?
These little capsules of omega-3s, which are made with everything from sardines, anchovies, and mackerel to vat-grown algae and krill, are more popular than probiotics and glucosamine combined.
The millions of Americans who take fish oil supplements have become quite familiar with the intensely fishy burps they cause. However, it’s a small price to pay to lower the risk of cardiovascular disease, which remains the leading cause of death in our country.
Yet the science says otherwise. We’ve done some research and spoken with some experts, so let’s dive into the matter!
Studies can be a bit confusing when it comes to fish oil supplements
By 1900, seafood had captured the attention of cardiac experts. That year, 51 studies were published exploring the connection between fish oil and heart disease. But according to scientists, the research was mainly “observational.”
It compared the health outcomes of individuals who ate a lot of fish to those who didn’t, and by doing so, it indicated intriguing correlations between consuming fish and cardiovascular health. However, these studies didn’t, and couldn’t, prove causation.
In 2008, researchers published 114 studies on fish oil and heart disease. As fish oil’s role in human health became further elucidated, especially the one in reducing inflammation, it became a wellness panacea, providing apparent benefits for everything from triglycerides and blood pressure to vision, pain, and mental health.
While a study published a few years ago in the New England Journal of Medicine found that taking fish oil capsules could slash the chance of a heart attack by up to 40% in those who didn’t regularly consume fish, it didn’t pass the test of reducing both strokes and heart attacks in a study population.
Omega-3: the main star
Proponents claim that fish oil can lower your risk of cardiovascular disease by decreasing cholesterol and blood pressure. This is due to the fact that fish oil supplements are a capsule form of omega-3 fatty acids, which have been studied for several decades and have proven benefits for heart health.
Omega-3 fatty acids are vital nutrients found in fish like mackerel, bluefin tuna, wild salmon, and herring. Your body can’t produce them on its own, which is why fish that contain high levels of omega-3 fatty acids are such an essential part of a healthy diet.
However, scientists point out that there’s no real proof that fish oil supplements do much of anything. While it’s known that people who eat fish regularly have a lower risk of cardiovascular events, that hasn’t been proven in studies about over-the-counter doses of fish oil.
According to experts, the existing data just isn’t very convincing.
An avalanche of null findings
In 2010, the first major null randomized controlled clinical trial (RCT), which is the gold standard for ascertaining the safety and efficacy of a treatment, found that fish oil didn’t considerably reduce the risk of major heart events among patients who had a myocardial infarction and who were under antithrombotic, antihypertensive, and lipid-modifying therapy.
By 2012, nearly 20 million American adults were taking fish oil supplements. Another RCT found that a daily capsule of omega-3 fatty acids didn’t reduce the rate of cardiovascular events in people at high risk for heart disease.
In July 2012, another major meta-analysis reported that fish oil supplements have “little to no effect on cardiovascular health or mortality.” Scientifically, fish oil looked dead.
Except fish oil wasn’t dead.
The dose is important
In the first-ever fish oil randomized controlled clinical trial, participants received 1 gram of fish oil. A Japanese study that followed in 2007 featured 1.7 grams. And then there’s a third trial that came shortly after, which features such a large dose—2 grams twice a day—that it’s difficult to distinguish between a nutritional supplement and a pharmaceutical intervention.
Many of the null studies, in contrast, used small doses. For instance, in one null study, subjects consumed around 0.375 grams of fish oil. In another study, subjects consumed 840 milligrams of omega-3s.
Then again, it’s important to know which type of fish oil your supplements contain. Two of the studies with the most dramatic results in the history of fish oil research didn’t use standard fish oil. What they used was EPA, which is one of the two main fatty acids found in fish oil. The other one is called DHA.
So, the harshest critics of fish oil supplements might be right—fish oil might have no effect at all, and its apparent benefits could simply be the result of poor study design or chance, although experts agree that this seems like a long shot at this point.
But there’s one more issue with fish oil supplements, and that has to do with the category of products to which they belong: dietary supplements.
Supplements aren’t strictly regulated
The US Food and Drug Administration doesn’t regulate health supplements in the same way as it does drugs and food. This means that companies aren’t required to submit products to the FDA for approval before adding them to the market.
This can result in some misleading labels. A recent study where 57 dietary supplements, including fish oil supplements, were analyzed showed that 84% didn’t contain the amount of ingredients claimed, 40% didn’t have any of the ingredients claimed, and 12% contained undeclared ingredients, which goes against the FDA rules.
It also implies the fact that companies don’t need to provide the FDA with evidence that what they sell actually does what their labels claim to do.
By the way, if you’re taking multiple supplements, make sure you take the right dosage. A pill organizer can help you prevent missing or taking too many doses.
Prescription fish oil comes with extra concerns
When it comes to prescription fish oil, which is different from fish oil supplements, there’s some controversial and conflicting information to sort through.
Many cardiologists have taken the position that the evidence isn’t very good for the benefits of prescription fish oils. According to experts, we need more studies in order for the doctors to be able to give a strong recommendation to consume these products.
A large study found that people who took a pure-EPA fish oil capsule reduced their risk of heart disease by 25% compared to subjects who took a placebo. That seems like good news. However, the placebo wasn’t actually a placebo, but mineral oil, which has since been known to have some negative cardiovascular effects, like increasing inflammation.
Experts explain that if the placebo is doing bad things, it may automatically make the drug look good.
Moreover, a 2021 study indicated that fish oil wasn’t showing any benefits and was found to increase the risk of atrial fibrillation, a type of arrhythmia (irregular heartbeat) that can result in a stroke.
Fish oil side effects
Taking OTC fish oil supplements is always risky. As already stated, they’re not regulated by the US Food and Drug Administration. Doctors advise that people should take medications that have proven benefits.
They also point out that, when it comes to fish oil supplements, at best, you’re just losing money on products that don’t do anything. At worst, those supplements can have negative effects.
Some fish oil capsules have been tested by consumer organizations and shown to be contaminated with mercury. And even safe, low-dose fish oil supplements can have negative side effects, including nausea, upset stomach, bad breath, and “fish burps.”
If you’re at high risk for cardiovascular disease, talk to your health care provider about the best options for reducing your risk. And if you want to ensure you’re getting all the benefits of omega-3 fatty acids, it’s best to forget about the fish oil supplements and just have salmon for dinner instead.
If you liked our article on fish oil supplements, you may also want to read Are You Experiencing These 8 Signs of Hidden Health Issues?
