Should I throw away my fish oil supplements?

Should I throw away my fish oil supplements?
Not yet, not if you are taking the right dose or the right brand!

Three recent studies have thrown doubt among the population on the benefits of fish oils, despite many years of evidence from populations on the benefits from cardiovascular disease, rhythm problems and strokes. I have reviewed these below, but in summary, they have all used a low dose of fish oils, and the quality of the fish oils used is almost certainly suspect. Two trials did show a slight improvement in heart attacks and rhythm problems, and suggested that perhaps if a higher dose had been used the results may have been different.

The take-home message is yes use fish oils, they can do absolutely no harm, and if given in sufficient doses using a quality supplement, could make a major difference in heart attacks, strokes and rhythm problems.



Over recent years there has been a strong anti-complimentary medicine push, probably supported by big Pharma, and the current target has been omega-3 fish oils. Despite the fact that numerous epidemiological studies (studies of populations) over many years have shown that people who eat a lot of omega-3 fish oil in their routine diet have fewer heart attacks and strokes, a lower mortality and less in the way of heart arrhythmias. For this reason, the American Heart Association and many other Auguste bodies have been recommending that people should have a high intake of omega-3 fish oils (and if vegetarian, probably flaxseed oil).
However, a couple of reviews have hit the headlines, suggesting that people taking fish oil supplements are wasting their money. They have fallen short of saying that they are doing any harm, because they are not!

1. A recent paper by the Cochrane organisation which has become the gold standard for clinical reviews, has been widely quoted. They reviewed 79 randomised controlled trials from literature, involving 12,059 participants. However they stated that only 25 of these trials had a low risk of bias, and these with the majority assessed. Most of the trials involve taking supplements, although they don't mention the dose, but some simply involved omega-3 enrichment of foods. They found no reduction in mortality, heart disease mortality or stroke mortality. The trials varied from one to 3 years.
Interestingly, however, at the bottom of the study, they do suggest that the information points towards a reduction in heart attacks and heart rhythm problems, but this effect is small.
2. Another study just released of the European Society of Cardiology in patients with diabetes again found no benefit, but the dose they used was 1 gram per day.
3. A very interesting paper in Nature reviewing fish oil supplements available in New Zealand (click here) found that over 83% exceeded the recommendation of oxidation of the products (making them the less effective or useless).  Only 8% met the acceptable international recommendations.
Almost all (see graph) contained less EPA and DHA than claimed on the label.

Conclusion – these three major studies confirm that low dose of fish oil, particularly if the quality is not satisfactory, do not give much benefit. They do not however indicate that proper use of omega-3 oils could make a major difference in health, as has been recommended in the past by Heart Association's and epidemiological studies.
My recommendation is to take a quality pharmaceutical grade fish oil supplement, at least 2 to 3 g per day, throughout life. This is still very likely to make an enormous reduction in cardiovascular disease, rhythm problems and strokes. (Trials using high doses of omega-3 oils are currently underway, but it would be many years before they are reported).