Fish Oil Supplement Benefits — and Risks?
Last updated: April 2017
My respect for the health and diet reporting of the main-stream media has fallen so low that I am inclined to do the opposite of whatever they suggest. So when in the same week the New York Times runs a story panning fish oil supplements, and ABC Good Morning follows up with an anti-fish-oil-supplement segment, I’m thinking it is time to give the golden capsules another try.
I regularly took fish-oil supplements for several years before I began eating my low-carb, high-fat diet. Starting out, I took one 1000mg capsule a day, and I gradually worked up to three capsules a day. At that time, I was eating the Standard American Diet, which was much higher in both carbohydrates and poly-unsaturated fatty acids (PUFA) than my current diet. While I doubt that the omega-3 fatty acids in the fish-oil capsules were enough to balance out all the omega-6 fatty acids coming from my PUFA heavy diet, they surely helped. (To learn why balancing omega-3 and omega-6 is important, view these search results.)
As a middle-aged, over-weight, sedentary man with border-line high blood-pressure, I was a prime candidate for a heart-attack. It never happened. Do I give all the credit to the fish-oil supplements? No. I’m sure luck played a role. Perhaps genes, too, although my father developed heart disease and diabetes in his late fifties and the heart disease eventually killed him.
If I hadn’t changed my way of eating, I don’t think just taking fish-oil capsules would have saved me. I have limited faith in pills or capsules.
But I believe the supplements did help me.
Then why did I give up taking fish-oil supplements? Well, first, after I started eating low-carb, high-fat, the supplements just didn’t seem necessary. First, I had increased my intake of oily fish such as sardines and salmon. I also started to eat other foods containing omega-3 fatty acids, such as walnuts and chia seeds.
Second, I had reduced my intake of vegetable oils with all that omega-6 content. Third, I had lost weight, and inches around my middle, and saw all of my conventional health markers improve. So I just quit buying and taking fish-oil supplements. They were a small but seemingly unnecessary expense.
But now I intend to resume taking fish-oil supplements. I was already leaning that way, and the recent news stories have pushed me further in that direction — quite the opposite of their intention.
You don’t have to read the New York Times article all that closely to realize its headline is misleading. That headline says “Fish Oil Claims Not Supported by Research,” but what claims is it referring to?
The research cited in the Times article was very narrowly focused on subjects with a history of heart disease or with risk factors for it such as high blood-pressure and Type 2 diabetes. No doubt these individuals were following a PUFA-laden diet. That’s the conventional dietary approach: high carb, low fat, with most of the fat coming from vegetable oils. But how many fish-oil capsules did the subjects take? For how long? How much oily fish did they eat in addition?
In one study cited by the Times, subjects were only given one gram of fish-oil per day. This small dose (one typical capsule daily) was not found to lower the risk of death from heart attacks or strokes among the subjects who already had atherosclerosis. The Times quotes the study’s lead author as saying that “the era of fish oil as medication could be considered over now” (emphasis mine). Notice how carefully qualified that statement is. The goal of this study was not to test the benefits of fish-oil as a dietary supplement for generally healthy people. Rather, the goal was to test the effectiveness of fish-oil supplements as medicine for patients already suffering from cardiovascular disease.
I’m not planning to take fish-oil as medicine, and that’s not how the capsules are typically sold. Costco, for instance, sells fish-oil in its category of Vitamins, Herbals, and Dietary Supplements.
And I’m not planning to take fish-oil only, or mainly, to prevent cardiovascular disease. Other significant benefits have been identified from fish-oil and are under study. (For instance, see this, this, this, and this.)
I think context makes a difference. There’s a difference between taking a supplement to repair damage and taking one to prevent damage. And there’s a difference between adding a supplement to a bad diet and adding one to a good diet.
I concede that taking a small amount of fish-oil while continuing to eat a low-fat, high-carb, PUFA-heavy diet won’t do any good. I’m not sure any amount of fish-oil would help much in that life-style context, at least not long-term. There’s way too much omega-6 to balance off. But adding fish-oil to a diet that is already close to being balanced in its intake of omega-6 and omega-3 fatty acids is another matter. I’m not planning to take four capsules a day, the way I once did, but I may take one or two a day — at least on days when I’m not getting omega-3 from another source.
It’s wise not to over-do supplements, fish oil or otherwise, in place of eating real food. Indeed, some risks have been indicated for men with higher levels of omega-3s in their blood. A study published in 2013 found that high levels of omega-3s in men “were associated with statistically significant increases in prostate cancer risk.” The increased risk was greater than that found in previous studies — 43% overall and 71% for aggressive forms of prostate cancer.
That sounds truly frightening for men and the women who love them, but a few caveats are in order. First, as I have written about before (for example, here and here), the “increased risk” statistic is deceptive.
It’s a matter of relative vs. absolute risk. If a risk increases from one in a million to two in a million, that’s an increase of 100% in relative risk. But the absolute risk is still just two chances in a million. You can bet that no researchers will state a risk as “two in a million” when they can call it a “100% increase.” They’d be drummed out of the union.
Second, the higher blood levels of omega-3s in the blood were from any source, including eating actual fatty fish, not just from supplements.
Third, just getting older puts a man at an ever-greater risk of prostate cancer — and of many other maladies as well, some of which risks appear to be mitigated by a proper balance of omega-6 and omega-3 fatty acids in our diets.
In the end, it comes down to a question of whether the fish oil supplement benefits out-weigh the risks. It’s not an easy question for even the experts to answer, let alone a blogger. But I believe that the judicious use of fish oil supplements can help me maintain a balance of fatty acids, and thereby improve my overall health.
It just might work.
And since the NYT and GMA are against it, I’m going to try it.