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Is fish oil still worth taking?

While fish oil has had a reputation for helping to keep our hearts and brains healthy, lately we’ve seen headlines telling us that it doesn’t do much for our hearts at all. Why is that? And is it still worth taking?

Frustratingly, the research seems to go in all directions, so I’ve spent a few weeks drilling in to it.

First, I’ve no doubt about the value of eating fish, as long as they swim in healthy waters and eat what wild fish are meant to eat. Seafood is a central part of what makes a Mediterranean diet healthy.

I also have no doubt about the importance of omega-3 fatty acids for our health, and there are plenty of studies that support the benefits of it for various aspects of healthy ageing. Apparently though, about 90% of Australians don’t get enough. 

Oily fish such as salmon and sardines are high in omega-3, but other fish such as flathead and bream, and shellfish such as scallops and squid contain some too. You probably also know that krill is used for omega-3 supplements. 

Unfortunately, we don’t all have access to good quality cold-water fish and shellfish, we don’t all like it, and it’s a finite resource. So supplements would seem to have a place in providing fishy sources of omega-3.

There are plant sources of it too — such as walnuts, chia and flaxseed. But it’s the long-chain omega-3s that are most valuable for heart and brain health, especially EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). Fish and shellfish are the best sources of these.

The research on supplements seems scatty for a few reasons: for example, some studies focus on people with heart disease while others involve people who are disease-free, different studies use vastly different doses, and we don’t know about the quality of the supplements they’re using.

The recent research grabbing the headlines was about people with heart disease. Fish oil doesn’t seem to make any difference to their condition.

That may be because heart disease patients can be taking blood pressure medication, statins and blood thinners, so there’s not a lot that fish oil can provide on top of that. In fact, blood thinning medication plus fish oil could be dangerous.

So is it useful for those of us who just want to stay healthy? That might depend on issues such as dose and quality.
The doses used in studies I’ve looked at range from 230 – 4000 mg of omega-3. That’s a big spread. More than 3000 mg is considered a high dose.

Some argue that the trials in which fish oil appears more beneficial are the ones that use bigger doses.

But it’s also argued that a given dose could be beneficial for some people and detrimental to others.

Right now, there’s not enough evidence to recommend taking any particular dose other than what’s prescribed on the bottle.

Another dose-related issue is the amount of EPA + DHA. While the Heart Foundation recommends we get at least 500mg EPA + DHA per day for heart health, it’s estimated that most of us get only about 160mg.

Arguably, the best way to meet the Heart Foundation’s recommendation is to eat two or three 150g serves of oily fish a week (skin on). You’ll also be getting protein, vitamins A, B12, D and E, plus iodine, selenium, calcium, zinc and iron with that.

If you’re taking a supplement, check the label so you know how much EPA + DHA you’re getting. 

Supplement quality is vital because fish oil oxidises easily: exposure to light, oxygen and heat can damage it. 

In 2016, the three biggest-selling fish oil supplements in the US were shown to have oxidation levels up to four times higher than what’s recommended. Studies in other countries have shown that up to 80 percent of supplements have at least one unacceptable measure of oxidation.

Oxidised fish oil is like eating trans fats, i.e. it’s not good for you. A Spanish study claimed that taking oxidised capsules increased cholesterol.

While I haven’t found any Australian research on the quality of fish oil supplements, what’s happened overseas should make us cautious about a lot of what’s being sold.

Here’s hoping that expensive ‘practitioner’ brands and high-end labels (such as Nordic Naturals and Ethical Nutrients) meet the required standards.

In summary, we have a lot to learn about fish oil, but along with a healthy diet and lifestyle, I still think its anti-inflammatory properties are useful, especially if you don’t regularly eat (oily) fish. 

The biggest issue might be ensuring that your supplements are of good quality. Unless you’re confident about that, it could be smarter to spend your money on a couple of fish meals a week.

Photo source: Bigstock

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Saturday, May 26, 2018 | Rhonda Anderson