Should you be taking a fish oil supplement?

FISH OIL???
Let’s be honest – there is a ton of research on this topic! And a lot of them are great studies, but …
A recent meta-analysis showed that omega 3 fatty acid supplementation had no significant association with fatal or nonfatal coronary heart disease or any major vascular event. I know this is contrary to what we have heard over the years. It is estimated that over 20 million Americans take fish oil supplements daily but is it necessary?
The American Heart Association for years has stated that they cannot make a recommendation to use omega 3 fish oil supplements for primary prevention of cardiovascular disease because of the absence of scientific data that shows any benefit in preventing heart attacks, stroke, heart failure, or death for people who do not have a diagnosis of cardiovascular disease. They still state that fish oil may benefit patients with a recent prior heart attack or heart failure which comes from a number of studies showing the effects of intravenous omega 3 oils on reperfusion injuries, post ischemic inflammatory responses, and even traumatic injuries including TBIs but none of them have shown sound evidence of reduced mortality.
Obviously this is a hot topic, so I think everyone should decide what is right for them after they read the research, but I wouldn’t worry about not taking fish oil if you are not! Omega 3 fatty acids including EPA, DHA & ALA may still be useful in patients after they have traumatic brain injuries or any type of reperfusion injury; we know Omega 3 fatty acids may lower triglycerides, remnant lipoproteins, prostaglandins, thromboxanes, and leukotriene levels so I wouldn’t say they are useless by any stretch, but we still need to know a lot more! For example, I first started taking fish oil pills back in 2004 in response to the famous studies showing a correlation between fish consumption with decreased coronary heart disease. From 2004 – 2009, I probably spent 2.5K on fish oil supplements, but since then I have maintained a high omega 3 level in my diet using ALA forms in chia seeds, flax seeds, soybeans, radishes, beans, and peas, which I do recommend.
Now I know a lot of people will start to ask about the effect of omega 3s on other systems or other disease processes. I truly believe, from the research, that Omega 3s reduce inflammation and are beneficial for a number of things! For example fish oil has been shown to reduce triglyceride levels in patients with hypertriglyceridemia. For patients who have high triglycerides, there are a number of other things they can do besides just take supplements. They can lower their saturated fat intake, they can increase their fiber intake and fruit/veggies, they can exercise more, and consume less processed high fat or empty calorie meals, they can also take statins or other triglyceride lowering medications. While fish oil may lower it, I think their are cheaper methods with exercise and dietary interventions.

For my fellow med students who have preceptors and attendings who still think fish oil supplementation is beneficial, I always think you should listen to your mentors and hear their thoughts/opinions but learn to ask in the appropriate way if it has worked for their patients. The idea of sharing this new research is not to challenge anyone or anyone’s beliefs, it is about sharing the research so we can make better informed decisions for patients!

As always, I love answering your questions! Below are some of the articles used to make this post.

Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks

Omega-3 Polyunsaturated Fatty Acid (Fish Oil) Supplementation and the Prevention of Clinical Cardiovascular Disease

Fish oil and omega-3 fatty acids in cardiovascular disease: do they really work?

Lack of benefit of dietary advice to men with angina: results of a controlled trial

EFFECTS OF CHANGES IN FAT, FISH, AND FIBRE INTAKES ON DEATH AND MYOCARDIAL REINFARCTION: DIET AND REINFARCTION TRIAL (DART)

The Role of Omega-3 Polyunsaturated Fatty Acids in Stroke

The Inverse Relation between Fish Consumption and 20-Year Mortality from Coronary Heart Disease

Disclaimer: Opinions are my own. I do not provide medical advice. If you have questions ask your doctor & do your own research. I am a med student & PhD candidate. I have 5 degrees including 2 masters in nutrition & metabolism. I am a certified personal trainer & have researched these topics for 9 years. The information I post is research based & info not always taught in school.

Hi! I am a third-year medical student and third-year PhD candidate with a passion for innovation, biomedical research, medical education, healthcare policy, biotechnology, nutrition and a healthy lifestyle. I am a bit of a non-traditional student as you can see from my personal bio. I am a host of medical podcast and the owner of an admission company focused on helping students get into the school of their dreams. I love educating and giving back so if you have questions feel free to email me!

What do you think?