Devlin Brown: With omega-3 oils, the fish beats the capsule

A quick google search for “fish oil” will bring up dozens and dozens of supplements available from online retailers of all shapes and sizes. Fish oil is clearly a big market. Americans spend more than $1bn a year on over-the-counter fish oil. 

However, there’s always something fishy about claims and counter claims that confuse the public even more. 

There’s no doubt about the importance of omega-3 fatty acids. Fish oil, which also contains things such as vitamins A and D, is about 30% omega-3 fatty acids. According to many sources, the omega-3 fatty acids found in fish deliver better health benefits than those found in plants.

We have been told to use fish oil supplements because they are good for us. Only those who read more widely are aware of research finding no real benefits to taking omega-3 fatty acid supplements and, most recently, suggestions that taking supplemental omega-3 fatty acids may be harmful for healthy people.

But before we get there — why omega-3 fatty acids? They support healthy lipid profiles and heart health, they support mental health, eye health, have anti-inflammatory properties, they’re good for joint health, they may support the immune system and much more.

In fact, if you put the phrase “omega-3 fatty acids found in fish oil may support” in front of most health benefits you can think of, chances are someone, or a study somewhere, has suggested it. 

So what’s the problem? Around the time we were going to the polls, researchers published a study in the journal BMJ Medicine based on the outcomes of a years-long study. What did they see? A slight increase in the risk of cardiovascular events — including stroke — in people who were not categorised as being at high risk for cardiovascular disease. Shocking, right? 

What the researchers did find was that those who already had cardiovascular disease benefited from taking fish oil supplements regarding how the disease progressed. 

What can we take from this? The study was huge: 400,000 participants between the ages of 40 and 69. According to a CNET article published recently, the study also tracked things such as binge drinking and smoking, however, it quoted the researchers as saying they didn’t track “behavioural changes in populations with different cardiovascular profiles”. 

The article’s author adds that the study “can't account for all health-affecting behaviours that may influence someone’s wellness choices, which are notoriously tricky to separate and pin down to one cause or effect”. 

Harvard Health entered the debate a week ago with an article titled “Fish oil: friend or foe?” In its typically measured — and calm — demeanour the take home message was more friend, as long as it comes from eating actual fish.

The article references research that found supplementing with omega-3 fatty acids did nothing to prevent heart attacks, strokes or death from heart disease in middle-aged men and women with no known risk factors, while also referencing earlier research that found no benefit for those with risk factors.

The overall theme is that eating fish is where the benefit lies — and that’s the whole fish not just dipping a straw in and sipping out oil. However, some people can’t eat fish. In those instances they can get omega-3 fatty acids from chia seeds, flaxseed oil, walnuts, canola and soy oil.

A recurring theme, among all rational people, is that supplements are there to supplement and not replace whole food. Supplementing with omega-3 fatty acids may help ward off a deficiency from not eating whole food sources (our bodies can’t make omega-3 fatty acids) but there’s no substitute for real food.

I finished a bottle of fish oil capsules just last month before reading about this latest study. Will I top up? Perhaps I’ll just eat more salmon, sardines, tuna, herring and mackerel.