By Susan Burke March
Plenty of evidence supports a diet rich in omega-3 fatty acids.
As reported by the Harvard Health Letter, there are two key omega-3 fats, DHA and ALA. These fats are an integral part of cell membranes and cell functionality and are necessary for hormones, blood clotting, arterial health, to regulate inflammation and more.
These fats are known as “essential” because, although the human body can make most of the fats it needs from other fats, we must get omega-3s from food. Fatty fish like salmon, mackerel and sardines are rich in DHA. Plant foods like chia, flax, canola, and pumpkin seeds, avocado, and walnuts are rich in ALA, which the body (to a limited extent) can convert to DHA.
I just searched online for “fish oil supplements” and got 135 million pages to explore, many from manufacturers claiming that their products are “a good choice to help support a healthy heart.” Dietary supplements often contain vague claims to promote health, and fish oil supplements are advertised as effective in lowering the risk for heart disease, inflammation, to lower symptoms of depression, even to prevent some cancers.
And the American Heart Association recommended fish oil in 2002, citing research showing that diets rich in omega-3s are linked to a lower risk for heart disease and inflammation. It’s known that diets deficient in omega-3s may increase the risk of those conditions. So, should we all be taking fish oil supplements?
Well, the AHA walked that recommendation back, and in fact, now advises, “Fish oil supplements may slightly lower the risk of dying of heart failure or after a recent heart attack. But they do not prevent heart disease.”
If you’re taking fish oil to prevent heart disease, you may be wasting your money. As reported in The New Atlas (July 2018), the journal JAMA Cardiology published a meta-analysis of 79 randomized controlled trials including more than 112,000 people taking long-chain omega-3 supplements in capsule form. The lead author of the study, Lee Hooper, is quoted as saying, “The review provides good evidence that taking [fish oil supplements] does not benefit heart health or reduce our risk of stroke from any cause.”
Does that mean that fatty fish are not good for the heart? Or that plant foods rich in omega-3s aren’t beneficial?
No, it just shows once again that if a little is good, more is not necessarily better.
The New Atlas quotes Tim Chico, a cardiologist from the University of Sheffield, UK, who suggests the results confirm the complexity of reducing a holistically healthy diet “down to a single element.” He says, “Previous experience has shown that although some types of diet are linked to lower risk of heart disease, when we try to identify the beneficial element of the diet and give it as a supplement it generally has little or no benefit. This was the case for vitamins; we know a diet rich in vitamins is associated with lower risk of heart disease, but studies giving people vitamin pills showed that these gave no benefit and indeed may have caused harm.”
I spoke with Dr. Jaime Moreno, a specialist in internal medicine and hematology at Santa Ines Hospital here in Cuenca. He does not advise people to supplement with fish oil, saying that the evidence is not there to link supplementation to a lower risk for heart disease or stroke. He reminds patients that fish oil supplements are not benign, and carry with them a risk of certain side effects, including bleeding, especially if taking blood thinners.
Other possible side effects include bad breath, belching, heartburn, nausea, loose stools, and nosebleeds.
And, what really is in those capsules? Are you getting what you paid for? Dietary supplements are notoriously unregulated. Is your product independently tested to assure content and purity?
I subscribe to ConsumerLab.com to keep up on the warnings, recommendations, and research on dietary supplements, and they write, “Because omega-3 fatty acids are obtained from natural sources, levels of fatty acids in supplements can vary, depending on the source and method of processing.” Some of the concerns include contamination, especially since large fish tend to accumulate mercury, PCBs and other toxins (which is why it’s advised to not eat very large prey fish like swordfish and king mackerel and to stick with small fish like sardines).
What about krill oil?
Krill (a tiny shrimp-like animal) are also rich in omega-3s but few studies been conducted on it, and according to ConsumerLab.com it will have the same side effects and potential risks of bleeding, and it’s super-more expensive.
Other concerns with supplements include freshness and possibility of oxidation/rancidity.
No doubt, a whole-foods diet rich in food sources of omega-3 fatty acids is healthful and these important anti-inflammatory fatty acids are essential, so you need to get them from food, or from supplements if you can’t eat food. But we can!
Aim for three servings of fish weekly (each serving about 3-4 ounces, cooked). Choose cold-water fatty fish including canned or fresh sardines, anchovies, trout, wild salmon (fresh or canned), and canned tuna; shellfish including shrimp, clams, and scallops are good choices too. Vary your fish choices (don’t eat the same fish daily).
Good plant sources of ALA include chia, flax, hemp, and pumpkin seeds, Brussels sprouts, and walnuts. And most importantly, cut your consumption of omega-6 fatty acids from refined vegetable oils, to achieve a healthy omega 6 to omega-3 ratio. Deep-fried foods, especially in restaurants; chips, packaged baked goods, just about all junk food is made with highly-processed and refined vegetable oils, easily avoided when you decide, “no más.”
Read more about the study from the journal JAMA Cardiology. https://jamanetwork.com/journals/jamacardiology/fullarticle/2670752