The answer is more friend than foe when fish oil comes from food sources rather than supplements.
Omega-3 in balance
What is special about fish oil? It is loaded with omega-3 fatty acids. These must come from food, since our body cannot produce them.
The two key omega-3 fatty acids are docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Oily fish like salmon, mackerel and sardines are rich in these omega-3s. Some plants are rich in another type of omega-3 fatty acid, alpha-linolenic acid, which the body can convert into DHA and EPA. Good sources include flax seeds, chia seeds, walnuts, pumpkin seeds and canola oil.
Omega-3 fatty acids play an important role in brain function, normal growth and development, and inflammation. Deficiencies have been linked to a variety of health problems, including cardiovascular disease, certain cancers, mood disorders, arthritis, and more. But that doesn’t mean taking high doses results in better health and disease prevention.
Fish oil supplements have been touted as a simple way to protect the heart, facilitate inflammationimprove mental health and prolong life. Such claims are one reason why Americans spend more than $1 billion a year on over-the-counter fish oil. And food companies add it to milk, yogurt, cereal, chocolate, cookies, juices and hundreds of other foods.
But the evidence for improved heart health is mixed. In November 2018, a study reported in the New England Journal of Medicine found that omega-3 fatty acid supplements did nothing to reduce heart attacks, strokes, or death from heart disease in middle-aged men and women without any known risk factors for heart disease. Previous research published in the same journal in 2013 also reported no benefit in people with risk factors for heart disease.
However, when researchers looked at subgroups of people who didn’t eat fish, the results suggested they could reduce their cardiovascular risk by taking a fish oil supplement.
The evidence linking fish oil and cancer is everywhere. Most research, including the 2018 study cited above, has shown no decrease in cancer risk. However, some previous research suggested that a diet high in fatty fish or fish oil supplements might reduce the risk of certain cancers.
Takeaway message
How food and its component molecules affect the body remains largely a mystery. This makes using supplements for anything other than treating a deficiency questionable.
Despite this one study, you should still consider eating fish and other seafood as a healthy strategy. If we could absolutely and positively state that the benefits of eating seafood come entirely from omega-3 fatty acids, then taking fish oil pills would be an alternative to eating fish. But more than likely you need the full orchestra of fish fats, vitamins, minerals, and support molecules, rather than just the EPA and DHA notes.
The same goes for other foods. Taking even a handful of supplements doesn’t replace the wealth of nutrients you get from eating fruits, vegetables, and whole grains.
What should you do if you are currently taking fish oil? If your doctor has prescribed them (this is an approved and effective treatment for people with high blood triglycerides), follow their instructions until you can have a conversation about the oil of fish.
If you’re taking them yourself because you think they’re good for you, it’s time to rethink that strategy. If you don’t eat fish or other seafood, you may benefit from a fish oil supplement. Additionally, you can get omega-3 from ground flaxseed or flaxseed oil, chia seeds, walnuts, canola oil, and soybean oil. One to two servings per day can help you avoid omega-3 deficiency.
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