Fish oil or snake oil?

The effectiveness of fish oil supplements for people at risk of suffering heart ailments is being questioned.

Medications derived from fish oils are among the world’s most popular supplements, but a new study from the Cleveland Clinic found high doses of common fish oils did not lower people’s risk of experiencing heart issues.

“A medication derived from fish oil, containing the omega-3 fatty acids EPA and DHA, was evaluated in a large, international study of more than 13,000 people who had existing heart disease or who were at high risk of heart disease due to other medical conditions. The medication did not reduce the risk of cardiac events compared to a corn oil-based placebo in the STRENGTH trial,” reports Science Daily.

“Many people continue to take fish oil supplements to prevent heart disease. However, the fish oil medication we tested in the STRENGTH trial was not effective for that purpose,” said lead author A. Michael Lincoff, M.D., vice-chairman for research of the department of cardiovascular medicine and an interventional cardiologist at the Heart, Vascular and Thoracic Institute at the Cleveland Clinic.

“We believe the questions surrounding the benefit versus risk of fish oil will remain unanswered unless another trial using a neutral placebo such as corn oil is able to definitively show cardiovascular benefits for an omega-3 fatty acid medication,” he said.

Healthline says evidence linking fish oil and heart health has been mixed and it varies based on the types and quantities of fish oil evaluated and the type of placebo used.

“More research is needed to understand how different types of fish oil impact the body.”

“Combination DHA and EPA fish oil did not demonstrate any significant cardiovascular benefit, even at high dosages, and specifically in this trial – [the] STRENGTH trial,” said Dr Guy Mintz, director of cardiovascular health at Sandra Atlas Bass Heart Hospital in New York.

According to Dr Mintz, fish oil is believed to improve heart health because it has anti-inflammatory properties and blood-thinning effects.

A previous study, which concluded that omega-3 fatty acids had a significant benefit on heart health, has been criticised because the mineral oil placebo used might have affected cholesterol levels, leading to the “mistaken impression” that fish oil was beneficial.

No studies have convincingly shown that common over-the-counter fish oils lead to clinical benefit, says Dr Richard Wright, a cardiologist at Providence Saint John’s Health Center in Santa Monica, California.

Dr Sanjiv Patel, an interventional cardiologist at Memorial Care Heart in California, says anyone considering taking fish oil should consult their physician.

“Given the slight increase in atrial fibrillation with use of fish oil, one conclusion is clear, patients should always discuss the use of this supplement as well as any other with their doctor,” Dr Patel said.

Dr Howard LeWine, from Harvard Health, says the omega-3 fatty acids in fish oil are crucial for brain function, normal growth and development and dealing with inflammation.

“Deficiencies have been linked to a variety of health problems, including cardiovascular disease, some cancers, mood disorders, arthritis, and more. But that doesn’t mean taking high doses translates to better health and disease prevention.”

Fish oil supplements promising better heart health, mental health and a longer life have become a $1 billion a year industry.

“How food, and its component molecules, affect the body is largely a mystery. That makes the use of supplements for anything other than treating a deficiency questionable,” says Dr LeWine.

He suggests that eating fish and seafood – with their “entire orchestra” of fats, vitamins, minerals and supporting molecules – is a healthy strategy, rather than taking the “lone notes” of EPA and DHA.

“The same holds true of other foods. Taking even a handful of supplements is no substitute for wealth of nutrients you get from eating fruits, vegetables, and whole grains.”

He suggests following food author Michael Pollan’s simple but now famous diet advice: “Eat food. Not too much. Mainly plants.”

Have you ever taken fish oil? Have you followed the debate on where supplements are bogus or beneficial?

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Written by Will Brodie

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