Last week, the New England Journal of Medicine published a study that caused my heart to skip a beat: daily supplementation of fish oil did not reduce the rate of lethal cardiovascular events (heart attack, strokes, irregular heart beat) in patients at high risk for such events.

As an avid fish oil enthusiast and chronic hypochondriac, it’s an understatement when I say that this unsettles me. Even though I am more at risk for a panic attack than a heart attack, I still assumed that taking a daily dose of fish oil would protect me from the day that I keel over from eating too much take-out Chinese food.

Now that this may not be the case, I thought it wise to investigate further on the topic of fish oil and its potential to enhance health before officially retiring my take-out menu drawer.

Is it worth the cost and fishy breath that comes with taking fish oil supplements, or is this just another pharmacological pipedream?

What is fish oil?

Although fish oil preparations have been around for ages (the precocious British first extracted cod liver oil around 1775), only recently has fish oil supplements been regarded as being the closest thing to the fountain of youth. In fact, just by typing the term fish oil in any online search engine (I prefer to ask Jeeves) you may find all sorts of health benefits just by taking a few pills of fish fat a day. Fish fat, you say? Essentially, yes.

Fish oil can be cultured from most marine life, ranging from mackerel to the great white shark. As these fish pray on smaller fish, plankton, and microalgae, they accumulate chemical buildings blocks of fat in their tissues that the fish oil supplements we buy are based on. Specifically, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), both part of the omega-3 fatty acid group, are largely studied as potentially health-enhancing substances when taken regularly. In basic lab settings, these molecules have been shown to reduce inflammation on a cellular level.

Because it is this inflammatory physiological state that is thought to damage vital organs and contribute to a wide array of human disease, researchers began to clinically test the anti-inflammatory molecules in humans in search of any benefits.

And benefits they certainly found.

The Victories:

Similar to the online search of fish oil we’ve all just completed, finding core clinical scientific journal articles studying the effects of fish oil on human health was, yes, like shooting fish in a barrel. (No applause necessary.)

Even limiting my search to the past few years revealed substantial evidence for the protective benefits of fish oil on human disease.

Are you worried about your eyes? Omega-3 fatty acid supplementation has been shown to significantly reduce the risk of age-related macular degeneration, the leading cause of adult blindness in industrialized nations, in the studied female population (sorry, guys).

Are you feeling down? Taking daily doses of fish oil significantly reduced depressive symptoms in a patient population experiencing major depressive episodes without co-existing anxiety symptoms. Taking omega-3’s has also been shown to protect the heart.

Studies have associated fish oil consumption with reduced triglycerides, a type of fat compound linked to hardening of the arteries and strokes, and found to increase in heart function in patients with congestive heart failure.

The Disappointments:

For as many journal articles I found suggesting fish oil to be the next slam dunk in medical pharmacology, I discovered just as many clinical trials showing it to be a complete air-ball.

In one study population, omega-3 supplementation in combination with diet and exercise did not improve weight loss. There goes tonight’s beef fried rice and egg rolls.

In another study, high dietary intake of fish oil was found to increase the risk of contracting type-2 diabetes. Admittingly, frightening.

Take Home Point:

Fish oil is certainly not the coming messiah. Taking it regularly will not make us immortal any more than jogging an extra mile a day or keeping that beef jerky bag in the grocery aisle.

Because remember, fish oil supplementation is essentially that–a supplement to our otherwise supposed healthy living.

So in the end, will I continue to brave the fishy breath and ever-widening hole in my pocket? Yes.

But I will also run that extra mile and, perhaps one day, resist the jerky.

Brian Secemsky, M.D.

Medical writing for patients, students
and practitioners.

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