I confess.

I once bought an enormous jar of fish oil supplements from Costco—and then let it sit in a cabinet mostly untouched until well past its expiration date. (I hate taking pills.)

That was doubly wasteful on my part. Not only for ignoring the capsules once I’d bought them, but for buying them in the first place.

A recent article in the business pages of the Washington Post marveled that the fish oil supplement industry is booming despite any solid evidence that fish oil supplements work as claimed.

People in the United States spend about $1.2 billion annually for fish oil pills and related supplements even though the vast majority of research published recently in major journals provides no evidence of a health benefit.

Earlier this year, the New York Times published an article on this same topic: Fish Oil Claims Not Supported By Research

From 2005 to 2012, at least two dozen rigorous studies of fish oil were published in leading medical journals, most of which looked at whether fish oil could prevent cardiovascular events in high-risk populations. These were people who had a history of heart disease or strong risk factors for it, like high cholesterol, hypertension or Type 2 diabetes.

All but two of these studies found that compared with a placebo, fish oil showed no benefit.

“There’s a major disconnect,” Dr. [Andrew] Grey said. “The sales are going up despite the progressive accumulation of trials that show no effect.”

Fish oil supplements, considered a source of omega-3 fatty acids, are mostly marketed with vague claims of “supports heart health” or “may reduce risk of coronary heart disease.”

Forty years ago, researchers found that Eskimo populations had a lower than average risk of heart disease. Their diets were also predominately fatty fish (whale blubber!). Thus the hypothesis was made that the good fats in fatty fish, the omega-3s, were heart healthy.

But the supplements are also sold as being helpful for Alzheimer’s disease, depression, diabetes, attention deficit disorder, arthritis, and more.

In general, be skeptical of any supplement that uses words like “supports” or “boosts.”

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Like so many nutrients, it’s better to get these healthy fatty acids from food rather than supplements.

A cardiologist quoted in the New York Times article agrees.

Like many cardiologists, Dr. [James] Stein encourages his patients to avoid fish oil supplements and focus instead on eating fatty fish at least twice a week, in line with federal guidelines on safe fish intake, because fish contains a variety of healthful nutrients other than just EPA and DHA. “We don’t recommend fish oil unless someone gets absolutely no fish in their diets,” Dr. Stein said.

I wrote about omega-3 fatty acids in another post about milk and other foods being fortified with DHA, one type of omega-3.

There are three forms of omega-3s: DHA, EPA and ALA. (I won’t bore you with the long chemical names.)

• DHA and EPA are found in certain fatty fish: mackerel, tuna, salmon, sturgeon, mullet, bluefish, anchovy, sardines, herring, and trout. Fish oil supplements are made from these fish.
• DHA (but not EPA) can be found in algae. Algal-based DHA is used for vegan supplements and for many fortified foods because it does not have a fishy smell or aftertaste.
• ALA is the omega-3 found in many plants, especially flax seeds, chia seeds, soybeans, beans, canola oil and walnuts. But ALA needs to be converted into DHA and EPA, so plant sources of omega-3s are not as efficient as fish sources. You need to eat more.

Fresh fish, such as salmon, can be expensive. I know I can’t afford to eat it two or three times a week! But I love canned sardines, and I’ve found several recipes using canned salmon. Both have about 1.5 grams of DHA or EPA per 4 ounce serving, and are also excellent sources of calcium and vitamin D.

A tablespoon of canola oil has about 1.3 grams of ALA.

Aim for 7-11 grams of omega-3s per week.

And consider how much you are getting of another essential fatty acid—omega-6.

One problem with the typical American diet is that we get too much omega-6. It’s found in lots of vegetable oils—soybean, corn, safflower, sunflower and cottonseed—that are used in processed foods.

Nutritionists believe it’s the ratio of omega-6 fatty acids to omega-3 fatty acids that is important. We should aim for about a 2:1 or 4:1 ratio. It’s more likely we get 10 to 20 times as much omega-6 fatty acid as omega-3.

So the take-home message from that observation is to eat fewer processed foods and eat more fish, vegetables and whole grains.

But that’s just common sense healthy eating, anyway.

Sláinte,

Frugal Nurse