Fish oil supplements may be more popular than beneficial

Recent research has modified earlier enthusiasm about the heart health benefits of fish oil supplements.

Fish oil supplements may be more popular than their presumed benefits for improving heart health warrant, according to recent research.

Some 20 million Americans report taking fish oil supplements, which contain EPA and DHA, two types of omega-3 fatty acids. Earlier studies indicated these supplements could help prevent or reduce heart disease. Now what’s clear is that more research is needed.

Omega-3 fish oil supplements may slightly lower the risk of dying after heart failure or a recent heart attack, but they don’t prevent heart disease, according to a 2017 advisory from the American Heart Association.

In one large international study, conducted from 2014 to 2020, a medication derived from fish oil didn’t decrease the risk of cardiac events compared to a placebo.

“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,” said the lead author of the study, Dr. A. Michael Lincoff. He’s an interventional cardiologist at the Cleveland Clinic.

Newer and better treatments introduced in recent decades have affected studies of fish oil supplements, which before 2002 showed stronger benefits than those conducted more recently.

For example, more patients take cholesterol-lowering statin drugs, blood pressure medications and other medications before and after a heart attack, said Penny Kris-Etherton, a nutrition professor at Penn State University who helped write the AHA advisory. New studies are dealing with an entirely different patient population, she said.

The supplement debate aside, eating fish such as salmon and tuna remains the best way to get enough omega-3s, experts said. Other foods that provide omega-3s include crab, mussels, flaxseed, chia seeds and canola oil.

“People are not getting enough omega-3 fatty acids,” Kris-Etherton said. “Of course, people should eat fish first, but if they can’t meet those recommendations with fish, fortified foods or supplements are OK.”