The mainstream media has been reporting about research this week that suggest omega-3 fatty acids don’t do anything to improve heart health. Greek researchers reviewed 18 previous studies involving 68,630 people, most of whom were heart patients, and they concluded that taking fish oil, either in capsules or by eating more fish, doesn’t appear to lower the chances of having a heart attack or stroke, or lower the risk of early death from other causes.
The studies each divided participants into two groups, one taking omega-3 supplements and the other group placebo pills. It also included two studies that instructed participants to increase their consumption of omega-3 rich foods. The studies also looked at whether the increased use of statins, used to lower cholesterol, or other medications might be masking the benefits of fish oils.
The researchers say all the studies had similar results, writing in the Journal of the American Medical Association (JAMA), “In conclusion, omega-3’s are not statistically significantly associated with major cardiovascular outcomes across various patient populations.” “Our findings do not justify the use of omega-3 as a structured intervention in everyday clinical practice or guidelines supporting dietary omega-3 (fatty acids) administration.” The researchers add, “Overall, omega-3… supplementation was not associated with a lower risk of all-cause mortality, cardiac death, sudden death, myocardial infarction, or stroke.”
The average daily dose of omega-3 taken by the participants was 1.51 grams per day and included both eicosapentanoic acid (EPA) and docosahexaenoic acid (DHA).
But one of the researchers, Dr. Moses Elisaf from the University Hospital in Ioannina, Greece, says further studies are needed to look at whether higher doses of omega-3 might be more effective. But until those results are in, the findings do not justify the use of omega-3 supplements regularly to prevent heart trouble.
It’s been known for some time that omega-3 fatty acids improve triglyceride levels, which helps to lower blood pressure and control hearth rhythm problems. The theory has been that omega-3 helps to prevent blood from sticking in blood vessels.
The American Heart Association is still recommending omega-3 supplements against high levels of triglycerides.
But following the release of this latest study, Dr. Donna Arnett, the president of the American Heart Association said that this closes the issue of omega-3’s role in heart disease, showing that the “supplements are of no benefit” whether or a not a person has had previous heart problems.
I believe that in order to shift the omega index in any significant manner, would require far more than 1-1.5 grams of fish oil daily to have any impact on a patient. I recommend no less than 5 grams twice a day of a high quality fish oil (I’ll discuss high quality at the end). The study also doesn’t address any of the other benefits of omega-3 fats on the rest of the body, like the brain, or their use in numerous foods and beverages and especially in infant formula, which accounts for the biggest source of omega-3 consumption.
The Global Organization for EPA and DHA Omega-3s (GOED), says the meta-analysis is “flawed” and by recommending consumers stop taking the supplements could be harmful to public health. Dr. Harry B. Rice, vice president of regulatory and scientific affairs for GOED, says, “We know from the studies that have shown a benefit that future research in this area should only analyze studies that do not include confounding medications, are longer than two years in duration, and use dosages greater than 1-2 grams of omega-3s per day. Very few of the studies included in this meta-analysis met these criteria.”
GOED says researchers at Harvard estimated that 84,000 deaths a year could be prevented by “adequate” omega-3 consumption, and that based on that evidence governments and scientific organizations around the world have set the minimum recommended intake of omega-3 acids.
Duffy MacKay N.D., and vice president of the Council for Responsible Nutrition says he’s worried the research results will be taken out of context. He says many of the studies were conducted on diseased individuals already undergoing treatment with one or more drugs (e.g., statins), that could mask the less potent and more long-term effects of omega-3 fats. He says, the meta-analysis also didn’t look at whether people in the placebo group were getting enough omega-3 fats in their diet. He says if participants in the placebo group already have a diet sufficient in omega-3, then it will be that much harder to demonstrate any difference among the two groups. It is impossible for a small number of researchers to control the diet of thousands of patients over several years, especially since omega-3 fats are added to a variety of foods.
MacKay said, in relation to a previous study this year on the impact of fish oil supplements and type 2 diabetics, “Consumers should not discount the many proven benefits of omega-3 fatty acids in all stages of life. There is extensive scientific evidence demonstrating the importance of omega-3 fats during pregnancy/lactation, breastfeeding and childhood. Furthermore, omega-3 fats have a role in maintaining the health of adults as well as in the prevention of age-related chronic diseases (e.g., cardiovascular disease and cognitive decline).”
What are some other reasons to take omega-3 fish oils?
– Omega-3 oils reduce chemicals in the body that are linked to inflammation in people with certain chronic and acute inflammatory conditions; chronic kidney disease, acute sepsis, and acute pancreatitis. Reductions in inflammatory markers are also likely to translate into fewer or milder inflammatory symptoms and slow disease progression in people with conditions like asthma, rheumatoid arthritis, inflammatory bowel disease, and cancer.
– Omega-3 oils seem to help people suffering from clinically diagnosed depression. There is very little evidence though that it will help people with a mild to moderate depressed mood or those trying to prevent depression.
– Researchers say there is not enough evidence, at this time, to suggest that healthy seniors using omega-3 supplements are protected from cognitive decline and Alzheimer’s disease.
– Omega-3 oils are good for the skin; they reduce signs of skin aging including fine lines, hydration, and signs of UV damage. They also reduce skin inflammation, acne, psoriasis, and may have an impact on adults with atopic eczema.
Quality Control and Purity
While Fish Oil is top of mind, we may as well cover “the bad in the good”. Because, when they get their act together and review the latest findings once more, you’ll want to be aware that not all fish oil is equal!
The world has become a toxic place. Fish live in water and waterways that have become sinks for these toxins. Once-pristine waters now contain contaminants such as mercury, dioxins and pesticides that ultimately become part of the food chain. The majority of these toxins accumulate over a lifetime in the fat of the host animal, with very little being excreted. Mercury escaping from an industrial facility or washed from the soil into the ocean can contaminate the algae on the ocean floor. These algae are food for small fish that are eaten, in turn, by larger fish that are eaten by even larger fish. When we eat tuna, a fish high on the food chain, the mercury that has worked its way up the food chain and concentrated in that fish is present at high levels. This concentrating effect is known as bioaccumulation.
With all our health awareness, we seem caught between protecting ourselves from heart disease and protecting ourselves from slow poisoning. But with a little care, we can accomplish this double feat by turning to purified, pharmaceutical-grade fish oil for our omega-3 supplementation.
North American labels don’t offer enough information to consumers when it comes to fish oil supplements—that is, information about the type of fish, in which body of water it was caught, how the oils were processed and, most importantly, if the product has been tested by a third party to validate its quality and purity. But high-quality fish oil manufacturers voluntarily adhere to guidelines established by other regulatory bodies such as the World Health Organization (WHO) and the Council for Responsible Nutrition (CRN). The CRN fish oil monograph has set out the permissible limits of contaminants in fish oils.
In summary, you need to look at the total oxidation or TOTOX value of the fish oil in question: you want it to be low, as the more oxidation there is, the more free radical damage there is to the oil. The higher the TOTOX the higher the chance the fish oil will do you more harm than good. The maximum you should tolerate is a level of 26. Acid value is another important measure, and you should look for oils that measure less than 3 mg KOH per gram. Rancidity factors such as the peroxide and anisidine values are also related to the oxidation of the oil and, if they are high, make it taste really bad: peroxide should be no higher than 5 mEq per kg and anisidine 20 mEq per kg. Heavy metals such as lead, cadmium, mercury and arsenic should be less than 0.1 m per kg in your chosen fish oil. If there are dioxins and furans, they need to be at levels less than 2 pg. Lastly, PCBs should be less that 0.09 mg per kg. These polychlorinated biphenyls aren’t produced any longer in North America, but they are still found in the environment and can cause hormonal disturbances.
The term “pharmaceutical grade” when applied to fish oil refers to quality and purity standards that comply with the CRN monograph. Since compliance with the CRN monograph is not mandatory by law, consumers can be fooled by misleading label claims. The only true assurance for quality and purity comes from companies that have each and every batch of finished product tested and validated by a third-party laboratory. Here are the most common misleading label statements:
Pharmaceutical Grade
Although I mention the importance of pharmaceutical grade, many products make this statement but have no proof as in third-party testing. No laws exist to govern this statement. Question your supplier on the product manufacturer’s basis for making this claim.
Third-Party Tested
Some products have been tested but not by independent labs. Some companies will subject several batches for third-party testing, yet only make available to consumers the test results that meet the grade. If a product states third-party testing, consumers should ask the manufacturer for the report on a specific batch number.
Toxin Free
This is perhaps one of the most misleading statements found on fish oil labels. Toxins exist in all foodstuffs, especially fish. The highest-quality fish oils have undergone purification to “reduce” contaminants down to CRN-compliant levels. No product on the market contains zero contaminants. Manufacturers that make this statement are purposely trying to be misleading or simply do not understand fish oil processing.
Highly purified fish oils from some manufacturers have been shown to be free of any detectable level of such contaminants as mercury. Here are a few questions to ask that may help you improve your chances of purchasing fish oil of reduced toxicity.
- Is the product in a dark bottle to eliminate light oxidation? If not, free radicals may already be accumulating in the oil.
- Has the product been submitted for third-party testing, and are these reports available to consumers? Badger your natural health-care provider and health-food store proprietor for this information.
- From which fish is the oil taken? (Herring, for example, is known to be relatively free of contaminants.)
- Where was the fish caught?
- How have the fish oils been refined?
- Did the manufacturer follow the CRN and WHO guidelines?
In the end, my brand preference is NutraSea omega-3 fish oil because it meets all of the above criteria. If you have their product and enter a lot number on their website, out pops a third-party laboratory quality test result.
I have supplemented my children’s diet with fish oils since the age of six months old. Before that, they got it through their mother’s breast milk, and before that through my wife’s diet.
I strongly urge you to not discontinue this dietary supplement.
The average dose I suggest you consider is 1 teaspoon (5 grams) twice daily providing an average ratio of 3:1 EPA:DHA if you’re looking to protect your heart.