By Tanya Edwards, MD, M.Ed. Director, Center for Integrative Medicine, Cleveland Clinic
Many of you have been left wondering whether fish oil is still worth spending money on, given the recent meta-analysis showing that it appears to have no benefit for decreasing your risks for developing cardiovascular diease or dying from a heart attack. I am still recommending that all my patients take daily fish oil (or some other source of omega-3 with at least 600mg of DHA), and here's why:
1. Although the recent analysis of 20 studies done since 1989 (out of over 3,600 studies performed!) showed that the 10% reduction in cardiac death was not statistically significant, the chance that it might help, in my opinion, outweighs the risk of taking it (basically, no risk!).
2. The studies performed from 1989 to 1998 more routinely showed significant benefit compared to the later studies. The possible reason for the change: Statin drugs have become the standard of care in patients with cardiovascular disease since 1998. With such powerful drugs on board, it may be very difficult to see an added benefit of fish oil.
3. Omega-3 fats are essential fats. That means our body needs them to function, but we can't make them on our own. We must get them from our diets. Unfortunately, most of us don't eat enough fish, or the fish we're eating may not be great sources of these necessary fats (often due to the type of fish or the farming practices). Plant-based sources of omega-3's (like walnuts, flax seeds and chia seeds) are great sources of one type of EPA omega-3, but not the other, DHA. You need to eat good sources of fish (wild salmon, trout, sardines, anchovies, herring and mackerel), or algae (as in sushi), or take supplements in order to get the DHA.
4. Omega-3's have been found to be beneficial for rheumatoid arthritis, reduction in breast cancer risk, reduction in ulcerative colitis risk, prevention of weight loss during chemotherapy, prevention of age-related macular degeneration, decreased symptoms of depression, anxiety, bipolar disease, and schizophrenia, decrease in premature births, and age-related cognitive decline.
We have a ways to go before the scientists have proven, without a doubt, all the benefits of taking omega-3 supplements, but for now, it makes sense to take at least 600mg/day of DHA as insurance against low dietary intakes, given the minimal risk (other than the cost of the pills or the risk of reaction in patients with severe fish allergy).