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Does Fish Oil Really Work? This is What the Science Says

Fish oil is a major source of omega-3 fats, which are essential for good health, just like basic vitamins and minerals. So, why do some studies question the benefits of fish oil? Here are the facts.

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According to the National Institutes of Health (NIH), “Omega-3s are important components of the membranes that surround each cell in your body.” This is a critical function. Much like the skin on our bodies, cell membranes act as a protective barrier and enable each cell to function properly and sustain life; damage to that protective “skin” will inevitably have unhealthy consequences. The NIH notes that omega-3s are essential for the healthy function of the heart, blood vessels, brain, eyes, lungs, immune system, sperm cells, and glands that produce hormones.

Unfortunately, says Suzanne Steinbaum, DO, an integrative cardiologist and director of the Women and Heart Disease Center at Lenox Hill Hospital in New York, “the body does not make omega-3s. It’s something that you can only get from diet.” And that’s where supplements—especially fish oil—come in.

The Vital Ingredients in Fish Oil

Fish oil contains two essential omega-3 fats: EPA and DHA (short for eicosapentaenoic acid and docosahexaenoic acid). Supplements made from algae are a vegan source of EPA and DHA, but fish oil is the most widely used and studied source.

Plant-based omega-3s come in a different form, alpha-linolenic acid, or ALA, which the human body converts into EPA and DHA. Top sources include flax seed oil and chia oil. Because the efficiency of the conversion process varies, it may be difficult to get sufficient amounts from ALA alone.

Conflicting Fish Oil Studies Explained

When studies question omega-3 benefits, says Steinbaum, “The headlines really mislead the population.” Here’s what typically happens: Researchers look at large groups of people and compare markers of heart health among those who take fish oil supplements and those who don’t, but they omit critical information.

“Supplementation alone is not enough to ensure that you’re getting what you need,” says Steinbaum, because the dose may be too low. Individual needs vary, depending upon overall diet, physical condition, lifestyle, genes, and ability to absorb and utilize omega-3s. Because these studies don’t typically evaluate whether participants are getting sufficient omega-3s for their personal needs, they likely don’t draw accurate conclusions.

Did you know…

Norway has been ranked the happiest and healthiest country in the world, with the longest life spans. It might not be a coincidence that Norwegians eat a lot of fish.

How to Benefit from Fish Oil

For optimum health, the trick is to get enough omega-3s to meet your needs, and most people don’t. In a study of 200 American and German adults, ages 18–80, researchers measured each person’s level of omega-3s and found that 99 percent fell below optimum levels that protect against heart disease. Most often, integrative physicians recommend getting 1,000 mg of EPA and DHA daily, but you may need more. The only surefire way to tell is to have your levels tested.

The Best Omega-3 Test

Unlike blood pressure, cholesterol, and triglycerides, omega-3 testing is not part of routine check-ups, but progressive doctors such as Steinbaum believe it should be. She recommends the omega-3 index test, which has been used in more than 200 studies. It requires a drop of blood from a finger prick, and measures levels of EPA and DHA in red blood cells, indicating levels of omega-3s and how well your body is using these fats.

Your doctor may or may not be familiar with the omega-3 index test, but you can ask for it. Or order the test directly from Results include recommendations for how much EPA and DHA to take to achieve optimum levels.

What to Look for on Labels

The label on the front of most products lists the total amount of fish oil, per serving, but the more important information is in the Supplement Facts section on the back. Look for amounts of EPA and DHA, which are listed separately, and add those two numbers. For example, some products contain:

  • Amount of fish oil per serving: 1,000 mg
  • EPA: 180 mg
  • DHA: 120 mg
  • EPA plus DHA: 300 mg

In this case, you would need about 3 servings to get the recommended 1,000 mg of EPA and DHA. However, some fish oils are more concentrated, with 1,000 mg or more of EPA plus DHA per serving.

Some people experience gas when taking fish oil and find that krill oil is easier to digest. The best vegan option is EPA and DHA from algae. Products may be called omega-3, vegan omega-3, or EPA-DHA, and often list amounts of EPA and DHA on front labels. With all forms, aim for the recommended daily dose of 1,000 mg of EPA and DHA, or amounts based on an omega-3 index test.

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