Is fish oil really snake oil?

Things got a bit fishy regarding fish oil this past year when new research called into question the long-held benefits of omega-3 fatty acids. After myriad studies had supported consuming these heart-healthy fats by eating fatty fish or supplementing with fish oil, a few studies left many wondering if the benefits were real. Or worse, were they perhaps taking too much?

“Splashy headlines get the media’s attention,” warns Brian St. Pierre, R.D. a fitness and nutrition coach with Precision Nutrition. “But, unfortunately, it can cause people to lose sight of the big picture. The research that showed fish oil didn’t have a positive impact on health tended to be in people who already had advanced cardiovascular disease. In those cases, the benefits were minimal.

But the majority of research shows omega-3 fats and fish oil, in particular, have cardiovascular and nervous system benefits. They’ve also been shown to improve eye health, brain health, and joint health; to decrease overall inflammation and the risk of depression; and to moderately decrease blood pressure in people with hypertension,” he explains.

Another recent study suggests omega-3s may even improve sleep. Not surprisingly, St. Pierre, like many nutritionists, is a proponent of consuming the most beneficial omega-3s found in fatty fish: EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid); and in some cases, ALA (alpha-linoleic acid), found in flax.

One aspect of omegas adding to the controversy is that our bodies naturally make a certain amount of EPA and DHA, which can be converted from ALA. “But making enough is dependent on having key nutrients in our diet. If you’re not eating grass-fed beef and organic eggs, it can be hard to achieve that so supplementing can be beneficial,” says nutritionist Haylie Pomroy, founder of The Fast Metabolism Diet.

St. Pierre likens it to creatine. “We produce enough to survive, but taking creatine as a supplement has benefits too. It can improve performance in athletes looking to increase explosive power as well as improve body composition.”

Both nutritionists recommend eating wild-caught, cold-water fish like salmon, mackerel, sardines, herring, or albacore tuna 2-3 times a week. If, like most people, your diet doesn’t include that amount, then supplement.

Here, their fatty acid supplement guideline:

How much to take “I suggest 1-2 grams of total EPA and DHA from fish oil. For most good quality supplements 1-2 pills will usually net you this. It’s conservative, because you’re going to get some other omegas through your diet–in the form of omega-3 eggs, fish you’re eating, chia or flax seeds—so your total intake will be a little higher,” says St. Pierre.

What to look for “You want a bottle that clearly states that it’s a highly concentrated, molecularly distilled and purified fish oil supplement with no heavy metal contamination. The label should also indicate the amount of EPA and DHA on the back,” he says.

When to add flax “While both sexes benefit from fish oil, sometimes women, particularly those with a hormonal imbalance or inflammation, also benefit from supplementing with flax,” says Pomroy. “The thought is that the way women balance their prostaglandins—hormone precursors that, in part, regulate the distribution and metabolism of the sex hormones—is more dependent on plant-based omegas. In those cases, I recommend the addition of 2-3 grams of flax oil.”

How to store it Fish oil is a polyunsaturated fat so it’s the least stable type of fat and most prone to oxidation when exposed to oxygen—even from opening and closing the bottle. Buy a smaller bottle (rather than a jumbo size) that’s stamped with an expiration date, then store it in the freezer. Flax oil is equally susceptible to rancidity, so store it in the fridge.

When to check with your doctor “Fish oil does thin the blood so if you’re on a pharmaceutical blood thinner like Warfarin, Coumadin, Heparin or if you’re taking baby aspirin, check with your doctor as pharmaceuticals and supplements can have compounding effects,” says St. Pierre.