Dear JJ: I visited a nutritionist who suggested I take fish oil to reduce inflammation, but then my doctor discounted taking it. I know you're a big fan of fish oil, so what are your thoughts with supplementing?
Tell your doctor to join the 21st century or find a new doctor. Fish oil has become mainstream, with even pharmaceutical companies producing this important supplement.
"There is a growing interest and market for omega-3 supplements as a result of the evidence-based health benefits," says Ornish Living, "and because so many people are now concerned about obtaining omega-3 from consuming fish because of potential toxins and high levels of mercury and PCBs."
Even if you're eating wild-caught fish regularly, you're probably getting too many inflammatory omega 6s, edging those crucial omega 3 fatty acids out of your diet.
When we say omega 3s, we're talking about eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the fatty acids in fish oil. (You'll find the third omega 3, alpha-linolenic acid or ALA, in plant foods like flaxseeds and walnuts.)
Researchers believe we once got equal amounts of omega 3s and omega 6s. When the industrial revolution occurred around 140 years ago, we started eating more omega 6 fats at the expense of omega 3 fats, thanks to the growing vegetable oil industry and increased use of grains to feed livestock, which alters meat's fat composition.
Between 1935 and 1939, the ratio of omega-6 to omega-3 fatty acids was about eight to one. Today that number is much higher, with a ratio as high as 50:1 in some individuals. That means today we get up to 50 times more inflammatory omega 6s than omega 3s.
"Omega-6s and omega-3s compete for the same enzymes," write Drs. Jonny Bowden and Stephen Sinatra in The Great Cholesterol Myth, "and when omega-6 intake is very high, it wins the competition by default."
Dr. Mark Hyman describes the detrimental repercussions of those fatty acid imbalances. "Omega 6 fats not only fuel your body's inflammatory pathways, but also reduce availability of anti-inflammatory omega 3 fats in your tissues, resulting in more inflammation," he writes. "In other words, omega 6 fats undo any benefit eating omega 3s would normally give you."
Even if you're eating wild-caught fish several times a week, supplementing with fish oil becomes the ideal way to better balance those omega-3 levels. While numerous reasons exist to take a high-quality fish oil, let's briefly look at these seven.
1. Fat Loss. One double blind, randomized, control study with 44 men and women determined fish oil's effect on resting metabolic rate, body composition, and cortisol production. After six weeks taking a fish oil supplement, researchers found significant increases in lean body mass and decreased fat with lower levels of their stress hormone cortisol.
2. Brain health. Research shows DHA and EPA can improve mood and boost overall cognitive performance. One meta-analysis also found fish eaters had lower depression rates. DHA seems to benefit brain development and performance, while EPA helps mood and behavior. Both fatty acids protect your brain.
3. Insulin sensitivity and lipid profile. One meta-analysis looked at how fish oil supplements impacted blood sugar and blood lipids for Type 2 diabetes. Researchers found fish oil lowered triglycerides almost 30 percent while also lowering blood pressure and improving vascular health. Another study found omega 3 fats can improve glucose metabolism by improving insulin's function among Type 2 diabetes. Animal research also shows fish oil can improve the pathways that process glucose; good news regardless whether you have diabetes.
4. Cognitive decline. One study found fish oil could prevent cognitive decline and brain atrophy in older adults. Prevention can never start too early. One review found omega 3s could recent or delay cognitive decline in its early stages.
5. Stress and anxiety. Research shows fish oil can dial down stress and anxiety. One small study found just three weeks of fish oil supplementation reduced all stress markers including adrenaline and cortisol. And a randomized controlled trial found fish oil could reduce inflammation and anxiety in medical school students.
6. Heart health. Research shows fish oil can lower triglycerides and those small, dense LDL particles that potentially trigger heart disease. Other research finds fish oil decreases the risk of heart attacks and myocardial infarction (MI), sudden cardiac death, and stroke.
Quality matters with fish oil. Shelf life, processing methods, inferior sourcing, and other obstacles can render supplements ineffective or rancid, creating more harm than good. Buying fresh, reliably sourced, professional quality fish oil becomes essential.
According to Drs. Bowden and Sinatra, you want to look for the amount of EPA and DHA, not total omega 3s, in softgels or liquid. Inferior brands might boast "1,000 mg omega 3s" or whatever but only contain small amounts of EPA and DHA.
Don't expect overnight results with fish oil. With a quality brand at the proper dose, you might require weeks or months to notice an effect. Be patient and you should see results.
If you have specific concerns, please speak with an integrative physician. In a few situations, such as if you are using a blood thinner, you should follow your doctor's guidance taking fish oil.
Jonny Bowden and Stephen Sinatra, The Great Cholesterol Myth. (Massachusetts: Fair Winds Press, 2012.)