Finding health information you can trust is a daunting task these days. It’s particularly frustrating when a simple search yields vastly different expert opinions and conflicting scientific evidence. The truth is that the mainstream media loves this confusion because conflict is what keeps their viewers interested… but that doesn’t help you much.

A case in point is the debate over the value of taking fish oil supplements. One headline says they are a cure-all, the next says that they are a total waste of money. Fish oil pills are promoted as good sources of omega-3 fatty acids, an essential nutrient that we know is good for cardiovascular health, cancer prevention, and cognitive function. But admittedly, studies examining the purported benefits of fish oil benefits have been mixed.

The pursuit of the truth using science and research is a process…not an event. Good-faith disagreements and conflicting research results are often par for the course before the proverbial dust settles. But I realize this process can be very frustrating, particularly when you are looking for health information that you can rely on. With that in mind, I like to share information that I hope will clarify both what we know and don’t know about fish oil supplements.

Why Omega-3-Rich Fish Oil is Good For You

It’s pretty well established that eating wild-caught cold water fish (particularly salmon, albacore tuna, sardines, herring, and mackerel) is very good for you. These fish are excellent sources of long-chain omega-3 fatty acids, a nutrient the body cannot manufacture on its own.

These fish-derived fatty acids play a critical role in combating inflammation, improving cognitive function, and promoting normal growth and development. Deficiencies of omega-3 have been definitively linked to an increased risk for cardiovascular disease, arthritis, some cancers, mood disorders, and many other health problems.

Many of my patients are well-versed health benefits of omega-3s. But some are not big fans of fish (because they don’t like the taste, they find it too expensive, or they are concerned about consuming contaminants like mercury). These are the folks that ask me if they can get omega-3s from plant-based sources like flax seeds, nuts, avocados, or coconuts.

Omega-3: Plants vs. Fish

It’s true… seeds, nuts, and even some vegetables (like Brussels sprouts) are good sources of omega-3s and I highly recommend you eat these foods. But the omega-3s from plant-sources are biochemically different from the omega-3s found in fatty fish. Here’s a quick breakdown of the difference and how it can impact your health:

• Plant-based omega-3 are made from a short-chain amino acid of a type called alpha-linolenic acid (ALA). Your body needs to convert that ALA into docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) which are the forms it can use. Unfortunately, the body is not very efficient in converting ALA into these super healthy compounds. So, unless you eat fish (or take fish oil) it’s hard to eat enough plant-based omega-3 sources to get enough of the EPA and DHA you need.
• The Omega-3 oils found in fatty fish are made from ready-made EPA and DHA. These two compounds are already in a form that your body can use immediately (without any conversion). By the way, the reason the body can use DHA and EPA right away is that these particular type of amino acids are a critical structural component of your cellular membranes in cell and every organ in your body.  That includes red and white blood cells, neurons in the brain, the blood vessels, and everywhere else. It should come as no surprise that there’s widespread agreement that DHA and EPA supports cognitive health, cardiovascular health, immunity, and every other body system you’ve got.

Are You Getting Enough Omega-3s?

So, whether they come from dietary sources or from an extract inside of a capsule, the oils found in fish are unique and have some remarkable health benefits. Plant-derived oils are important to include in the diet as well, but they are not the same as form found in fatty fish.

There’s another important reason to focus on the preformed omega-3s from fish sources. Marine omega-3s help to balance another type of fatty acid called omega-6. Like omega-3, omega-6 is a polyunsaturated fat. Your body needs both these compounds to carry out biological processes, but the two compete for space (so to speak).

But in excessive amounts, omega-6s have a pro-inflammatory effect meaning that they can promote, enhance, or increase inflammation. That is the opposite effect that you get from omega-3s which have an anti-inflammatory effect. Ideally, people should have about a 2:1 ratio of omega-6 to omega-3s. That’s the kind of balance our hunter-gatherer ancestors had and what works best for optimum cellular health. But Americans tend to consume a diet that has a more like a 20:1 ratio of omega-6s to omega-3s. This unhealthy ratio of omega-6 compared to omega-3s is correlated with:

• Cardiovascular disease
• Mood disorders
• Oxidative stress
• Increased risk of cancer
• Chronic inflammatory states

And of course, the solution to this unbalanced ratio problem is simple:

1. Eat less omega-6 (especially the ones in corn oil, soybean oil, cottonseed oil, and vegetable oils)
2. Eat more omega-3 (from wild fish, nuts and seeds)  

Takeaway

The results of a new study, published in the Journal of Clinical Lipidology, make clear that having a better ratio of omega-3s to omega-6s makes a huge difference not just to heart health, but also when it comes to reducing overall mortality.

I think it’s best to get your omega-3s from natural sources as a first resort. For one thing, EPA and DHA are better absorbed from eating whole fish than from taking fish oil. I also understand that eating fish two to three times per week may not palatable (or affordable) from many people.  If that’s the case, fish oil supplements can certainly help ensure that you get enough of a nutrient that is vital to your health.

Take good care,

Dr. Josh