Fish Oil: to Supplement or Not?
As a pharmacist, I am often flagged down in the supplement aisle for inquiries about various supplements. It is common for people to supplement with over-the-counter options; in fact, 77% of surveyed Americans take at least one supplement.1
A common supplement that people with heart failure integrate into their regimen is fish oil. This leads to the question: how effective is fish oil for the heart, and with all the various options available, which formulation is best?
What led to the popularization of fish oil supplements?
Fish oil has been consumed as a supplement for quite some time. It was traced back to the Romans, who made fish oil out of fish intestines. During the industrial revolution, cod liver oil was routinely used for its high Vitamin D concentration during a time when children were suffering from rickets. Eventually, the oil was purified and made into the type of fish oil we know today.2
Initial studies on fish oil
Studies emerging in the 1970s revealed that heart disease was lower in Inuit people who were ingesting a diet heavy in seafood. Eventually, the Omega-3 fatty acids were isolated to be the beneficial component of fish oil. As we all know, Omega 3 is touted to have numerous benefits other than those on the heart, including mood regulation, eye health, and immune protection.3-4
For heart disease, the Food and Drug Administration (FDA) allows manufacturers of seafood omega-3 fatty acid supplements to state that Omega-3 may help reduce the risk of high blood pressure and coronary heart disease. If you consume these products, you have likely seen these claims on the product.4,5
What the studies show
There are many studies on the effect of fish oil supplementation on our hearts; however, many of these studies are not robust in nature. This is why the FDA only allows the claim that fish oil “may” reduce the risk of the aforementioned conditions. Studies have shown positive effects such as:4
- Heart rate: fish oil may reduce resting heart rate by approximately 1.6 beats per minute
- Anti-inflammatory: fish oil may reduce inflammation in the body
- Triglyceride levels: fish oil can reduce triglyceride levels (a type of fat found in the blood)
- Blood pressure: fish oil can lower blood pressure; one study showed that systolic BP was lowered by 1.52 mmHG and diastolic by 0.99 mmHG
Overall, fish oil may improve heart outcomes. However, it is recommended that you discuss this with your heart team before you start supplementation.
Types of fish oil available
Contrary to the term fish oil, you don’t need to take an oil formulation to derive the benefits of fish oil. Gel capsules are also available; however, both formulations generally claim that there is no fishy smell. It is interesting to note that the most common reason why fish oil supplements are discontinued is the fishy smell after burping.4
When should they be taken?
For people who can’t be bothered to time their meals with their supplement use, fish oil can technically be taken any time of day, with or without food. However, they are best absorbed with a high-fat meal, such as avocado, cheese, and beef. Taking it with food may also help reduce the fishy smell when belching.4
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