Dietary supplements are big business, and I mean the Billions of Dollars kind of big business. Of the 38% of the US population who engages in some form of complementary medicine, the majority of those individuals are using natural products such as dietary and herbal supplements [1]. And the Number One dietary supplement used in the USA is Fish Oil [1]. Fish oil is taken by individuals to treat a myriad of problems including Depression, Cardio Vascular Disease, Attention Deficit Disorders, joint problems like Rheumatoid Arthritis, and decreased metabolism. So does fish oil really help with any of these problems, or are people just wasting their money?
Let's start with Cardio Vascular Disease (CVD) and related risk factors like inflammation, blood pressure, triglyceride and HDL levels. Several studies have shown that that fish oil supplements do in fact decrease blood triglyceride levels while increasing HDL levels (aka "good cholesterol") [2]. However, while the affects are statistically significant, they were still very small. When it comes to inflammation in the circulatory system, the active component in fish oil, Omega 3 fatty acids, have been shown to reduce inflammation which can protect against CVD [3].
Take Home Message: Fish oil supplements have some protective effects against CVD.
Okay, so what about joint health and Rheumatoid Arthritis? A large study in 2008 found that taking fish oil supplements significantly decreased NSAID (pain medication) use when compared to a placebo in patients with Rheumatoid Arthritis [4]. As it turns out, clinical trials have shown that the anti-inflammatory effects of those Omega 3s extends to joint inflammation [5].
Take Home Message: Individuals with joint pain and Rheumatoid Arthritis may benefit from fish oil supplementation.
A new study just published this year found that omega 3 Fatty acids, like those found in fish oil, decreased anxiety in otherwise healthy medical students [3]. While no improvements where seen in depression symtoms, this trial provides evidence that individuals may see improvements in overall anxiety levels by taking fish oil supplements. However, I would recommend waiting on more research before starting on a fish oil supplement regimen to reduce anxiety.
Take Home Message: Fish oil supplements may reduce anxiety in otherwise healthy individuals, but I'm not signing up just yet.
When it comes to Attention Deficit Disorders, metabolism, and all other health claims, the evidence that fish oil has any effects is significantly lacking. While some studies show positive results, others show negative results, and almost all of the research trials are very small. In order to determine the true effects of fish oil supplements in any of these diseases and disorders much more research is needed.
Natural does NOT mean Safe!
There are plenty of natural things in this world that will kill you like sharks, volcanos, and poison mushrooms; so just because a product is said to be natural it does not mean that it is automatically safe. Before taking fish oil supplements it is important to understand that they are considered dietary supplements and are therefore not required to be proven safe or effective. The FDA is only responsible for removing such supplements fromt the market if they have been proven unsafe. Fish oil supplements are at risk of containing contaminates such as Mercury, Lead, Arsenic, and Pesticides [6].
Warning: Fish oil supplements should not be used in conjunction with blood thinners or by individuals with bleeding disorders.
References:
1- NCCAM. The use of complementary and alternative medicine in the United States. US Department of Health and Human Services; Dec. 2008. http://nccam.nih.gov/news/camstats/2007/camuse.pdf
2- Hill AM, et al. Combining fish-oil supplements with regular aerobic exercise improves body composition and cardiovascular disease risk factors. Am J Clin Nutr. 2007; 85: 1267-1274.
3-Kiecolt-Glaser JK, et al. Omega-3 supplementation lowers inflammation and anxiety in medical students: A randomized controlled trial. Brain Behav Immun. 2011.
4- Galarraga B, et al. Cod liver oil (n-3 fatty acids) as an non-steroidal anti-inflammatory drug sparing agent in rheumatoid arthritis. Rheumatol. 2008; 47:665-669.
5- NCCAM. Rheumatoid Arthritis and CAM.
http://blackboard.utk.edu/webapps/portal/frameset.jsp?tab_tab_group_id=_2_1&url=%2Fwebapps%2Fblackboard%2Fexecute%2Flauncher%3Ftype%3DCourse%26id%3D_757123_1%26url%3D
6- United States Governement Accountability Office. 2010. www.goa.gov
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