Categories: FreshnessHeart HealthOmega-3

Omega-3 Research on Cardiovascular Events Doesn’t Measure Up

By
Bo Martinsen, MD
September 20, 2012

It’s confusing.

For years, we’ve been told to take our fish oil, since studies have touted the benefits of omega-3 for everything from protecting against cardiovascular disease to reducing joint pains to improving mental health.

And then, just last week, came a review from the Journal of the American Medical Association suggesting that omega-3 may not have an impact on major cardiovascular events, including heart attack, cardiac death, and stroke.

So what’s really true about the benefits of omega-3 fish oil and the findings of this recent review?

If you search the word ‘omega-3’ at the Library of the Congress website, you will see more than 15,000 references to clinical studies and articles on the subject. Since researchers discovered 40 years ago that fish oil contained large amounts of extremely flexible molecules called omega-3, the scientific community has published thousands of studies showing that fish oil is critical to heart, joint, and mental health.

But lately, many studies are reporting contradictory results, leading many scientists to wonder why. Is it because new clinical trials include healthier participants? Or is it simply related to the quality of the oil being used?

There may be several factors at work. The most important fact to consider is that the research protocols are not standardized. Many new research studies do not use a significant dose, a high quality oil, or even a natural fish oil that mirrors the chemical structure of the fatty fish. Yet, in spite of the fact that these studies are not controlling for enough variables, they make large claims about the effectiveness of omega-3 as a whole.

The next time you hear about the results of a new omega-3 study, here are some well established points that will help you evaluate the findings:

1. What kind of dose did the researchers use? Omega-3 molecules’ anti-inflammatory effects only kick in at a dose of at least 1.7g of EPA/DHA per day. That’s more than five regular fish oil capsules. Many studies use only half of this amount. Not surprisingly, these same studies are the ones concluding that omega-3 does not provide the health benefits cited in earlier studies.

2. Did the study use omega-3 oil containing the entire family of omega-3? Despite the fact that even the American Heart Association states you need both EPA and DHA to protect the heart – and also says that ALA or DHA omega-3 alone will not provide the same benefits – several hundred studies are using only single members of the omega-3 family. Since EPA, DHA, and ALA are only part of the omega-3 family, one acting alone does not provide the same benefits as all the members of the omega-3 family acting together.

3. Did they use a natural oil? The majority of the new pharmaceutical grade or prescription omega-3 oils are chemically changed by esterification. Ethyl esther omega-3s are not found naturally in nature. Many studies show that these ethyl ester omega-3 molecules have a reduced impact on cell metabolism as compared to their natural counterparts. Despite this fact, clinical trials often do not mention whether or not they used an artificial omega-3 or a natural oil that mirrors the composition of fatty fish.

4. How fresh was the oil? Studies show that freshness of the fish oil greatly influences the body response. A recent study from Norway revealed that about 95 percent of more than a hundred omega-3 supplements on the market were so rancid that they did not comply with industry standards. Some researchers are now suggesting that the harmful by-products found in rancid oils offset the health benefits of the omega-3. But despite the fact that freshness of an oil impacts the effectiveness of the omega-3, researchers almost never report the oxidation levels of the oil used.

5. Did the participants take the full dose every day? While some studies describe the compliance level among the test subjects, most do not. When it comes to fish oil, this is a crucial point. Not only is fishy burping noted as a common problem among users, but many omega-3 users also describe taking multiple capsules a day as a hardship. In a study from Denmark involving pregnant women, the researchers found that after 3 months, all of the study participants had stopped taking the fish oil. But that didn’t prevent the authors from concluding that fish oil didn’t have any benefit for the women or their children.

Omega-3 research is only as good as the precision and relevance of the protocol. In a review of the benefits of omega-3, researchers must take into account the variables that naturally impact the performance of the oil. Unfortunately, the fact that a study was published by a university does not guarantee scientific excellence.

We are going to see a lot of strange and confusing findings in the years to come unless researchers and reporters start accounting for the dose, quality, and compliance of the omega-3 used in the studies. But luckily, fish oil consumers can take action and interpret the findings themselves by asking the above questions.

Bo Martinsen, MD

Dr. Martinsen is an omega-3 specialist, innovator, and advocate for natural foods. As co-founder and CEO of Omega3 Innovations, he has created multiple patented technologies for medical devices designed to improve consumer compliance. He is also the creator of several medical food products that combine dose-effective ingredients of omega-3 fish oil with soluble fibers and other nutrients. Before Omega3 Innovations, Dr. Martinsen practiced medicine in Norway for 20 years. During his career, he also served as a medical consultant to large international corporations, focusing on stress management and synergistic medicine.

View Comments

    • This piece provides a good list of ways to assess freshness and how to avoid buying rancid omega-3 products: Is Your Fish Oil Rancid?

      Your best bet as a consumer is to taste and smell the oil (yes, break open the capsules and taste what you are getting). You can also ask the manufacturer for the peroxide and anisidine values of their oil (those are two important freshness measurements), plus the date those numbers were taken.

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