A Walletectomy?
I can’t eat pepperoni or hot dogs and now you want me to take fish oil?
In 2012, almost 8% of the US population said they had taken a fish oil supplement within the past 30 days. Most take it for “heart health”. The reality is that there is only one reason approved by the FDA to take fish oil and that is to lower triglycerides.
Okay, well 8% of the population can’t be wrong can they?
Another reality check. There has been no study done on “healthy people” to see if fish oil supplements prevent heart attacks.
What about fish oil supplements in people at high risk of heart disease?
Good question. Let’s look at the data. Of the four good studies looking at people at high risk of heart disease (i.e. diabetics, smokers, high blood pressure, high cholesterol, peripheral arterial disease), 3 of them showed that fish oil did not prevent heart attacks or heart related death (Study 1, Study 2, and Study 3). The one study that did show a benefit was done in Japan on men who had total cholesterol >250mg/dl. The men received 1.8grams/day of the Omega 3 eicosapentaenoic acid and a statin. The other guys received a statin only. They noticed that the men who took the fish oil tablet had slightly less chest pain, balloon angioplasty, or bypass surgery but it did not effect the number of heart attacks or heart related death. The benefit was only seen in men with a prior heart attack and 50 men needed to take the Omega 3 over about 5 years for 1 person to benefit.
What if I’ve had a prior heart attack? Will fish oil help me?
If you could take a time machine back to 2001, fish oil may help you. In a review of all good studies of fish oil published through 2012, there was a slight reduction in heart death with fish oils (1,000mg/day), but most of the studies that showed a benefit were published before 2002. There was no effect on preventing heart attacks. There was no protection against stroke noted in this study either. A finding which has also been seen on two studies after 2012 (Study 1 and Study 2).
C’mon, give me something with fish oils–I have tons of fish oil bottles at home I’ve bought at Costco!
One study has looked at people with heart failure and found that 840mg/day of fish oil over four years prevented death and hospitalizations….BARELY, over those who didn’t take fish oil. In my opinion, one study doth not usually a recommendation make. I hate to break it to you too, but fish oil doesn’t prevent atrial fibrillation.
Fine, what’s the bottom line?
1). Most people spend money on fish oil and all they get is bad breath and a walletectomy. Save your money.
2). In people with prior heart attacks, most studies after 2002, show no real effect of fish oils on cardiac death or heart attacks.
3). Fish oil (>/=4 grams/day) can lower triglycerides.
4). I don’t really recommend fish oils to my patients. The few studies that show a benefit say it takes a lot of people to take fish oils for one person to benefit (ie. 1 problem stopped for every 50 people taking fish oils over 5 years).