Gavin Guard: Is Fish Oil Good for Heart Health?
Key Takeaways
- Fish oil is a type of omega-3 fat
- It has been shown to improve heart health as well numerous other health issues
- There’s a few notes to consider before supplementing with fish oil (details below)
- Improve your heart health with a multi-factorial approach that goes beyond just cholesterol
Is fish oil worth the hype?
You are most likely pretty familiar with fish oil. When you walk into the local grocery store or drug store, there seems to be at least a half a dozen fish oil brands and types. Chances are that you’ve taken them as a supplement a time or two.
But it seems as though the tides are shifting regarding fish oil over the last few years. At one point, they are a miracle supplement and at another point, they are a waste of money. It’s hard to know who to believe. Is this supplement helpful or a complete waste of time?
I’ve recently taken a deep dive into research on fish oil to bring you what you need to know. In this article, I walk you through:
- What is fish oil
- How heart disease is about more than cholesterol
- How fish oil may be able to help heart health
- Practical steps of how to use fish oil and determine if it’s working
WHAT IS FISH OIL?
Let me break down what fish oil is, so that you can understand how to get it through your diet and understand better how it works.
Dietary fat is one of 5 major macronutrients. It comes in different 3 different forms, or “variations”:
- Saturated fat (e.g. lard, butter, animal fat)
- Monounsaturated fat (e.g. canola oil, avocado oil, avocado, olives, olive oil)
- Polyunsaturated fat (e.g. safflower oil, vegetable oils, fish, fish oil)
The terminology here just refers to the number of double bonds in the carbon chain of the fat molecule. The polyunsaturated fats are then further classified as:
- Omega-6 fatty acids (vegetable, safflower, corn, sunflower oils)
- Omega-3 fatty acids (fish oil, flaxseed oil, algae, chia seeds)
And then within omega-3 fatty acids, it can be even further broken down into 3 main molecules:
- Alpha-linolenic acid (flaxseeds, chia seeds, algae)
- EPA
- DHA
Fish oil is especially rich in EPA and DHA. This is important to note since humans have a hard time converting alpha-linolenic acid into EPA and DHA, the major active omega-3’s. This is why you often hear health enthusiasts encouraging you to get enough omega-3s through fish oil (instead of flax, chia seeds, algae).
EPA and DHA have been studied for their cholesterol-lowering effects as early as the 1970s. It was around this time that many health organizations encouraged the population to eat enough of these health-promoting molecules.
This was important given the fact that an average person only eats 150 mg of EPA/DHA through their diet. This is in stark contract to fish-eating populations such as the Okinawan people who would eat ~2,000 milligrams per day. The Greenland Eskimos would get closer to 6,000-7,000 mg per day. Perhaps, this is why Eskimo populations suffered less heart attacks.
What you need to know is that:
- Omega-3s are a healthy type of fat
- Fish and fish oil is the optimal source of omega-3 fatty acids
- Most of us don’t get enough omega-3 fatty acids through our diet
INFLAMMATION PROMOTES HEART DISEASE
Let’s now transition to discuss how omega-3s and fish oil ties into heart health. It’s important to know that cholesterol is not the only important thing to do with heart health. As a clinician, I also look at the other following factors to measure heart health and heart disease risk:
- Immune system balance
- Inflammation
- Blood sugar balance
- Endothelial function
- Genetic risk factors
Inflammation in particular is a powerful driver of heart disease. It is linked to many chronic health conditions including poor heart health. For instance, higher inflammatory levels (as measured by CRP levels) are predictive of future heart disease events. In other words, more inflammation means a higher chance of heart disease.
Furthermore, lowering inflammation can lead to less heart disease. In one study published in the New England Journal of Medicine, a drug designed to block inflammation, led to a 15% lower heart disease events in those with elevated baseline inflammation. However, this beneficial finding was not replicated in another study using a different anti-inflammatory drug.
Nonetheless, I believe that inflammation is:
1. Necessary for the onset of heart disease
2. Lowering inflammation will likely improve heart health
HIGH TRIGLYCERIDES ALSO PROMOTE HEART DISEASE
Whenever you get your annual cholesterol panel, your doctor also measures something called triglycerides. Unfortunately, these levels often go ignored unless they are very high.
However, new research is pointing to the fact that high triglycerides (along with inflammation) are also associated with heart disease. This is because high triglyceride levels change how other cholesterol particles behave - making them more prone to causing heart disease.
Studies have shown that genetic mutations that result in higher triglycerides are associated with higher heart disease risk. This means that triglycerides are causing heart disease.
Importantly, inflammation and high triglycerides have a two-way relationship:
1. High triglycerides lead to inflammation
2. Inflammation leads to high triglycerides (in fact, high triglycerides may be seen as an inflammatory marker and often decrease when you treat the root cause of inflammation
I share all of this information to show you that:
1. Heart disease is much more than just cholesterol (it also includes factors like inflammation and triglycerides).
2. If we can lower inflammation and triglycerides, we may be able to improve heart health.
FISH OIL FATTY ACIDS REDUCE INFLAMMATION AND HIGH TRIGLYCERIDES
Fortunately, omega-3s can do both (lower inflammation and lower triglycerides)!
Research has shown that people have 35% lower triglycerides when they eat a diet high in omega-3s as compared to saturated fat or vegetable oil rich diets. Other types of studies have shown that supplemental omega-3s can lower triglycerides by 20-45% depending on the dose.
Also, omega-3s can lower inflammation levels. This has been shown by a multitude of well-designed studies.
Again, omega-3s can:
- Lower triglycerides
- Lower inflammation
But do they actually lead to less heart disease? Let’s see…
FISH OIL MAY LOWER HEART DISEASE RATES
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