By: Nicole Recine APRN
Health Benefits Of Supplements
I have always been a skeptic of supplementation. In general, I believe the health benefits of supplements are often overstated or completely unsubstantiated. In recent years, omega-3 supplements have become the popular supplement for cardiovascular health. Other proposed, but less established, benefits of omega-3 supplements included improved brain health, decreased risk of breast and colorectal cancer, and reduced inflammation.
Most of these claims came from large, epidemiological studies that looked at the eating patterns of different populations. Researchers observed that populations whose diets included more fatty fish had lower rates of cardiovascular disease. As I have mentioned before, epidemiological studies in nutrition are extremely unreliable, and usually very biased. They simply look at correlations that occur in large populations, and attempt to make claims about the correlations without considering context. Even so, the health benefits of omega-3 fats were based on observation studies that looked at people whose diets included eating fatty fish, not people who took omega-3 supplements. Can a person get the same benefit from a capsule?
Healthy Diets Include Omega-3 Fats
Omega-3 fats are essential fatty acids, meaning we must consume them to live. They are polyunsaturated fatty acids that come in three forms. Ecosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are found in fish while alpha-linolenicacid (ALA) is found in plant foods like walnuts or flaxseeds. The belief that these fatty acids have unique health benefits has lead to the mass marketing of fish oil supplements, as well as ALA supplements for vegetarians and vegans.
Many consumers (and medical professionals) were lead to believe that supplementing with omega-3 capsules could make up for a diet that lacked fatty fish, and that taking these supplements would reduce cardiovascular risk. As I often say, isolating and consuming single nutrients seldom has the same beneficial effects as actually living the lifestyle and eating the diet in which the benefits were observed. In this case, it was populations of people that consumed fatty fish as a part of their overall pattern of eating. But, we have no way of knowing if it was specifically the omega-3 fats, or something else, that caused these people to have better health. They certainly were not taking omega-3 supplements in the context of an otherwise lacking diet.
Supplementation vs Healthy Diet
Two studies have come out this year that have examined the claims behind omega-3 supplementation. The first was published in the Journal of the American Medical Association (JAMA). This was a meta-analysis of 10 trials. The researchers wanted to know if omega-3 fatty acids from fish have any associations with reductions in coronary heart disease in people at high risk of cardiovascular disease. They found that omega-3 fatty acids did not reduce cardiovascular risk, and they did not support for current recommendations for the use of omega-3 supplements in people with a history of coronary heart disease.
The second study was published in the Cochrane Database of Systematic Reviews. This was a meta-analysis and systematic review of 79 randomized-controlled trials that looked at whether increased consumption of EPA, DHA, and ALA altered the risk of all-cause mortality, cardiovascular deaths, cardiovascular events, coronary heart disease deaths, coronary heart disease events, stroke, arrhythmia, adiposity and lipid disorders. The researchers found little to no benefit from increasing omega-3 intake on any of these outcomes. increasing omega-3 intake on any of these outcomes.
Establish A Healthy Lifestyle & Eating Pattern
I was not surprised by these findings as I am a longtime skeptic of supplementation to compensate for an unhealthy diet. I never claim to know the healthiest way for all humans to eat. However, I generally believe establishing a pattern of eating and a lifestyle that supports your personal health is far more effective than searching for a cure in the supplement aisle. As such, incorporating more omega-3 rich, whole-foods in your diet (such as lamb, grass-fed beef, walnuts, or wild caught seafood) into your diet is likely a better strategy than popping omega-3 supplements.
About The Author:
Abdelhamid AS, Brown TJ, Brainard JS, Biswas P, Thorpe GC, Moore HJ, Deane KHO, Al Abdulghafoor FK, Summerbell CD, Worthington HV, Song F, Hooper L. Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease. Cochrane Database of Systematic Reviews 2018, Issue 7. Art. No.: CD003177. DOI: 10.1002/14651858.CD003177.pub3.
Aung T, Halsey J, Kromhout D, et al. Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks Meta-analysis of 10 Trials Involving 77 917 Individuals. JAMA Cardiol. 2018;3(3):225–233. doi:10.1001/jamacardio.2017.5205