Fish oil is one of the most consumed dietary supplements on the market. Global sales were 2.25 billion in 2014 and it’s expected to reach over 3 billion by 2020.(1)
According to the 2012 National Health Survey, 7.8 percent of adults (18.8 million) and 1.1 percent of children aged 4 to 17(664,00) had taken a fish oil supplement in the last 30 days.(2)
Omega-3 acids found in abundance in oily fish can be important to our health. The American Heart Association recommends the general adult population should eat fish (particularly fatty fish) at least two times a week to help prevent coronary or heart disease.(3)

What is Fish Oil?

As the name suggests, fish oil comes from the fat or oil that is extracted from fish tissue. It most commonly comes from oily, or fatty, fish like tuna, herring or mackerel. It can also be found or produced from the livers of some other fish, which explains the cod liver oil that our grandparents used to force down our necks.

Fish, especially oily fish, can be high in omega-3 fatty acids that provide many health benefits to the human body often protecting against or fighting off many serious diseases. The World Health Organization actually recommend eating 1 – 2 portions of fish a week due to the many health benefits.(4)

As well as not eating enough fish, the modern western diet can be to blame for you not getting enough omega-3s as other fats like omega-6s tend to have replaced many omega-3s. Although omega-6s are an essential fatty acid needed by the body, too much omega-6s can be detrimental to our health.

The modern vegetable oil industry can be mainly blamed for this; soybean oil accounts for almost 20 percent of Americans calories from a single food source, with nearly 9 percent of all calories coming from the omega-6 fat linoleic acid alone.(5)

If you are not a big fan of fish, you can find many fish oil supplements on at your local health food shop, the pharmacy or even on the shelves of the supermarket.

Around 30 percent of fish oil consists of omega-3 fatty acids with the other 70 percent being made up of other fats. Vitamin A and D can also be found in unprocessed fish oil.

Dialing-In The Right Ratio

Nutritionists, researchers, and scientists vary in their opinions of the perfect ratio of omega-6 to omega-3 fats. At the low end of the omega-6 to omega-3 range is a ratio of 1 to 1 (1:1), and on the high end of the range is a ratio of 4 to 1 (4:1).

Typical Western diets have a ratio of about 16 to 1 (16:1). That’s not good. With sixteen times more omega-6 than omega-3 fats, inflammation is going to wreak havoc on the body.

Omega Ratio Adjustments

The overabundance of omega-6 fatty acids in the Western diet is largely due to:

High-consumption of processed foods
Certain fatty foods
Excessive amounts of certain animal fats
Insufficient consumption of omega-3 foods

To properly adjust your omega-6 to omega-3 ratio, you need to do more than simply consume more omega-3 fats. You also have to consume fewer omega-6 fats. The solution is to reduce your consumption of omega-6 fats and increase your intake of omega-3 fats.

When it comes to cutting down or cutting out processed foods (which are rich in omega-6 fats), it’s a good idea to reduce or eliminate foods processed using the following:

Soy oil
Corn oil
Sunflower oil
Cottonseed oil

You would also be well served by eliminating:

Grain-fed meats
Fast food

Healthier choices include:

Olive oil
Blackcurrants
Hemp oil
Avocados
Leafy vegetables
Free-range eggs
Grass-fed beef

Remember that if your omega-6 to omega-3 ratio is out of balance, you’re at risk of developing a variety of illnesses and diseases. To increase your intake of omega-3 fatty acids, include the following in your diet:

Eggs
Fatty fish oil
Olive oil
Kale
Collard greens
Winter squash
Algae
Krill
Pumpkin seeds
Chia seeds
Walnuts
Grass-fed meats

It’s also highly recommended to add wild fish, such as:

Salmon
Mackerel
Halibut
Herring
Sardines
Lake trout
Albacore tuna
Anchovies
Bluefish
Shrimp
Cod
Sturgeon

Those familiar with, or already following, a paleo lifestyle will recognize the above as essentially eating the same foods as our ancestors. Consuming the right omega ratio requires the elimination of refined and/or processed foods, excess sugar, and grains. It’s a return to whole foods, organic veggies, and organic meats.

Omega-3 Fatty Acids

Omega-3 fatty acids, or simply omega-3s, are a group of polyunsaturated fatty acids important to many functions of the human body. Our main source of omega-3s tend to be oily fish or shellfish but it can also be found in some vegetable oils. Dietary supplements can also be a key source of omega-3s.

The main omega-3s found in fish oil are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), with omega-3 plant sources having mainly alpha-linolenic acid (ALA). Although ALA is an important essential fatty acid, today we are looking at fish oil which has EPA and DHA omegas that have greater health benefits.(6)

ALA, often found in soybean and flaxseed oil, can be converted in the body into small amounts of EPA and DHA. More common sources of EPA and DHA are found in seafoods like fatty fish (e.g, salmon, tuna, anchovies, trout) and shellfish like crab, mussels or oysters. Although many dietary supplements use fish oil for extra EPA and DHA, algae oils can be a vegetarian friendly source of DHA.

Omega-3 fatty acids can be important for many of the body’s functions including muscle activity, digestion, blood clotting, and cell division and growth. DHA can also be vital for development of the brain and its healthy function. By missing out on omega-3s, we can miss out on many health benefits.

Food Sources Of Omega Fats: DHA, EPA, And ALA

It’s good to know which whole foods contain DHA and EPA. As mentioned earlier, the body can convert alpha-linoleic acid (ALA) into DHA and EPA; however, the conversion process is inefficient. For that reason, experts believe that DHA and EPA provide much better health benefits than ALA.

That said, we’ll first cover the best sources of the two omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). These are found in the following fish and seafood:

Halibut
Mackerel
Wild salmon
Lake trout
Sardines
Albacore tuna
Herring
Anchovies
Sturgeon
Bluefish
Shrimp
Cod
Algae
Krill

While it’s recommended to eat omega-3 fish or seafood twice per week, it’s important that you make the healthiest choices possible. Certain fish and seafood contain higher levels of toxins, mercury, and polychlorinated biphenyls (PCBs). In order to avoid these contaminants, you might want to stay away from:

Wild swordfish
Tilefish
Shark
Farm-raised fish (of any type)

It’s strongly recommended that pregnant women and children avoid consuming these fish entirely. For anyone else that chooses to eat these fish, it is recommended to eat no more than about seven ounces per week.

If you opt for the omega-3 alpha-linoleic acid (ALA) instead of DHA and EPA, then good food sources include:

Flax and flaxseed oil
Olive oil
Soybean oil (not paleo)
Rapeseed (canola oil) (not paleo)
Walnuts
Tofu (not paleo)
Collard greens
Kale
Winter squash

Plant- And Animal-Derived Omega-3s

Both animal- and plant-based sources of omega-3 are required for optimal health.

With the exception of certain algae, alpha-linoleic acid (ALA) is the only plant-derived omega-3 fatty acid. Remember, it’s also an essential fatty acid, meaning that you must consume it in your diet because your body cannot produce it on its own. Foods rich in ALA include:

Flaxseed oil
Canola oil (not paleo)
Soybean oil (not paleo)
Walnuts

Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are animal-derived omega-3 fatty acids. DHA and EPA can only be converted from ALA in very small quantities, so it is recommended to add DHA- and EPA-rich foods into your diet. Both docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) can be found in:

Fish
Shellfish
Krill

Docosahexaenoic acid (DHA) can also be found in:

Cod liver
Fatty fish

Fish Oil Benefits

Heart Health

One of the biggest causes of death worldwide is heart disease, with over 15 million deaths attributed to heart disease and strokes in 2015 according to the World Health Organization.(7) There have been many studies over the years that show people who eat more fish have lower rates of heart disease, although studies are inconclusive on using fish oil supplements.(8)

The consumption of fish oil can reduce many of the risk factors for heart disease. Fish oils, or the omega-3s within, can help with cholesterol levels by boosting the amounts of good cholesterol (also known as HDL) but doesn’t seem to appear to reduce LDL otherwise known as bad cholesterol.(9)

Fish oil has been shown to lower triglyceride levels by about 15 – 30 percent which can be especially useful for the heart health of many diabetic patients.(10) Small doses of fish oil can also help to lower blood pressure for people with high blood pressures. Fish oil can additionally help to prevent plaques from forming the arteries and may reduce fatal arrhythmias, abnormal heart rhythms, that can cause heart attacks in some patients.(11)

Despite being shown to reduce many of the risk factors, there is very little scientific evidence that fish oil supplements can actually prevent heart attacks or strokes. Eating more fish as part of a healthy diet can have the same, if not better, beneficial effects on your heart.

Mental health

Many of the fats which makes up almost 60 percent of the brain are omega-3 fatty acids and can be essential for normal functioning of the brain. Certain mental conditions like depression and schizophrenia have actually been linked to lower levels of omega-3 acids.(12)

Fish oil supplements can be used for the treatment and to prevent many mental disorders including psychotic disorders, schizophrenia and bipolar disorders. Although fish oil was shown to improve the depression in bipolar, it had very little effect on the mania.(13) Increasing omega-3 fatty acids intake, in particular, the DHA omega-3 can improve the brain function significantly.

Recent research has shown that attention deficit-hyperactivity disorder in children can be treated with fish oil too. Research has demonstrated that taking fish oil can improve the attention, mental function and behavior of children between the ages of 8 years old and 13 years diagnosed with ADHD.(14)

Skin

As the largest organ of the human body, skin contains a large amount of omega-3 fatty acids. Skin health can often decline as we get older or with daily exposure to irritants including ultraviolet sunlight or pollutants.

Many skin disorders like dermatitis or psoriasis have been shown to benefit from fish oil supplementation. Many of the supplements also contain vitamin E which can also benefit the overall condition of your skin.(15)

Asthma and Allergies

Asthma is becoming ever more prevalent, affecting over 25 million people in the US at a cost of $56 billion in medical costs, lost school and work days and early deaths.(16) A lung disorder that can cause swelling in the lungs and shortness of breath, asthma can be a very serious ailment especially for an infant.

Some studies have shown that increasing your uptake of fish oil may reduce asthma, especially earlier in life. One study linked the intake by the mother of a child of fish oil or omega-3s could reduce the risk of asthma in children by 24 – 29 percent.(17)

Other studies have also shown that the amount of fish oil or fish oil supplements a mother takes during pregnancy may help to reduce the risk of various allergies in many infants.(18)

Pregnancy

Many omega-3s are essential for the growth and development of our bodies especially in the earlier years. It can be important for a pregnant mother to ensure she gets adequate omega-3s during the term of her pregnancy and when breastfeeding.

Many of the benefits of fish oil can go straight to the unborn infant from its mothers nutrition. Supplements of fish oil in pregnancy have been linked with improvements in hand to eye coordination in infants but the connection to learning or improved IQ are still unclear.(19)

Using fish oil supplements by the pregnant mother or when breastfeeding has also been linked to the brain development and visual health of an infant.(20)

Inflammation

The body’s immune system is our natural defense or way of fighting off infection or injury to the body. Inflammation is the immune systems way of defending the body. But unfortunately inflammation can sometimes happen at very low levels for long periods of time.

When this happens it’s referred to as chronic inflammation. This can make other chronic diseases like obesity, diabetes, depression or heart disease worsen. When this happens, reducing inflammation can often help treat the symptoms of the many other conditions.

Fish oils are known for their anti-inflammatory properties that can help with the treatment of the many diseases involving chronic inflammation.

One study looked at the effects of a diet high in omega-3 fatty acids and fish oils on patients who suffered from rheumatoid arthritis, one of the major diseases of chronic inflammation. Fish oil was shown to a significant reduction in tender joints, down from 28 percent to 11 percent, with swollen joints also down from 34 percent to just 22 percent in the group that followed the anti-inflammatory diet.(21)

Side Effects

Whoever said you can’t get too much of a good thing, was obviously lying! Although many of the benefits have been debated by researchers for many years, on the whole fish oil is considered to be a good healthy supplement. But you should only administer high doses of fish oil supplement under medical supervision.

Too much fish oil can cause belching, bad breath, heartburn, nausea, rashes and nosebleeds. One study even suggests that fish oil may cause havoc inside your body by increasing oxidative damage to proteins, DNA and other important cell structures.(22)

Conclusion

There are many nutrition experts who argue that the case for fish oil supplements has been grossly overstated. Most of the studies carried out on fish oil have only shown short term effects and benefits, often lasting less than a year. Many studies have also found no evidence that fish oil supplements can benefit the average person’s health.

The key like most things in life is moderation. Yes it’s okay to eat oily fish a couple of times a week, it can even be good for you. But unless your doctor or physician tells you that you have a deficiency of omega-3 fatty acids, you may be wasting both your time and money by taking some of the many fish oil supplements available. Enjoy a nice piece of salmon instead!