Is It Time to Give up on Fish Oil?

The idea that fish oil and omega-3s are good for your heart has been nutrition orthodoxy for decades. A few dissonant voices have argued that this particular emperor has no clothes. But they have largely been drowned out by the crowd.

Although fish consumption has increased somewhat, most Americans still fall short of the recommended two or more servings of fish per week. And until recently, health experts ranging from Harvard to the American Heart Association have recommended a fish oil supplement for those who aren't eating enough fish, as a way to bridge the gap.

Fish oil supplements are the third most commonly taken nutritional supplement. There have been concerns about possible contaminants in commercial fish oil supplements, as well as the negative effects of over-fishing in order to produce enough fish oil to meet the demand. Even so, the presumed benefits have largely overshadowed these concerns.

But just how firm is the evidence to support taking fish oil supplements?

What's the evidence on fish oil?

Epidemiological studies have found that people who eat more fish and/or take in more omega-3s have lower rates of death from cardiovascular and other diseases. Randomized trials have established that fish oil supplements reduce inflammation and lower triglycerides. But as recently as 2010, authors of a scholarly article on “Fish oil for the Treatment of Cardiovascular Disease” conceded that “The role of omega-3 fatty acids in reducing mortality, sudden death, arrhythmias, myocardial infarction, and heart failure has not yet been established.”

Over the years, trials showing that fish oil supplements do not, in fact, reduce the risk of heart attacks or death have begun to pile up.

That was 2010. Over the years following, trials showing that fish oil supplements did not, in fact, reduce the risk of heart attacks or death began to pile up. In 2018, researchers published the results of a large meta-analysis looking at ten different clinical trials in which people with heart disease (or at high risk of developing it) took either fish oil supplements or a placebo. Overall, they could detect “no significant association with fatal or nonfatal coronary heart disease or any major vascular events” and concluded that there is “no support for current recommendations for the use of such supplements in people with a history of coronary heart...

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