Supplements: Fish Oil

Fish oil is derived from the tissues of oily fish, such as mackerel, herring, tuna, and salmon. Fish oil supplements contain oil that is extracted directly or concentrated and put in capsule form. The active ingredients in fish oil are omega-3 fatty acids (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA])

The human body can make most of the types of fats it needs from other fats or naturally occurring already in the body, but this isn’t the case for omega-3 fatty acids. These are essential fats—the body can’t make them on it’s own and must get them from food.

Omega-3 fats are an integral part of cell membranes throughout the body and affect the function of the cell receptors in these membranes. They provide the starting point for making hormones that regulate blood clotting, contraction and relaxation of artery walls, and inflammation. They also bind to receptors in cells that regulate genetic function.

Omega-3 fats are a key family of polyunsaturated fats. There are three main omega-3s:

•    Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) come mainly from fish, so they are sometimes called marine omega-3s.

• Alpha-linolenic acid (ALA), the most common omega-3 fatty acid in most Western diets, is found in vegetable oils and nuts (especially walnuts), flax seeds and flaxseed oil, leafy vegetables, and some animal fat, especially in grass-fed animals. The human body generally uses ALA for energy, and conversion into EPA and DHA is very limited.

Potential Benefits of Fish Oil Supplementation:

Current research on the use of fish oil for specific conditions shows benefits for the below conditions:

• Heart disease- While research shows that people who eat dietary sources of fish oil at least twice a week have a lower risk of dying of heart disease, taking fish oil supplements seems to have little to no benefits to heart health.

•  High blood pressure -Multiple studies report modest reductions in blood pressure in people who take fish oil supplements. There's some evidence that the beneficial effects of fish oil might be greater for people with moderate to severe high blood pressure than for those with mild blood pressure elevation.

• High triglycerides and cholesterol- There's strong evidence that omega-3 fatty acids can significantly reduce blood triglyceride levels. There also appears to be a slight improvement in high-density lipoprotein (HDL, or "good") cholesterol, although an increase in levels of low-density lipoprotein (LDL, or "bad") cholesterol also was observed.

• Rheumatoid arthritis. Studies suggest fish oil supplements might help reduce pain, improve morning stiffness and relieve joint tenderness in people with rheumatoid arthritis. While relief is often modest, it might be enough to reduce the need for anti-inflammatory medications.

 Increased benefits of Omega 3’s for Athletes ?

In recent years, the role of omega-3 fatty acids in sport has received increasing research attention. Omega-3 fatty acids are perceived as a potential supplement that may beneficially affect performance, recovery and the risk for illness/injury. While there are some data that EPA/DHA may improve endurance capacity and promote recovery in athletic populations, the current evidence lacks consensus.

An article published in the National Institute of Medicine titled Omega-3 Fatty Acids for Sport Performance—Are They Equally Beneficial for Athletes and Amateurs? A Narrative Review looked at the current evidence to support a role of EPA/DHA in improved performance such as enhanced endurance, markers of functional response to exercise, enhanced recovery or neuroprotection. The majority of current evidence stems from studies in amateurs rather than athletes, although most recommendations for EPA/DHA supplementation for improved performance are made for athletes. In practical terms, athletes, and likely more so, amateurs may benefit from the consumption/supplementation of EPA/DHA. The extent to which the different metabolic state, i.e., training status influences the response to the supplementations warrants further research. In general terms there seems to be an effect of supplementation duration, with favorable outcomes appearing more consistently after approximately 6–8 weeks. Finally, it appears the beneficial outcomes are more consistently seen in amateurs (not athletes).

Studies of less than 8 weeks duration in athletes showed no clear picture of the benefits of omega-3 fatty acids, only 2 out of 5 studies reported beneficial outcomes. However, 6 out of 6 studies with more than 8 weeks reported positive changes due to the EPA/DHA supplementations. Studies in amateurs showed positive changes of the omega-3 fatty acids in 4 out of 5 studies below 6 weeks of duration and 6 out of 6 studies of more than 6 weeks duration.

  Longer term studies may be needed to evaluate if fish oil supplementation has a benefit on endurance performance, and larger sample sizes also are needed. In addition, comparisons of the same amount of fish oil, with the same ratio of EPA to DHA, are required to more definitively assess if fish oil supplementation plays a role in athletic performance. For individuals who are not vegans or vegetarians, consumption of more fish in the diet will increase fish oil intake and provides an excellent source of protein. Consuming fish at the lower end of the food chain (e.g., sardines or anchovies) will reduce the risk of mercury contamination. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7760705/)

The Takeaway:

Omega-3 fatty acids are essential for good health, and given that EPA/DHA is considered safe up to 5 g per day there seems little harm in recommending EPA/DHA supplementation.

Try to get these essential fatty acids from your diet from eating fish before supplementing. Fish oil supplements might be helpful if you have high triglycerides, rheumatoid arthritis or another inflammatory condition, however there is little support that fish oil supplementation will help improve athletic performance.