Fish oil consumption is once again in the news: What to believe?

The Controversy Surrounding Fish Oil Consumption: Separating Fact from Fiction

The consumption of fish oil, a primary source of omega-3 fatty acids, has once again stirred debate. In 2021, a review published in the journal Circulation raised concerns, linking high fish oil intake to an increased incidence of atrial fibrillation (A-fib), causing irregularities in heart rhythm. However, a recent review in the Journal of the American College of Cardiology contradicted this claim. Determining what to believe amidst these conflicting reports poses a challenge, particularly in understanding the benefits and risks of fish oil consumption, especially in a country like India, the leading nation in South Asia for fish oil demand.

Omega-3 fatty acids, crucial for various bodily functions such as muscle contraction, cell growth, blood clot regulation, and inflammation reduction, cannot be produced by the body and are acquired through food intake. Seafood like herring, mackerel, salmon, trout, and tuna are rich sources of omega-3 fatty acids known as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Additionally, nuts, seeds, and vegetable oils contain alpha-linolenic acid (ALA), a different type of omega-3 fatty acid.

While fish oil is prescribed as a medicine to lower elevated triglyceride levels, numerous supplements are available and widely consumed. In the United States, millions take fish oil supplements, as indicated by the National Health Interview Survey. Similarly, India shows significant demand, with the fish oil market worth over USD 37.7 million.

The purported benefits of fish oil, particularly in improving heart health, have been a subject of study, but the evidence remains inconclusive. The Food and Drug Administration (FDA) offers cautious guidance, stating that while research suggests a potential reduction in coronary heart disease risk, it remains inconclusive.

Claims regarding infant health, neurodevelopment, rheumatoid arthritis, and even cancer have been explored, yet findings have often been ambiguous or disappointing. Similarly, the effects of fish oil on memory improvement, Alzheimer’s disease, and various other conditions are in preliminary stages with inconclusive results.

However, there are side effects associated with fish oil consumption, ranging from a fishy aftertaste and bad breath to more severe concerns such as increased risk of bleeding and interactions with medications.

Regrettably, research predominantly focuses on fish-derived DHA and EPA rather than ALA from plant foods, potentially influenced by the prevalence of fish consumption in research-conducting countries and commercial interests of fish oil manufacturers eyeing the supplement market.

The scientific evidence regarding the benefits of fish oil remains inconclusive. This prompts a critical question: should one invest in a product with an unproven track record amid emerging controversies? The decision lies with the consumer.

In conclusion, while fish oil holds promise in some areas, its risks and inconclusive benefits suggest a need for cautious consideration before its widespread consumption. As research continues, a balanced understanding of its advantages and potential drawbacks is essential for individuals considering its use.

Prof. Manoj Sharma is Chair of the Social and Behavioral Health Department at the University of Nevada, Las Vegas.

Maneesh Pandeya is a Fulbright Professor and Ph.D. Scholar at Howard University in Washington DC.