A diet rich in fish oil may improve heart and brain health, some research suggests, but questions remain about how much fish people need to eat and what fish oil supplements are the best.
A recent study found older women with the highest levels of omega-3 fatty acids, found in fish oil, had better preservation of their brain as they aged than those with the lowest levels, which might mean they would maintain better brain function for an extra year or two.
The results suggest that higher omega-3 fatty acid levels may hold promise for delaying cognitive aging and dementia, the researchers concluded.
To get to a high enough level, people would have to eat oily varieties of fish at least five times a week — or eat it twice a week and take fish oil supplements daily, the researchers said.
A study out last fall found that taking fish oil pills rich in omega-3 fatty acids doesn't appear to have a significant effect on heart attacks, strokes or death. Other research suggests that omega-3 fatty acids benefit the hearts of healthy people, those at high risk of heart disease and those who have it, the American Heart Association says.
Omega-3 fatty acids decrease the risk of arrhythmia (abnormal heartbeats that can lead to sudden death), decrease triglyceride (blood fats) levels, slow plaque growth rate and lower blood pressure slightly, the association says.
The group recommends eating at least two servings of fish a week, particularly fatty fish such as salmon, mackerel, herring, lake trout, sardines and albacore tuna. A serving is about 3.5 ounces cooked or about ¾ cup of flaked fish.
Increasing omega-3 fatty acid consumption through foods is preferred, the group says, but those with heart disease may not get enough omega-3 by diet alone. Those patients should talk to their doctors about taking supplements.
When it comes to fish oil supplements, "I recommend them to most of my patients after 50," says preventive cardiologist Gina Lundberg, a spokeswoman for the heart association and an assistant professor of medicine at the Emory University School of Medicine in Atlanta. "Not just for the triglyceride lowering benefit and cardiovascular benefits, but for the powerful antioxidant and brain-power benefits."
Although there are prescription omega-3 fatty acids available, Lundberg says, many over-the-counter fish oil supplements "are very good and more affordable, so I let the patients take them."
"We don't have any studies that show fish oils cause fewer heart attacks or make you live longer," she says, "but they seem to have positive cardiovascular benefits. So in general, I think they are worth the cost."
Physician Steven Masley, a fellow with the heart association, recommends that his patients consume 1,000 milligrams a day of long-chain omega-3 fatty acids — which are EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) — either by eating fish or taking fish oil supplements.
He suggests consuming wild salmon, trout, sole, sardines and herring. "Not all fish is equal, so don't expect the same heart benefits from eating fried fish and chips," says Masley, author of The 30-Day Heart Tune-Up.
Those who want to take fish oil supplements need to look for ones that taste fresh, not rancid, and contain at least 1,000 milligrams of EPA and DHA, he says.
Which fish oil supplements are the best?
LabDoor, a company that evaluates the quality of dietary supplements, recently tested 30 fish oil supplements, and found that 21 had omega-3 fatty acid levels that varied by more than 10% from their label claims, says the company's CEO, Neil Thanedar.
The supplements rated as being the highest quality included Dr. Tobias Optimum Omega 3 Fish Oil; Nordic Naturals Ultimate Omega D3; Axis Labs Citrus Omega Fish Oil; GNC Triple Strength Fish Oil and NOW Foods Ultra Omega 3, Thanedar says.
ConsumerLab.com tested 35 different omega-3/fish oil supplements and found problems with the quality of labeling in 11 of those products.
Two supplements exceeded contamination limits for PCBs, and one soft gel product contained spoiled fish oil, says research physician Tod Cooperman, the company's president. No mercury was found in the products, he says.
He says the top low-cost, high-quality soft gel supplements in his tests included Kirkland (Costco) Signature Natural Omega-3 Fish Oil; Swanson EFAs Super EPA; Vitacost Mega EFA Omega-3 EPA & DHA. The top high-quality, low-cost liquid product was Vitamin Shoppe Omega-3 Fish Oil 800 EPA/500 DHA.
After you open a bottle of the liquids, they start to spoil and can become rancid. You should definitely be refrigerating these and the soft gel pills, Cooperman says. "It will extend the shelf life."
5:03 a.m. EST February 1, 2014
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How to boost your heart and brain health with fish oil