Taking fish oil pills rich in omega-3 fatty acids doesn't appear to have a significant effect on heart attacks, strokes or death, a study published Tuesday in The Journal of the American Medical Association finds.
The news comes even as sales of fish oil supplements are booming. In 2011 Americans spent $1.1 billion on them, up 5.4% from 2010, according to the Nutrition Business Journal.
Researchers reviewed 20 well-designed clinical trials that looked at health outcomes of people taking omega-3 polyunsaturated fatty acid supplements derived from fish oils. The trials, from 1989 to 2012, included 68,680 people studied for at least a year. No statistically significant association was found between the pills and all deaths, cardiac deaths, sudden deaths, heart attacks or strokes.
The review was led by Evangelos Rizos, a professor of medicine at the University Hospital of Ioannina in Greece.
The medical world long ago noted that societies with diets high in fatty fish such as salmon, sardines and mackerel had lower rates of heart disease. A large 1989 study found that men who had already had a heart attack and changed their diets to include more fatty fish were 29% less likely to die in the next two years. Because of these and other findings, many medical groups suggest that people at risk for heart disease either increase their fatty fish intake or take omega-3 supplements.
However, subsequent studies on omega-3 supplements derived from fish were less clear. The study released Tuesday attempts to pull together all the current research.
The message Americans may not want to hear is that eating healthy foods, not taking pills, is what helps heart health, says Richard Karas, director of the preventive cardiology center at Tufts Medical Center in Boston.
Time and time again, research shows a diet rich in a certain vitamin or nutrient is beneficial. But then people think "if you take a pill containing that ingredient, you'll be healthier," Karas says. It doesn't work that way.
He now tells his cardiac patients to eat fatty fish in at least two meals a week.
Duffy MacKay of the Council for Responsible Nutrition, a supplement industry group, disputes the findings. He says many of the studies in the review were on people who were already sick and so might not apply to maintaining health.
Many also didn't test whether people were starting out with diets very low in omega-3s. Americans know they should eat a diet high in fatty fish, he says, but many don't. Supplements are "an affordable, convenient and safe way" to get them.
No one knows exactly why eating lots of omega-3 fatty acids appears to be good for health. It's been suggested, but not proved, that they might lower triglyceride levels.
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