The Question everyone is asking - Should I stop my fish oil supplement?

Controversial study links prostate cancer with omega 3 fatty acid consumption

A recent study published in the Journal of National Cancer Institute reported a 71 percent increased risk of high grade prostate cancer in men who ate fatty fish or took fish-oil supplements.  The study accounted for risk factors such as family history of prostate cancer and diabetes but failed to include other important risk factors such as PSA level, age, ethnicity or body weight.  Many experts are commenting that the study is flawed and the results can not be generalized to the general population.

Michael Savage, PhD in nutrition and epidemiology  ….”a very dangerous report that does not support the conclusion that there is a high risk of prostate cancer among men that consumed omega 3 fatty acids”.

Anthony Victor D’Amico, MD, an expert on prostate cancer…..”the study really can not make the conclusion that it is trying to, because these types of studies are not cause and effect; that is, if you take the fish oil you are going to get prostate cancer.

From my standpoint, I see two other major issues with this study.  First of all, there is abundant evidence that fatty fish can contain toxins such as mercury and arsenic, which can vary in different types of fish and with the geographic area.  Secondly, there is wide variability in the quality and manufacturing of nutritional supplements.  Not all fish oil supplements are distilled, thus could potentially contain a variety of contaminants.  Having said that, how can we clearly make the connection between prostate cancer and omega 3 fish oil consumption?   Perhaps it was a toxin, rather than the omega 3 fish oil that put these men at a higher risk?  Either way, the study was not designed in a way that this type of direct connection can be made.

The benefits of Omega 3 Fish Oil

There are hundreds of articles and studies that support the benefits of fish oil.  These benefits were initially uncovered in the 1970s when two Danish researchers were studying the Inuit people of Greenland. Because their diets were rich in fatty fish, seal and whale blubber, the researchers expected to find a much higher incidence of cardiovascular disease, while in fact, it was actually much lower than anticipated. Further blood analysis revealed high levels of two essential fatty acids – eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

In contrast, our current American diet, is heavy in omega 6 polyunsaturated fats (from vegetable oils) and saturated fats (from dairy and meat), causing an imbalance by as much as 20:1. This imbalance can lead to symptoms such as fatigue, impaired memory and other symptoms associated with inflammatory disease.

The Evidence speaks for it’s self

Since the 1970s, multiple studies have documented the benefits of omega 3 fatty acids. Omega 3 fatty acids include: marine sources, flaxseed and walnuts. High levels of EPA & DHA are found in fatty fish such as salmon, herring, sardines, mackerel, sablefish, albacore tuna and anchovies. Plants sources of omega 3 fatty acids, such as flaxseed, canola oil and hempseed, contain a shorter chain omega 3 oil known as, alpha-linolenic acid (ALA). While ALA is important for health, it does not have the same overall health benefits as EPA and DHA. This is primarily related to the fact that ALA is not easily converted EPA and DHA in the human body. Certain conditions, such as diabetes and schizophrenia, may further interfere with the conversion of ALA to DHA & EPA.  So in other words, flaxseed and fish oil are not interchangeable. For most of us, fish oil is a better choice for omega 3 supplementation, and has been shown to decrease inflammation more than flaxseed.

Our body needs essential fatty acids – either through diet or from supplements. EPA and DHA are absorbed from the gastrointestinal tract and transported to the liver largely as triglycerides and chylomicron particles. From the liver, EPA and DHA are released into the circulation as triglycerides in lipoprotein particles or “cholesterol particles” such as LDL and HDL. The cholesterol particles are deposited in the cell membranes, especially in the heart, brain and fat cells.

A few facts about Omega 3 Fish Oil…

§ Low levels of EPA and DHA have been associated with multiple health problems such as pre-term labor, obesity, diabetes, cardiovascular disease, arthritis and cancer

§ DHA is essential for early brain development during gestation & infancy

§ Studies show multiple cardiovascular benefits such as slowing the progression of arterial plaque and decreasing CV events such as heart attack (MI), stroke and heart related deaths.

§ Lowers blood pressure

§ Lowers serum triglycerides by 25 – 30% (3 – 4 gms per day)

§ Prevention and treatment of the cognitive decline seen with dementia (Alzheimer’s disease)

§ Improvement in symptoms associated with depression, attention deficit disorder and neuro-psychiatric disorders.

§ Reduced frequency of seizures.

§ Improves immune function

§ Reduces the reactions to allergens that can trigger asthma attacks.

§ Reduces inflammation and may help reduce pain & symptoms with autoimmune disorders such as lupus, rheumatoid arthritis, Crohn’s disease, ulcerative colitis, multiple sclerosis and psoriasis.

§ Combination of fish oil & flaxseed beneficial in certain vision-related conditions

How much Fish Oil should I take?

§ Healthy individuals should consume 1,000 mg of fish oil daily (total of the EPA & DHA added together). This is equivalent to eating fatty fish 3 – 4 times weekly.

§ Certain conditions, such as elevated triglycerides and inflammatory disorders may need much higher doses ie. > 3,000 mg daily

§ High doses of both, flaxseed or fish oil may cause blood sugar elevation in some individuals with diabetes (typically > 3 gms per day). High dose fish oil can have some blood thinning affects so should be used with caution with blood thinning medications.  Fish oil can be used safely in both circumstances but should be followed closely along with your health care provider.

§ Fish oil capsules can be frozen – this helps prevent reflux or fishy after taste.

§ Of course, you should partner with your health care provider to find the right fit for you.

So no…..do NOT stop your fish oil because of this study.  Instead, make sure you are taking a high quality, distilled pharmaceutical grade fish oil that is free of potential contaminants.