Tip: Screw JAMA and Their Fish Oil Report

Every once in a while, someone says that fish oil doesn't work and the whole world gets suckered in. Here's where they get it all wrong.

Here We Go Again...

JAMA published a paper on fish oil and heart disease and concluded the following:

"This meta-analysis demonstrated that omega-3 fatty acids had no significant association with fatal or nonfatal coronary heart disease or any major vascular events."

Sigh. I guess it's time to queue up a funeral dirge for fish oil. I guess it's time for all those sardines, anchovies, herring, and mackerel to tell their little fry and fingerlings that Santa Cod won't be coming this year because daddy's out of a job.

Yeah, right. Look, the paper looked at the effects of omega-3 fatty acids on old coots with prior coronary heart disease and found no preventative effect. Never mind that they under-dosed the fish oil – in some cases by a factor of four – or that they failed to recognize and incorporate one of the basic tenets of the relationship between omega-3s and omega-6s (more on that later), the entire dim-witted world heard about the study and automatically assumed that fish oils weren't good for anything.

Clean up on aisle four, please!

Where The JAMA Paper Screwed Up

Given that the paper was a meta-analysis, it compiled the results of several individual studies, few of which used enough EPA to reach a pharmacological effect, and almost none of which used enough DHA to achieve a pharmacological effect.

Secondly, and perhaps more importantly, none of the studies included subjects that had simultaneously reduced their intake of omega-6 fatty acids. As I wrote in Fish Oil: You're Using It Wrong,

"Omega-6s and omega-3s appear to compete with each other for space in the cell membrane and consequently, for the attention of various pro- or anti-inflammatory enzymes.

"You can't just take a few fish oil capsules and expect everything to click into place like a fatty-acid Rubik's cube without simultaneously reducing your omega-6 intake, because the existing omega-6s will bully the omega-3s away. Each time someone tries to attack the omega-6 fatty acid bulwark, it's like the 300 Spartans trying to take on the entire Persian army, and we all know how that turned out."

It's no surprise that the studies fell flat. Scratch that, it's a little bit of surprise, because there have been hundreds of other respected studies over several decades that point to the role of fish oil and cardiovascular health and hypertension.

Of course, many of those successful studies looked at the role fish oil plays in preventing heart disease and not, like the JAMA paper, on how fish oil affects people who already suffer from it.

But never mind the association between fish oil and cardiovascular health. Most of us take – and should keep on taking – fish oils for an entirely different reason.

Fish Oil

Why Most of Us Take Fish Oil

If you've got the stomach to analyze 100 of the most problematic diseases of mankind, including cancer, stroke, Alzheimer's, and yes, heart disease, you'd see that these diseases are either caused by inflammation or made infinitely worse by inflammation.

Control inflammation and you've won half the battle, and this is where the omega-3s in fish oil rule, especially when you consider that omega-6 fatty acids exacerbate inflammation. In fact, the billions we spend every year on drugs like ibuprofen, acetaminophen, and their prescription-only counterparts may well be a result of having too much omega-6 fatty acid in our diet.

But since omega-3s compete with omega-6s for both space on the cell membrane, it's easy to see how they can effectively help quash inflammation, provided there's some effort to reduce overall omega-6 intake.

Further, you can't ignore the role fish oils play in increasing insulin sensitivity, improving body composition, fighting depression, combating the effects of air pollution, and probably about a thousand other beneficial things that we're currently unaware of.

How To Make Omega-3s More Effective

Just about everybody could benefit from taking a high quality fish oil, but in most cases, they should simultaneously reduce their intake of omega-6 fatty acids by doing the following:

  • Avoid high omega-6 cooking oils like sunflower, soy, corn, safflower, and cottonseed and instead use olive oil or high-oleic versions of safflower or sunflower oil.
  • Try to cut down on fried foods from restaurants, as they're almost always cooked in high omega-6 cooking oils.
  • Try to avoid most foods that come in boxes or polyethylene bags as they're usually made from high omega-6 grains (omega-6 oils have a long shelf-life; that's why food manufacturers love them).
  • Try to eat more green leafy plants instead of seeds or grains, as leaves in general are higher in omega-3 fatty acids.

Most importantly, remember that the ratio of omega-3 fatty acids to omega-6 fatty acids is more important than the amounts. If you find yourself eating more omega-6 fatty acids, eat more omega-3 fatty acids (or take more fish oil).