Is it time we stopped taking over-the-counter fish oil supplements?

One must have to be living under a rock if they haven’t yet come across those reels of “health” influencers raving about the many health benefits of omega-3 and fish oil supplements. From aiding weight loss in those suffering from PCOS to promoting bone and skin health, there’s little these tiny golden capsules can’t achieve, as far as they are concerned.

To their credit, fish oil supplements do seem to be helpful to a certain extent and their role in protecting against cardiovascular risks is well documented. However, a recent study conducted by a team of international researchers has thrown the fish oil supplement's presumed safety into question. And understandably, ripples are being caused.

Contradictory results surprise scientists

After monitoring 400,000 participants in the UK Biobank for an average of 12 years, researchers were in for a surprise! The findings revealed a 13% higher risk of atrial fibrillation — irregular heart rhythm — and a 5% heightened risk of strokes in those with no prior history of cardiovascular disease.

But for individuals who already had heart disease, the fish oil supplements resulted in a 15% lower risk of progression from atrial fibrillation to heart attack, and 9% lesser chances of advancing from heart failure to death. This is in line with previous studies indicating how Omega-3 fatty acids, especially EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), are beneficial for reducing cardiovascular complications.

However, there is a catch: the study found mixed results for the effects of omega-3 supplements. Interestingly, women and non-smokers who were healthy at the outset saw 6% higher risks of going on to have heart attacks, heart failure or strokes. Conversely, older people and men seemed to have derived greeted benefits from fish oil, with the transition from good health to death being 11% and 7% lower respectively.

It is important to note that this study is based entirely on data from mostly white people, so it doesn’t precisely account for the impacts of fish oil supplements on other ethnicities. Then again, scepticism about the side effects of fish oil supplements on people with no history of heart disease isn’t new.

Groups that have traditionally consumed a lot of fish containing omega-3 fatty acids have been known to have lower instances of heart disease. Fish oil supplements, the pill form of these polyunsaturated fats, have a decades-long track record of proven benefits for heart health — for people who already have these risks being key here.

Now, according to a 2023 Lancet study, cardiovascular diseases are the leading cause of death and disability in India. In that regard, omega-3 supplements do have quite a bit of merit in the Indian market. Nutraceutical businesses have already gained traction cross-country and are growing increasingly popular. What’s more, this market is only expected to grow further due to the rise in product knowledge, disposable income and the desire for preventive medicine and self-treatment.

Are over-the-counter products safe?

Based on older studies, as well as the recent one, the risks that fish oil supplements pose do outweigh the benefits in healthy people. So if you’ve been chugging fish oil capsules in hopes that it would help you circumvent health complications in the future, it might be a good idea to take a step back and think.

The problem with over-the-counter supplements is that there’s no real proof that they are actually helping with anything. And given recent controversies in some of the food products being manufactured in India, caution regarding food-grade products is paramount.

There is no need to villainise fish oil supplements just yet. However, getting advice and a prescription from a certified healthcare professional who knows your specific health conditions might be a better idea than just relying on half-baked and generalised information from the internet.

Furthermore, opting for pharmaceutical-grade fish oils is considered a safer bet to take in high doses. Over-the-counter fish oil supplements contain a low dose (about 1 gram) of two different omega-3 fatty acids DHA and EPA. Prescription fish oil pills contain about 4 grams of either a DHA/EPA combo or pure EPA — the compounds mainly responsible for cleaning you of triglycerides.

With a barrage of nutraceuticals having entered our pharmacies, we might need a lot more research in the Indian context to determine just how safe these fish oil supplements are. In the meantime, stay informed and stay safe.