Reviewed by dietician Maria Laura Haddad-Garcia
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Key points
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Prescription fish oil can lower high triglycerides and reduce heart risks in 4 to 12 weeks.
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Over-the-counter fish oil supplements vary in quality and may not provide the same benefits.
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Eating fatty fish twice a week is a proven way to support heart health without supplements.
Fish oil is a well-known source of omega-3 fatty acids, nutrients found in high concentrations in the eyes and brain. Unlike other nutrients, your body can’t make omega-3s on its own, so it’s important to get them through foods like fish or supplements.
Fish oil is often touted for its heart-healthy benefits, but taking a supplement isn’t right for everyone—and improvements aren’t always immediate. We spoke with a cardiologist to discuss the science, expectations, and timeline of fish oil’s impact on heart health.
How fish oil supports heart health and when the benefits might occur
Fish oil contains two key omega-3 fatty acids: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), in varying amounts, which are often marketed as heart-healthy. You may have seen them marketed as a way to promote heart health. But before you reach for a supplement, consider this: The research isn’t promising for most people.
“There have been many studies of fish oils over the years. Although some have shown benefit in certain populations, when used for prevention in otherwise healthy patients, multiple, well-conducted, very large studies have not shown a benefit,” says Eugenia Gianos, MD, FACC, president of the American College of Cardiology Cardiovascular Disease Prevention and director of the Cardiovascular Disease Prevention Council at Northwell Health.
Taking fish oil without a medical reason can actually be harmful. Some studies have linked fish oil supplements to an increased risk of atrial fibrillation, a type of irregular heart rhythm, Gianos adds. They should be used in patients where the benefits are likely to be greatest,” she says — primarily those with very high triglycerides. Triglycerides are a type of fat in the blood, and elevated levels can increase the risk of plaque building up in the arteries, which can lead to heart attack or stroke.
Additionally, it’s also important to consider the type of fish oil that doctors recommend for high triglycerides: prescription fish oil. This is because over-the-counter supplements are not FDA-approved for managing high triglycerides, and their quality and dosage can vary widely. Many also contain impurities.
Another key difference is dosage. Prescription fish oil provides a much higher dose of omega-3 than over-the-counter supplements. To reach a similar amount using over-the-counter fish oil, you would have to take multiple capsules, which can increase the likelihood of gastrointestinal side effects, including nausea and the unpleasant “fish burps” that many people experience.
Prescription versions, such as icosapent ethyl (Vascepa), provide a much higher dose of EPA and have been shown to reduce inflammation, stabilize arterial plaque, and lower the risk of heart attack and stroke, Gianos notes.
Back to the question at hand though: when will you see a benefit? If your healthcare provider recommends taking a prescription fish oil medication to lower your triglycerides, you should see a benefit in about 4 to 12 weeks, Gianos adds.
How to use fish oil wisely for heart health
While you can easily buy fish oil supplements at the store or online, make sure your doctor recommends taking one first. To lower triglycerides, the usual dose is 2 grams twice a day, taken with meals. “Fish oils are generally very safe. They are unlikely to interact with other medications and are well tolerated,” says Gianos.
For most people, however, the best way to get omega-3 for heart health benefits is through food. Fatty fish such as salmon, sardines, mackerel, anchovies, bluefin tuna, mussels and oysters are all excellent sources. “This has been a recommendation for decades because of research showing benefits for preventing heart disease, and it can be a healthy way to get important protective nutrients,” she explains.
The American Heart Association recommends eating fish twice a week—a goal that supports heart health without the need for supplements in most cases.
Our expert
Fish oil supplements are often thought to be great for your heart, but the evidence doesn’t support their use for everyone. In addition, in some cases, it can lead to harmful or unpleasant side effects. If you are managing high triglycerides, prescribed fish oil can provide measurable benefits within weeks. But for most people, eating fish regularly is a more powerful and well-established strategy for supporting heart health.
Read the original article on EatingWell