By Richmond Natural Medicine

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June 18, 2014

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I can almost guarantee that anyone who goes into a grocery store, picks up a packaged, processed and otherwise unrecognizable item off of the shelf and takes it home for dinner will at some point (at least subconsciously) ask themselves, “Do the benefits outweigh the risks?”  We have a lot of blind faith in the food and supplement industry that whatever is in the package or supplement bottle is, in fact, safe and real food. It’s hard to know sometimes. Food labeling laws are becoming more lax. “Food-like substances” are becoming more the norm, and the supplement industry is questionable at best sometimes. Quite often, I’m confronted with the quandary from patients about fish oil – is it safe? Should they take it? What about heavy metals? And, most importantly, Do the benefits outweigh the risks?

So here’s the scoop on fish oil.

Touted for it’s cardiovascular protecting benefits, it was recommended to increase fatty fish consumption soon after the publication of a 1980 study on Greenland Eskimos (with a diet high in fatty fish) and their unusually low risk for coronary heart disease. Following further clinical research, fish oil was shown to benefit patients with high cholesterol, reduce the chance of stroke, aid in clinical depression and even help age-related macular degeneration. More and more clinical studies are coming out now encouraging us to supplement with fish oil high in Omega-3, DHA and EPA, and the popularity of fish (and fish oil) had soared. With all of this new interest in the health benefits of fish, demand has skyrocketed and the harvesting practices of cold-water fish have really taken a hit. Enter Good Manufacturing Practices (GMP’s) into the mix.

Good manufacturing practices (cGMPs) are regulatory requirements that provide guidelines for procedures and documentation necessary to assure that the product produced has the identity, strength, composition, quality, and purity it is represented to possess.

To keep up with demand, millions of pounds of fish must be harvested and processed every year, sold “fresh” to the supermarkets or turned into supplemental form fish oil. Like any food (especially animal derived) the FDA must oversee the manufacturing of the actual fish for the safety of the general public pretty scrupulously. However, the FDA does not regulate dietary fish oil supplements. That’s up to the individual manufacturers, hence where a concern arises. The International Fish Oil Standards Program (IFOS) was established as a third-party testing agency to test supplemental fish oil for three main criteria: Omega-3 content, contaminants, and stability. This ensures that fish oil sold commercially has a guaranteed level of omega-3, is virtually free of heavy metals and is manufactured in a stable manner (not denaturing the oil in processing) to ensure freshness. Not all manufactures ensure their fish oil is tested with the IFOS, unfortunately. That is not a requirement.

 Risks

Fish does have the potential to be contaminated with high levels of mercury and other environmental chemicals (depending on where it was harvested). Mercury is all over the planet from natural sources like volcanos to more man made sources like coal fired electric power plants and chlorine production. It is recycled through rainwater into our oceans and streams and into our soil. Mercury is generally not well absorbed by the human body and cannot cross into tissues or the placenta. However, mercury is often converted into organic methylmercury via microbial activity while still in this recycling process. This methylmercury is the main concern because it can be easily absorbed into the body, transport into tissues and even affect fetal health. This happens within the fish (hence the higher absorption rates in fatty fish like salmon, sardines & tuna) and in effect into our own bodies. If the fish is living an area high in mercury, any supplement made from that fish will also contain mercury.

There is also the risk of PCBs and Dioxins in fish oil supplements. PCBs were once used in industrial processes as synthetic organochlorine compounds until the late 70’s when they were prohibited. Dioxins are the by-products of organochlorines from things like pesticides, paper bleaching, and the production of polyvinyl chloride plastics. These chemicals can persist in the environment for decades and still be present in some foods. Dioxin use has been significantly reduced since the late ’80s, however, it is still in use in some places. Both PCBs and dioxins have been found to be carcinogenic in humans and especially present in some meat products (beef, chicken, and pork), some vegetables and dairy products. Fish products were thought to contain a lesser amount, however, with recent testing, farmed salmon was shown to contain the same amounts as the before mentioned foods.

Finally, there is the issue of freshness. Fish oil, like any oil, can go rancid and has a finite shelf life. When you’re taking something in a capsule, most companies take extra care that everything looks the same, has no smell, and especially with fish oil, you shouldn’t even be able to tell you’re taking fish (the taste is not fantastic). So how are you to know if you’re taking a fresh capsule or a rancid one if it has been chemically treated to have no smell? Good question. This is why I always encourage my patients to purchase fish OIL, not in a soft gel. Smell your food and taste your food folks – its important on so many levels. Unless it comes from a super reputable source, stick with the liquid fish oil.

So what to do? Personally, I believe that eating fish or supplementing with fish oil actually does have more health benefits than risk. Fish oil is high in Omega-3 and omega-9, essential fatty acids that are essential because our bodies cannot make these fatty acids on our own. We must get them from food. The protective effects of fish oil for our cardiovascular health, joint health, brain health, and cholesterol health (among so many other benefits) cannot be ignored. I also think where you get your fish is the most important factor in this puzzle. When purchasing fish at the store, aim for variety. Don’t stick the same type of fish all the time. Also, get organic fish as much as possible and local whenever available. And, wild-caught fish as often as possible (there are fewer chemicals and antibiotics in wild-caught fish). ASK WHERE THE FISH CAME FROM. Stores need to know you care about this or else they will not care where they purchase it from.

When purchasing fish oil supplements, look for the IFOS seal and also that it is extra virgin cold-pressed. Ideally, your fish oil supplement companies will harvest sustainably and not use high heat multi-step processing on their oils either. Do not buy the cheapest brand out there. That is a hands-down way to get poor quality fish oil.

In my experience, the best brands I have found are Nordic Naturals, Carlson, and New Chapter.

You can also talk with your health care provider or nutritionist about appropriate dosing and where to find a good source. Ask questions and make sure to do your own research!