By Maryann Tomovich Jacobsen, MS, RD
It seems everywhere you turn fish oil is being called out as a fraud. Whether it’s not making kids’ brains smarter or no longer protecting against cardiovascular disease, this dietary trend is being called into question.
Fish oil contains two (almost) essential fatty acids: docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), which can only be made by the body in limited amounts.
Here’s why I think these beneficial fats are vital in the American diet despite what you hear on the news.
We need it from the very beginning
Over the last 20 years omega-3 fats like DHA have been found to be vital even before day one. During the second half of pregnancy, fetuses increasingly accrue DHA, which ends up making half the total fatty acids in the retina (eye), a critical component of brain tissue. In her book, Ultimate Omega 3 Diet, Evelyn Tribole, MS, RD, equates the need for DHA in brain development to how calcium and vitamin D is needed for strong bones.
A report from the joint FAO/WHO Expert on Fat and Fatty Acids (2008) says the evidence is convincing regarding DHA’s essential role in retinal and brain development from 0 to 24 months of age. This is why it is now added to formula and recommended as a supplement for pregnant and breastfeeding women.
Why we get less DHA today
According to an NIH study published in the American Journal of Clinical Nutrition, the biggest change in the 20th century food supply has been a 1000-fold increase in soybean oil. While soybean oil contains some beneficial fat, it also is high in omega-6 fatty acids.
It is also hypothesized that, before the industrial revolution, people got more DHA and EPA in everyday foods than they do now. That’s because cows ate grass instead of corn, therefore milk, cheese, and meat contained more of these beneficial fats. Fish intake, the greatest source of DHA and EPA, has stayed relatively constant.
This trend of higher intakes of omega-6 fats and lower intakes of omega-3 fats changes the proportion of these fats in fatty tissue, which has been linked to a variety of diseases, including psychiatric and cardiovascular disease and neurodevelopment deficits in children.
Why DHA is not a Flash in the Pan
Unfortunately, without this background information, people get confused about the stories in the media, such as this one in Forbes. The study cited in this article was published in the September issue of The Journal of the American Medical Association, and it concluded that fish oil doesn’t lower heart disease risk.
“This study had some basic flaws,” says Tribole. “They didn’t measure compliance, there was no background information on omega-6 intake, and there was no omega-3 index done, a test that measures DHA and EPA in fatty tissues”
Tribole explains that this is an ongoing issue, as many people complain that taking fish oil results in fishy burps. And the benefits of fish oil get murky when people consume high levels of omega-6 fatty acids because these fats compete for the same enzymes as omega-3s, crowding them out.
The real issue
“The real issue is Americans don’t get enough omega-3s in their diet,” says Tribole. “If people aren’t consuming 10 ounces of fish per week, they aren’t getting enough and can benefit from taking fish oil.”
While there are international recommendations for DHA/EPA, the U.S. is still behind in setting Recommended Daily Allowances. International recommendations range from 100-250 mg of DHA/EPA for children 2 to 10 and 500 mg for older children and adults.
According to a 2011 study published in the British Journal of Nutrition, children from age 2 to 19 only get 45 mg of DHA/EPA while adults consume between 120-150mg. This means, as a population, we are getting less than half of what many experts believe is needed to prevent disease and maximize health.
In a world where there are fewer sources of DHA and EPA, and these fatty acids clearly play a role in health and development, fish oil supplements become important to fill in gaps. But instead of looking at these fats as a cure-all, let’s figure out how much we actually need from age 2 onward. Without doing that, we risk the public giving up on what they perceive as a trend, instead of what it really is — a necessary component of a healthy diet.
How do you feel about fish oil? Hype or a necessary part of the diet?