Not all Omega-3s are Created Equal

Every month, nearly 19 million Americans take an omega-3, or fish oil dietary supplement that may include a mixture of DHA, EPA, saturated fats and other ingredients. In fact, omega-3s are the most-used dietary supplement in the U.S. Since many users are looking for heart health and other unproven benefits that go beyond simply supplementing their diets, it’s important to understand some myths and facts about these popular products.

Myth: All omega-3 products are created equal.

Fact: The process by which omega-3s are properly produced is extensive and complex. This leads to great variation from product to product. The content of most common fish oil products includes only 30 percent omega-3 and may include other unwanted ingredients, including saturated fats and toxins. Also, if they aren’t handled properly, they may become spoiled. These unwanted and spoiled ingredients may lead to potential health risk. Fish oil dietary supplements are not interchangeable with a prescription medication and are not intended or approved by the FDA to treat any medical condition.

Myth: Omega-3 dietary supplements improve cardiovascular health.

Fact: There has been no conclusive proof, to date, that getting omega-3s from common fish oil dietary supplements has a positive effect on cardiovascular health in patients at risk. Dietary supplements, unlike prescription drugs, are not intended to treat any medical condition.

Myth: Fish oil dietary supplements that are available without a prescription at pharmacies and grocery stores are reviewed by the FDA for safety and efficacy.

Fact: Fish oil dietary supplements are regulated as food, not drugs. They are not approved by the FDA to treat patients with medical conditions. Dietary supplements are not required to provide the same stringent clinical proof as drugs, including over-the-counter prescription drugs (dietary supplements are not over-the-counter drugs).

Myth: Omega-3 products aid in lowering LDL-cholesterol (aka bad cholesterol).

Fact: Most omega-3 dietary supplements contain DHA, which may increase bad cholesterol in some people. The effect of this increase on cardiovascular health and safety has not been extensively studied.

Myth: Omega-3 dose levels are not important.

Fact: The content of most common fish oil dietary supplements is only 30 percent omega-3. Taking a few of these capsules provides a very low daily dose of omega-3. Taking this amount has not been conclusively proven to provide any cardiovascular benefit.

Myth: You can get the same amount of omega-3 in a prescription by taking more fish oil capsules.

Fact: Increasing the number of capsules you take has not been shown to provide the same amount of omega-3 as taking a prescription. Prescription omega-3 products are different from dietary supplements in many ways, including purity, stability, clinical effect, safety and FDA review and oversight. The content of supplement products varies, particularly with respect to EPA (the active ingredient in one patented prescription drug is pure EPA) the molecular structure and clinical effect of which has been shown to be unique from other forms of omega-3. Labeling of drugs is FDA approved. Labeling of dietary supplements, however, is created by the manufacturers of the supplement. Calling them “prescription grade” or “clinical grade” on their labels is not an FDA recognized standard and does not make them the same as a drug. Dietary supplements are not intended to treat serious medical conditions. The effect and safety of taking dietary supplements at high dose levels is unknown.

“I often get questions from my patients about the best ways to improve their heart health, and if a supplement is right for them,” said Dr. Ann Marie Navar, assistant professor of medicine at the Duke Clinical Research Institute. “For people at an increased risk of cardiovascular disease, such as those who are overweight, have diabetes or smoke, it’s important to speak with your doctor about the right course of treatment.”