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Flip Flops on Fish Oil: Omega 3 Fats Now Have Heart Benefits

Studies of supplements rich in omega 3 fats have reached conflicting conclusions. The latest analysis concludes that they reduce the risk of heart disease.

Are you fed up with flip flops? The latest U-turn on dietary supplements has to do with omega 3 fats. There was a time when Americans were told that little golden footballs containing some kind of fish oil would be good for them. Then they were told it would not protect the heart and might raise blood sugar levels or increase the risk for a bleeding stroke. But now, fish oil is back!

The Waxing and Waning of Omega 3 Fats:

Scientific support for fish oil supplements (omega-3 fatty acids abbreviated n-3) has waxed and waned over the last 50 years. Now, the same researcher who said fish oil was worthless for the heart has changed her tune.

Dr. JoAnn Manson is a Professor of Medicine at Harvard Medical school and Chief of the Division of Preventive Medicine at the Brigham and Women’s Hospital in Boston. She is considered one of the nation’s leading epidemiologists. She holds an endowed chair (the Michael and Lee Bell Professor of Women’s Health) at Harvard.

Writing in the New England Journal of Medicine (Jan. 3, 2019) she and her colleagues concluded that:

“Supplementation with n-3 fatty acids did not result in a lower incidence of major cardiovascular events or cancer than placebo.”

Nine months later Dr. Manson and her co-authors concluded:

“Marine omega‐3 supplementation lowers risk for myocardial infarction [heart attack], CHD [coronary heart disease] death, total CHD, CVD [cardiovascular disease] death, and total CVD… Risk reductions appeared to be linearly related to marine omega‐3 dose” (Journal of the American Heart Association, Sept. 30, 2019

In other words, the higher the dose of fish oil, the lower the risk of heart problems. So, the same distinguished physician and researcher did a U-turn on omega-3 fatty acids in less than a year. 

Readers and Omega 3 Fats:

Many readers of this column have stuck by fish oil despite the ups and downs of the research.

One shared this story:

“I have been taking 4 grams of premium fish oil capsules for 20 years. This began on the recommendation of a lipid specialist at a major teaching hospital in Houston.

“He prescribed prescription Lovaza (fish oil) for my high triglycerides and low HDL. I had suffered a heart attack 5 years earlier that was treated with balloon angioplasty.

“Since then my triglycerides have been under 100, and my HDL and LDL are in perfect range. I had a stent placed in the same area as the angioplasty about 12 years after the heart attack. I no longer take any prescription meds for my heart and the fish oil is OTC. No doctor has ever questioned why I am taking it or told me it was useless.”

A Cardiologist Says Omega 3 Fats Are Worthless:

Another reader had a different experience:

“I started taking omega-3 fatty acids about 10 years ago. I developed a heart problem and continued taking fish oil because the data that I read was encouraging.

“My cardiologist told me it was useless, so I stopped. Doctors are not always correct. Last week, after I read the results of newest study, I bought my new supply. My instincts were correct after all.”

Omega 3 Fats vs. Arthritis:

Some people take fish oil for a completely different reason:

“I discovered, somewhat by accident, that fish oil is great for my osteoarthritis. I had been taking Aleve for years along with fish oil for my heart (I am currently 69).

“Around five years ago, I ran out of fish oil and didn’t get around to getting more for a week–all my arthritis pain came back! So I discovered that Aleve was not the pain killer that worked on my joints.

“Once I got back on the fish oil, it took a couple of weeks to kick back in, after which, I never took Aleve again. I take 1000 mg of omega-3 fatty acids twice a day (a total of 2000 mgs of omega 3 fats every day) and do fine without any other pain killers.”

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Does Research Support Fish Oil for Arthritis?

Many health professionals pooh-pooh dietary supplements like omega 3 fats. They assume that there is little, if any, scientific evidence to support fish oil for arthritis. Here is “A Critical Review” on the use of “Omega-3 Fatty Acids in Rheumatic Diseases” (Journal of Clinical Rheumatology, Sept. 2017). 

The authors note:

“Many clinical trials of omega-3 fatty acids, supplied as fish oil supplements, have been carried out in rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), lupus nephritis, and osteoarthritis (OA) over the past 3 decades…”


There are 20 clinical trials for rheumatoid arthritis (RA). Of those, 16:

“exhibited significant improvements in multiple disease clinical outcomes.”


There are 9 clinical trials involving systemic lupus erythematosus (SLE). Of those, 6

“6 exhibited significant improvements in 1 or more clinical outcomes.”


“A total of 4 clinical trials have been conducted in OA [osteoarthritis], of which 3 exhibited significant improvements in at least 1 clinical parameter. Multiple mechanisms for the clinical effects of omega-3 fatty acids have been implicated, including the modulation of eicosanoid synthesis toward a more anti-inflammatory profile and suppressed production of proinflammatory cytokines. Overall, fish oil supplements appear to be a safe and effective agent that could be added to the current treatment regimens in RA.”

A more recent study published in Joint, Bone, Spine (July, 2019) reports:

“In animal studies omega-3 polyunsaturated fatty acids reduced the expression of inflammatory markers, cartilage degradation and oxidative stress in chondrocytes… Human intervention studies with omega-3 polyunsaturated fatty acid supplementation may indicate a beneficial effect on pain and function and might be associated with less structural damage… Existing studies indicate a promising effect of especially omega-3 polyunsaturated fatty acids on osteoarthritis signs and symptoms.”

Omega 3 Fats and Osteoarthritis–A Reader’s Perspective:

Theresa shares this story about fish oil and OA:

“I have been taking some type of fish oil since the 90s. I burned my knees out from step aerobics and jogging. That led to the ole crunchy knees syndrome. I went to a sports doctor and he told me to take fish oil. At that time, it was a new treatment.

“I am now 61 and have no knee pain at all (knock on wood). All my friends and family have painful knees, but I seemed to have escaped that fate so far. I am hoping it has been beneficial for my heart too.”

What to Make of Fish Oil Flip-Flops?

The newest analysis of fish oil for the heart reminds us that science is constantly evolving. At least today we can say that omega 3 fats are good for the heart. You can learn more about the history of fish oil at this link plus more information on the pros and cons of omega-3 fatty acids.

What Do You Think?

Share your thoughts and experiences with fish oil in the comment section below.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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  • Manson JE et al, "Marine n-3 fatty acids and prevention of cardiovascular disease and cancer." New England Journal of Medicine, Jan. 3, 2019. DOI: 10.1056/NEJMoa1811403
  • Hu Y et al, "Marine omega-3 supplementation and cardiovascular disease: An updated meta-analysis of 13 randomized controlled trials involving 127 477 participants." Journal of the American Heart Association, Sept. 30, 2019. DOI: 10.1161/JAHA.119.013543
  • Akbar U et al, "Omega-3 fatty acids in rheumatic diseases: A critical review." Journal of Clinical Rheumatology, Sept. 2017. DOI: 10.1097/RHU.0000000000000563
  • Loef M et al, "Fatty acids and osteoarthritis: Different types, different effects." Joint, Bone, Spine, July, 2019. DOI: 10.1016/j.jbspin.2018.07.005
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