Fish are a crucial part of the world's food supply for a number of reasons. They provide not only protein, but crucial fats called omega-3s.
Overwhelming evidence demonstrates significant health benefits throughout life -- from babies in the womb throughout the rest of life. Yet many people may not have heard of these omega-3 fats.
More Fish? More Supplements? Both?
Whether they've heard of this nutrient or not, millions are beginning to wonder if they should eat more fish, take fish oil supplements, or do both. Part of the decision is knowing what that could mean for your heart, brain, and mobility.
For instance, the 20 years of biking, swimming, and running in triathlons started taking their toll on neurosurgeon Joseph Maroon.
"I overused my joints and ended up with some joint problems of significant degree. It was actually recommended to have a total knee replacement and I took so much Advil that I got an ulcer from it," Maroon said.
At that point Maroon, team neurosurgeon for the Pittsburgh Steelers, started researching joint problems in the medical literature. Fish oils, because of those omega-3 fats, looked like they could hold the answer to Maroon's joint pain.
He began a regimen of daily fish oil capsules.
"Sure enough, I was able to get off the Celebrex, the Advil, ibuprofen and all the non-steroidal anti-inflammatories," he said.
From his research he knew he was getting other benefits as well.
Research from Japan
After all, omega-3 fats are good for the heart, too. New research from Japan shows that Japanese men have far less heart disease than American men.
Even though their lifestyles aren't that great -- many of them smoke -- Japanese men eat fish every day. And that fish is high in heart-healthy omega-3 fats.
When Japanese men move to other places, they stop eating so much fish, missing out on the omega-3s. The study found their heart health becomes as bad as men in the United States.
Maroon, a leading physician in neurological surgery, also finds omega-3s useful in his specialty. The medical literature and his own experiences led him to design a study for his large numbers of back and neck pain patients with disc problems.
Maroon worked on the study of 250 patients with Jeffrey Bost, his co-worker at the University of Pittsburgh Medical Center. Many of the patients were in a world of hurt, having been recommended for surgery.
In the study, patients took 2,300 milligrams (2.3 grams, or 1/12th of an ounce) daily of concentrated fish oil. Sixty percent were able to go off their pain medication and many are expected to be able to delay or even to avoid surgery.
Dr. Ann Louise Gittleman, known as "The First Lady of Nutrition," sees a broad range of benefits from omega-3 fats.
Broad Range of Benefits
"The omega-3s are just about the ticket these days for healthy hearts, for healthy brain function, for healthy joint function. And they're also important, believe it or not, for weight loss," Gittleman said.
She cites a study that appeared in the International Journal of Obesity. The research had two groups who ate the same level of calories and fats.
But one group took 6,000 milligrams (6 grams) of fish oil in place of an identical amount of dietary fats like butter and cooking oil. The fish oil group burned fat at a 25 percent higher rate and lost 2 pounds of body fat in three weeks.
That's significant for reducing belly fat, also known as visceral fat. That type of fat causes lots of inflammation, harming the brain and circulatory system.
Gittleman says reducing inflammation inside the body can have an unexpected benefit on the outside of the body.
"We've seen a lot of kids with acne or people with eczema or psoriasis clear up beautifully within a relatively short period of time," she said.
And for the sake of babies in the womb, Maroon says it's just plain wrong for doctors not to encourage omega-3 fats for pregnant women.
"It's almost criminal at this time because the baby's brain, the fetal brain, as it develops requires a large amount of so-called DHA," she said.
DHA and EPA
DHA is one of the two main active components of fish oil. The other is called EPA.
For instance in that obesity study, the 6,000 milligrams (6 grams) of daily fish oil contained 1,800 milligrams (1.8 grams) of DHA and EPA combined.
That combination is only 30 percent of the total omega-3s. The remaining portion is not harmful, but doesn't provide the special benefits. Most products have a much higher ratio of these two potent factors.
Maroon, author of Fish Oil: The Natural Anti-Inflammatory says one of the ways DHA and EPA work together is by squelching the silent inflammation of disease. He says that inflammation really is hidden.
"I know if a splinter is in my finger, it hurts. My coronary arteries don't know when the plaque is building up to the point that it's squeezing the blood from my heart until I get angina or a heart attack," Maroon said.
That same silent damage characterizes Alzheimer's disease as well. High doses of omega-3s are reported to slow down that inflammatory brain damage.
So how can Americans compete with the Japanese in getting the benefits of omega-3 fats?
Difference is in Diet
The challenge is that the Japanese average a serving a day of fish, about three ounces (85 grams). That provides 1,300 milligrams (1.3 grams) of omega-3 fats.
By contrast, the average American averages little more than one serving of fish a week. That provides a fraction as much fish oil, only 200 milligrams (0.2 grams).
So how can that discrepancy be addressed? For most people, one to three fish oil capsules a day will take up the slack. For children and those who don't like capsules, the appropriate dose can come from liquid or chewable forms of omega-3.
The other way to go is, of course, to eat fish. But fish do vary widely in their omega-3 content. Select fish higher in fat such as salmon, mackerel, and sardines.
Eating fish also requires some caution because large fish such as tuna and swordfish can accumulate toxins like mercury. Small fish like those sardines are much safer.
The issue is serious enough that the U.S. Food and Drug Administration recommends that pregnant women and young children eat very little fish. For them, fish oil supplements are a better choice, because they're processed to remove impurities.
Health experts like Maroon and Gittleman recommend getting omega-3s as a key part of an active lifestyle to fight back against the pitfalls and inflammation of daily living.
"If we can prevent the inflammation by taking something as simple as fish oil on a daily basis and modifying our diet and exercising, I think we can do much more for ourselves than any pill or surgery," Maroon said.
Originally published August 12, 2008.