The next time you go for a checkup, it's unlikely that your doctor will write you a prescription for twice-weekly doses of trout and salmon. And that means he's ignoring a cheap, easy way to improve your heart health, says Carl Lavie, MD, medical director of cardiac rehabilitation and preventive cardiology at the Ochsner Heart and Vascular Institute in New Orleans. Dr. Lavie recently published a review of studies on the heart benefits of omega-3 fatty acids, which are abundant in fish and easily available in the form of fish oil supplements. The research consistently shows, he found, that omega-3s reduce heart failure, cut down on artery disease, and reduce the risk of death from major cardiac events. "Many people have recognized that omega-3 is a healthy food, but mostly the promotion of omega-3 has mainly come from the health-food industry or nutraceutical companies [supplement manufacturers]," he says. Very few doctors, he adds, seem aware of the clinical trials supporting their use.
Yet while the science on omega-3s seems clear, the best way to get those oils can be a little murky. Making the right choice is important: Fish are high in industrial pollutants, and harvesting too many now could mean that down the line, there won't be enough of them left in the sea to save our hearts. So should you go for the real thing, or get your oil from over-the-counter supplements?
This: Fish Oil
Pros: For people who don't like the taste of fish, fish oil supplements provide an alternative without having to eat any fish. Oils are also less likely than whole fish to be contaminated with mercury, which is concentrated in muscle tissue rather than in fats or oils. Furthermore, the nonprofit Environmental Defense Fund (EDF) says that most fish used in fish oils are from small fish like anchovies and sardines, which aren't under pressure from overharvesting. Fish oil made from wild Alaskan salmon is also an ecofreindly, heart-healthy choice.
Cons: While those tiny fish may be abundant, they're also food for other fish, and removing them from the food chain can leave a lot of larger species to go hungry. And although mercury levels may be low in fish oil supplements, those pills may have high levels of polychlorinated biphenyls (PCBs), which build up in the fat of fish and make their way into oils. Finally, anyone who's swallowed a fish oil supplement has likely experienced the unpleasant side effect of "fish burp."
Pros: Healthy people can get the recommended level of omega-3s, 500 milligrams per day, by eating fish twice a week, says Dr. Lavie, and nutritionists note that it's easier for your body to absorb nutrients directly from food than from a pill. And fish are more than just a source of beneficial fatty acids. They’re also high in protein, as well as antioxidants like vitamin E and beta-carotene.
Cons: Deciphering the "good" fish from the "bad" fish, in terms of both fishery management and environmental contaminants such as mercury and PCBs, can give any fish-lover a headache. Both wild fish and farmed fish have environmental problems, and some types of farmed fish can have even higher levels of PCBs than their wild counterparts.