The Definitive Guide to Fish Oil for Heart Disease
Cardiovascular, or Heart,Disease, including heart attacks and strokes, are the second leading cause of death in Canada, and yet, they are also highly preventable. The underlying mechanisms of cardiovascular disease are rooted in the same bases as for all chronic disease:
It is these three processes which lead to the symptoms and health changes that we associated with cardiovascular disease - including, but not limited to, chest pain (angina), increased blood pressure, higher cholesterol levels and headaches.
Addressing these 3 mechanisms can be relatively straightforward from a diet & lifestyle perspective:
Fish oils are the best studied nutraceutical supplement, period. In shear quantity of studies, but also the quality of studies, fish oils are better studied than many pharmaceutical drugs. Despite this, even most medical professionals I speak with, don’t know how to properly dose fish oil, or how to evaluate a fish oil for quality.
It doesn’t matter how much “fish oil” you’re taking, you’re taking it for the
benefits of two specific omega-3 fatty acids - EPA & DHA. Look for a fish oil
that has as close to 1000mg of EPA and DHA combined, for maximum effect from EPA & DHA from the least amount of fish oil. When comparing prices, determine how much you are paying per 1000mg EPA & DHA.
Fish oil naturally provide EPA & DHA in a ratio of 3:2, but 2:1 and higher ratios are commonly found in the fish oils available to us. But for cardiovascular disease protection, this ratio doesn’t matter - studies done with entirely EPA, entirely with DHA and in various ratios all show similar benefit. You don’t need to spend more money or concede a lower dosage of EPA+DHA for a product that has a special ratio of fish oils.
Small fish caught as a byproduct of the existing fishing industries such as anchovies and sardines are preferred as they are most renewable, and because they are smaller and live shorter life spans, they accumulate fewer toxins such as PCBs and heavy metals such as mercury or lead from our oceans. That being said, any molecularly distilled, or similarly processed fish oil will effectively rid the final product of any appreciable levels of unwanted chemicals.
Flaxseed, hempseed, and some other plants can provide us with omega-3 essential fatty acids. Unfortunately the EPA & DHA content is generally very low or non-existent in these sources. You cannot convert these other forms of
omega-3 to EPA & DHA very efficiently. They still have great health benefits, they’re just not as good as EPA & DHA. Algal sources of EPA+DHA are becoming available now, giving vegetarians and vegans a legitimate supplement source, though the actual chemical nutrients you’re getting are exactly the same as from fish oil, and you will pay a premium for these products.
Krill oil is substantially more expensive than fish oil, and though it is a natural source of some great antioxidants and other healthy fats, it is very low in EPA & DHA. Is it better? Maybe, but it’s certainly not worth the money, and there’s no science to prove it yet.
Minimum 1000mg per day of combined EPA+DHA in any ratio. Look for fish oils that have high combined EPA+DHA in a single capsule (capsules minimize oxidation and maximize shelf-life and stability of fish oils, but liquids are reasonable if you don’t tolerate larger gelcaps).
Fish oils have not been proven in clinical studies to thin the blood or cause bleeding, despite theoretical concerns, even at very high doses, though some people subjectively feel that they may bruise more easily when taken fish oil. That being said, be sure to consult your licensed and experience healthcare practitioner prior to taking fish oils, if you are taking other supplements or medications of any type or have any pre-existing medical condition that may lead to changes in bleeding time or blood thinning.
- Inflammation,
- Oxidative stress (free radical damage) and;
- Blood sugar imbalances.
It is these three processes which lead to the symptoms and health changes that we associated with cardiovascular disease - including, but not limited to, chest pain (angina), increased blood pressure, higher cholesterol levels and headaches.
Addressing these 3 mechanisms can be relatively straightforward from a diet & lifestyle perspective:
- Eat a diet consisting of mostly colourful vegetables, which contain lots of phytonutrients like antioxidants and fiber - This may be referred to as an Anti-Inflammatory diet, and many generalized diet plans associated with lower rates of heart disease are based on this simple principle (eg. Mediterranean Diet, DASH Diet, Portfolio Diet). You can maximize this effect by adding a phytonutrient-heavy greens powder, and additional fiber in supplement form.
- Minimize sugars and simple carbohydrates;
- Manage mental/emotional stress;
- Maintain a healthy weight and Exercise, but not too much;
- Quit smoking and limit alcohol intake.
The Magic Bullet?
Fish oils are the best studied nutraceutical supplement, period. In shear quantity of studies, but also the quality of studies, fish oils are better studied than many pharmaceutical drugs. Despite this, even most medical professionals I speak with, don’t know how to properly dose fish oil, or how to evaluate a fish oil for quality.
EPA & DHA, Not “Fish Oil”
It doesn’t matter how much “fish oil” you’re taking, you’re taking it for the
benefits of two specific omega-3 fatty acids - EPA & DHA. Look for a fish oil
that has as close to 1000mg of EPA and DHA combined, for maximum effect from EPA & DHA from the least amount of fish oil. When comparing prices, determine how much you are paying per 1000mg EPA & DHA.
What Ratio of EPA:DHA?
Fish oil naturally provide EPA & DHA in a ratio of 3:2, but 2:1 and higher ratios are commonly found in the fish oils available to us. But for cardiovascular disease protection, this ratio doesn’t matter - studies done with entirely EPA, entirely with DHA and in various ratios all show similar benefit. You don’t need to spend more money or concede a lower dosage of EPA+DHA for a product that has a special ratio of fish oils.
Omega-3 from Plants?
Small fish caught as a byproduct of the existing fishing industries such as anchovies and sardines are preferred as they are most renewable, and because they are smaller and live shorter life spans, they accumulate fewer toxins such as PCBs and heavy metals such as mercury or lead from our oceans. That being said, any molecularly distilled, or similarly processed fish oil will effectively rid the final product of any appreciable levels of unwanted chemicals.
Flaxseed, hempseed, and some other plants can provide us with omega-3 essential fatty acids. Unfortunately the EPA & DHA content is generally very low or non-existent in these sources. You cannot convert these other forms of
omega-3 to EPA & DHA very efficiently. They still have great health benefits, they’re just not as good as EPA & DHA. Algal sources of EPA+DHA are becoming available now, giving vegetarians and vegans a legitimate supplement source, though the actual chemical nutrients you’re getting are exactly the same as from fish oil, and you will pay a premium for these products.
What About Krill?
Krill oil is substantially more expensive than fish oil, and though it is a natural source of some great antioxidants and other healthy fats, it is very low in EPA & DHA. Is it better? Maybe, but it’s certainly not worth the money, and there’s no science to prove it yet.
Fish Oil Dosage for Heart Health
Minimum 1000mg per day of combined EPA+DHA in any ratio. Look for fish oils that have high combined EPA+DHA in a single capsule (capsules minimize oxidation and maximize shelf-life and stability of fish oils, but liquids are reasonable if you don’t tolerate larger gelcaps).
Safety of Fish Oils
Fish oils have not been proven in clinical studies to thin the blood or cause bleeding, despite theoretical concerns, even at very high doses, though some people subjectively feel that they may bruise more easily when taken fish oil. That being said, be sure to consult your licensed and experience healthcare practitioner prior to taking fish oils, if you are taking other supplements or medications of any type or have any pre-existing medical condition that may lead to changes in bleeding time or blood thinning.
