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The debate over fish oil supplements

There's nothing fishy about the hoopla over fish oil supplements.

Research suggests that they do indeed reduce high levels of triglycerides, a type of fat in the blood that can contribute to heart disease. The supplements are taken for a wide variety of other conditions, too, from depression to attention-deficit disorder, although scientific evidence on their effectiveness varies from condition to condition.

Whether they're for you, though, depends on your age, your health and whether you eat enough fish to avoid having to bother with the supplements in the first place.

"Eating fatty fish is very healthy, but few individuals eat these fish often enough to have a therapeutic effect, and therefore supplementation may be needed," said Nancy Mazarin, a nutritionist and registered dietitian in Great Neck. She recommends fish oil supplements for people over 50 and those who have specific conditions that the supplements might help.

The power in fish oil supplements comes from the presence of omega-3 fatty acids, an unsaturated fat found in fish, especially in tuna, salmon, sardines, mackerel, herring and trout. Those who don't like fish can also get omega-3s from plant-based foods such as flaxseed, walnuts, soybeans and canola oils.


ACID TESTS

Fatty acids lower inflammation, decrease excessive blood clotting and help cells function better, said Josephine Connolly-Schoonen, a registered dietitian and executive director of the nutrition division in the department of family medicine at Stony Brook University School of Medicine.

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"I use omega-3 fatty acid supplements primarily with people with heart disease, high triglycerides, diabetes ... rheumatoid arthritis and asthma," Connolly-Schoonen said. People with diabetes, she noted, are at higher risk for heart disease and tend to have high triglycerides.

She also uses it to treat asthma. "Although the research is not that strong here, I find it works for my patients," she added.

Mazarin said that research supports the use of fish oil supplements to treat arthritis, inflammatory bowel disease, atrial fibrillation, stroke risk and breast cancer. "There is ... contradictory science behind the use of omega 3s for neurological issues -- like attention-deficit disorder and attention-deficit/hyperactivity disorder -- and psychological issues," she said.


HEART HEALTHY

The Natural Medicines Comprehensive Database, which tracks scientific analysis of alternative medicine, says that medical research has proved that fish oil reduces high levels of triglycerides, which contribute to heart disease. It describes fish oil as "likely effective" as a way to help healthy people avoid heart disease and as "possibly effective" as a treatment for a variety of conditions, including high blood pressure, menstrual pain, attention-deficit/hyperactivity disorder, bipolar disorder, high cholesterol, psychosis, rheumatoid arthritis and more.

But it rates fish oil as "possibly ineffective" or "likely ineffective" for several other conditions, such as breast pain, stomach ulcers, gum infection, liver disease and type 2 diabetes.

Then, there's the debate over whether supplements yield the same benefits associated with omega-3s from foods. Some health experts contend that the body absorbs nutrients from supplements in a different way than it does from food. Studies have produced mixed results.


A SITE TO CHECK

For those who choose to supplement their diet with over-the-counter fish oil pills, Robyn Cotler, a nutritionist and registered dietitian in Plainview, said that information on the pros and cons of various brands of supplements is available online at ConsumerLab.com, an independent testing company.

Prescription versions of fish oil supplements also are available. "They're good because they can be covered by a person's drug plan, and they are certified to be free of problematic ingredients like PCBs and mercury," Connolly-Schoonen said. Doctors sometimes prescribe them for patients with an inflammatory condition or high triglycerides, she said.

But Cotler cautions that fish oil supplements aren't a get-out-of-healthy-eating card.

"What I have found through years of counseling people is that food must be stressed first," Cotler said. "Taking a pill is easy. Making better food choices is difficult. The pill is a 'supplement' -- supplemental to your diet. If you make poor food choices, the supplement will be unable to provide the utmost nutrition benefits."

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