Supplements Dietary Supplements Benefits of Fish Oil for Heart Disease Prevention By Cathy Nelson Published on November 29, 2022 Medically reviewed by Yasmine S. Ali, MD, MSCI Print Table of Contents View All Table of Contents OMega-3s and Heart Health Potential Benefits How Much Should You Take? Side Effects Which Is Best? Frequently Asked Questions Fish oil comes from the tissues of fatty fish and is a good source of polyunsaturated fats known as omega-3 fatty acids, which play a role in heart function. Fish oil supplements have long been marketed as having heart health benefits. While fish oil supplements have been found to help lower triglycerides and blood pressure, there is a lack of scientific evidence supporting their use to prevent heart disease in the general population. This article will examine what fish oil does, its benefits, side effects, breeds with the highest omega-3s, and what to know about taking and choosing supplements. Evgeniia Siiankovskaia / Getty Images The Link Between Omega-3s and Heart Health Omega-3s are important components of cell membranes and are vital to heart, blood vessel, lung, hormonal, and immune system functions. Research has shown that eating fish and other seafood is beneficial for heart health, especially if these foods are chosen over less-healthy foods. Eating seafood one to four times a week can lower your risk of dying from heart disease. Studies on whether taking fish oil supplements can protect against heart disease have produced conflicting results. While some older studies have suggested fish oil could be beneficial, more recent studies have found little or no evidence that fish oil supplements protect against heart disease. Types of Omega-3 Fatty Acids There are three types of omega-3 fatty acids:Alpha-linolenic acid (ALA): Found in plant oils such as flaxseed, soybean, and canola oils; nuts, and seedsEicosapentaenoic acid (EPA): Found in oily fish like salmon and tuna, and other seafoodDocosahexaenoic acid (DHA): Found in oily fish like salmon and tuna, and other seafoodALA is an essential omega-3 fatty acid, which means your body can’t make it and you must get it from food. EPA and DHA are not considered essential omega-3s, because they can be produced from ALA. However, the body can only convert ALA into EPA and DHA in small amounts, so proper levels can only be derived from food or supplements. There have also been conflicting research results on whether fish oil supplements are helpful in reducing future cardiovascular events in those with existing heart disease or at high cardiovascular risk. The reasons for conflicting study results could be because they didn't account for the greater consumption of seafood and more people taking medications that reduce the risk of heart attacks. The formulation and dosage of fish oil supplements might also play a role in differing study results. One 2019 study found that taking daily fish oil supplements was effective at lowering the risk of heart disease and death and that greater heart health benefits are achieved with higher doses. Common Fish Breeds High in Omega-3s Omega-3 content varies greatly among fish and seafood. Cold-water fatty fish contain the highest amounts of omega-3s. Fish breeds high in omega-3s include: SalmonMackerelTunaHerringSardinesFish that are lower in fat such as bass, tilapia, cod, and shellfish also contain omega-3s, but at lower levels than fatty fish. 3 Potential Heart Benefits of Fish Oil Although fish oil supplements haven't been proven to directly help protect against heart disease, fish oil is considered to be beneficial in lowering certain risk factors for heart disease. These benefits include: Lowering Triglycerides Fish oil has been shown to lower blood triglyceride levels. Triglycerides are a type of fat found in the blood that can build up in artery walls. Having high levels of triglycerides is linked to increased risk of heart attack and stroke. High-dose (4 grams) EPA fish oil supplements have been found to significantly reduce cardiovascular events in people with high blood triglyceride levels who are at increased risk of heart disease. Lowering Blood Pressure High blood pressure is a major risk factor for heart disease. Fish oil has been found to lower blood pressure in people with normal blood pressure and those with high blood pressure. Consuming 3 grams of EPA and DHA omega-3s per day through seafood or fish oil supplements is recommended as the optimal dose for controlling blood pressure, especially for those with high blood pressure. People with high blood pressure or who are at high risk of heart disease may experience added benefits from consuming more than the recommended 3 grams per day of EPA and DHA. Lowering Inflammation Inflammation plays a role in heart disease, heart attacks, and stroke. It increases the growth of plaque (made up of fatty substances) in the blood vessels and loosens plaque, which can lead to blood clots. Fish oil supplements have been found to increase anti-inflammatory molecules in the body for up to 24 hours, although it’s not clear if this plays a role in reducing heart disease risk. The use of fish oil to reduce inflammation in those with and without heart disease is still being researched. How Much Fish Oil Should You Take? Fish oil supplements should only be taken by those with heart disease under the direction of a healthcare provider. Eating two 3.5-ounce servings of non-fried seafood one to two times a week has been shown to have heart health benefits including reducing the risk of heart disease, stroke, and cardiac death. Three grams of EPA and DHA fish oil per day consumed through seafood or fish oil supplements has been found to be the optimal dose for blood pressure control. The Food and Drug Administration (FDA) recommends consuming no more than 5 grams per day of EPA and DHA combined from dietary supplements. Prescription Fish Oil Supplements There are two prescription fish oil supplements approved by the FDA for adults with high triglycerides. They are: Lovaza: A combination of DHA and EPA with daily recommended dosage of 4 grams per day; can be used along with diet to reduce very high triglycerides, being greater than or equal to 500 milligrams per deciliter (mg/dL) Vascepa: EPA-only supplement with a daily recommended dosage of 4 grams per day; can be used along with diet to reduce very high triglycerides (greater than or equal to 500 mg/dL), or with statins to reduce the risk of cardiovascular events for adults who have high triglycerides (greater than or equal to 150 mg/dL) and heart disease or high risk of heart disease Side Effects Side effects from taking fish oil are typically mild and can include: Unpleasant taste Bad breath Heartburn, nausea, or stomach discomfort Diarrhea Headache Smelly sweat Choosing the Best Fish Oil Supplement Fish oil supplements are available in formulations that include fish oil, krill oil, and cod liver oil. Dosages can vary widely, but a typical supplement will provide approximately 1,000 milligramsof fish oil including 180 milligrams of EPA and 120 milligrams of DHA. The omega-3s in fish oil generally come in either triglyceride or ethyl ester forms, with the triglyceride form being better absorbed by the body. It's important to note that other than the prescription therapies Lovaza and Vascepa, fish oil supplements are not regulated by the FDA, and may contain toxins and additional unhealthy ingredients like saturated fatty acids. Dosage and formulations also can vary widely between products, making it important to check product labels for the types and amounts of omega-3s they contain. People with high triglyceride levels should also not attempt to treat themselves with nonprescription fish oil supplements. If you are considering using fish oil supplements for any reason, it is best to consult with a healthcare provider first. Talk to your healthcare provider before starting any fish oil supplement. Omega-3 supplements can interact with some medications, including drugs that affect blood clotting. High doses may also increase the risk of an irregular heartbeat called atrial fibrillation. It is not known if they are safe for those with seafood allergies. Summary Fish oil supplements are widely marketed as having heart health benefits. However, research is conflicting and fish oil supplementation is not recommended for preventing heart disease in the general population. Fish oil supplements have been found to help lower triglycerides and blood pressure, and fight inflammation, which are all risk factors for heart disease. Over-the-counter fish oil supplements can vary widely in dosage and formulation and are not overseen by the FDA. It is important to consult with a healthcare provider if you are considering taking fish oil supplements. A Word From Verywell Despite the hype, many of the claims about fish oil supplements and heart health have not been backed up by the most current scientific research. If you are considering taking fish oil, it’s best to consult with your healthcare provider to see if taking the supplements could be beneficial based on your individual health concerns. Frequently Asked Questions Is it safe to take fish oil daily? Yes, for most people. But experts recommend getting omega-3s by eating two 3.5-ounce servings of non fried seafood one to two times a week. Learn More What Are Omega-3 Fatty Acids? Why would you not want to take fish oil? Fish oil has not been proven to protect against heart disease in the general population. Fish oil supplements can also interact with some medications such as blood thinners, and high doses have been linked to atrial fibrillation. it is now known whether they're safe for those with seafood allergies. Learn More Study: High Doses of Omega-3s May Not Be Heart Healthy Which breed of fish has the highest omega-3s? Salmon generally has the most omega-3s of any oily fish. Other fatty fish such as mackerel, tuna, herring, and sardines are also high in omega-3s. Learn More 14 Foods High in Omega-3 Fatty Acids Should you take fish oil at a certain time of day? Fish oil can be taken at any time of the day, but it's best to take it with a meal that contains fat for better absorption. It's also best not to take fish oil on an empty stomach to avoid an upset stomach. Learn More The Difference Between Prescription Fish Oil and Supplements 19 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Penn Medicine. The truth about fish oil, omega-3 fatty acids, and heart health. American Heart Association. Prescription omega-3 medications work for high triglycerides, advisory says. National Institutes of Health Office of Dietary Supplements (consumer). Omega-3 fatty acids. National Institutes of Health Office of Dietary Supplements. Omega-3 fatty acids. National Institutes of Health National Center for Complementary and Integrative Health. Omega-3 supplements: In depth. Bhatt DL, Steg PG, Miller M, et al. Cardiovascular risk reduction with icosapent ethyl for hypertriglyceridemia. New England Journal of Medicine. 2019;380(1):11-22. doi:10.1056/NEJMoa1812792 Nicholls SJ, Lincoff AM, Garcia M, Bash D, Ballantyne CM, Barter PJ, Davidson MH, Kastelein JJP, Koenig W, McGuire DK, Mozaffarian D, Ridker PM, Ray KK, Katona BG, Himmelmann A, Loss LE, Rensfeldt M, Lundström T, Agrawal R, Menon V, Wolski K, Nissen SE. Effect of high-dose omega-3 fatty acids vs corn oil on major adverse cardiovascular events in patients at high cardiovascular risk: The STRENGTH randomized clinical trial. JAMA. 2020 Dec 8;324(22):2268-2280. doi:10.1001/jama.2020.22258. Bornfeldt KE. Triglyceride lowering by omega-3 fatty acids: A mechanism mediated by N-acyl taurines. J Clin Invest. 2021;131(6):e147558. doi:10.1172/JCI147558. Hu Y, Hu FB, Manson JE. Marine omega-3 supplementation and cardiovascular disease: An updated meta-analysis of 13 randomized controlled trials involving 127 477 participants. J Am Heart Assoc. 2019 Oct;8(19):e013543. doi:10.1161/JAHA.119.013543. Zhang X, Ritonja JA, Zhou N, Chen BE, Li X. Omega‐3 polyunsaturated fatty acids intake and blood pressure: a dose‐response meta‐analysis of randomized controlled trials. Journal of the American Heart Association. 2022;11(11):e025071. doi:10.1161/JAHA.121.025071 Johns Hopkins Medicine. Fight inflammation to help prevent heart disease. Souza PR, Marques RM, Gomez EA, et al. Enriched marine oil supplements increase peripheral blood specialized pro-resolving mediators concentrations and reprogram host immune responses. Circulation Research. 2020;126(1):75-90. doi:10.1161/CIRCRESAHA.119.315506 American Heart Association. Could fish oil fight inflammation? Rimm EB, Appel LJ, Chiuve SE, et al. Seafood long-chain n-3 polyunsaturated fatty acids and cardiovascular disease: A science advisory from the american heart association. Circulation. 2018;138(1):e35-e47. doi:10.1161/CIR.0000000000000574 Backes J, Anzalone D, Hilleman D, Catini J. The clinical relevance of omega-3 fatty acids in the management of hypertriglyceridemia. Lipids Health Dis. 2016;15(1):118. doi. 10.1186/s12944-016-0286-4. Published July, 2016. FDA. Vascepa label. Chevalier, L., Plourde, M. Comparison of pharmacokinetics of omega-3 fatty acid supplements in monoacylglycerol or ethyl ester in humans: A randomized controlled trial. Eur J Clin Nutr 75, 680–688 (2021). doi:10.1038/s41430-020-00767-4 Curfman G. Omega-3 fatty acids and atrial fibrillation. JAMA. 2021;325(11):1063. doi:10.1001/jama.2021.2909 Vaga. When is the best time to take fish oil?—morning or night? By Cathy Nelson Nelson is a freelance writer specializing in health, wellness, and fitness for more than two decades. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit