Are Fish Oil Pills Better for You Than Eating Fish?
Key takeaways:
Fish oil supplements are one of the most popular dietary supplements on the market, with a third of people in the U.S. looking to add more omega-3s to their diet.
Omega-3s are one of the healthy types of fats found in oily fish, nuts, and seeds. They’re good for your heart, immune system, and brain.
In general, it’s better to get your nutrients from food than supplements. Both the American Heart Association and the Dietary Guidelines for Americans support eating fatty fish twice per week.
While there may be some benefits to fish oil supplements, research shows they don’t reduce the risk of coronary heart disease, as once thought. They might also add risk for people without heart disease.
Table of contents
Omega-3 fatty acids are a type of polyunsaturated fat found in oily fish, walnuts, soybean oil, flax seeds, algae, and dietary supplements. And a third of people in the U.S. are looking to add more omega-3 fatty acids to their diets. This isn’t surprising, since the health benefits are pretty well-known.
Omega-3s are most known for their role in heart health. But they may also have other functions in immune, eye, and brain health. This is why both the American Heart Association and the Dietary Guidelines for Americans recommend eating fish twice per week (more specifically, a total of 8 oz of fatty fish per week).
But many people either don’t want to eat fish or can’t. So, it makes sense that fish oil supplements might be the next best step. But are supplements the same as eating the real thing? Is one or the other better for your health? In this article, we breakdown the facts about oily fish and fish oil supplements, so you can decide for yourself.
Save over 40% on Qsymia with GoodRx
Discover the once daily Qsymia for weight management. Qsymia is for adults and children 12-17 in combination with a healthy diet and regular exercise.
Are fish oil pills the same as eating fish?
Most healthcare professionals take a food-first approach when it comes to nutrition. This means they recommend getting nutrients from actual food, rather than supplements. In other words, supplements are meant to supplement your diet, not replace anything.
If going the supplement route, opt for a food-based vitamin (such as fish or krill oil, instead of a pill) and mix it into a smoothie or a food you’re already eating for better absorption. Some research suggests that omega-3s are better absorbed from krill oil versus fish oil supplements.
In the past, experts recommended fish oil supplements as a way to help prevent coronary artery disease — the type of heart disease that causes heart attacks. But this is no longer the case. Research has since shown the supplements didn’t help. It’s clear that supplements and fish don’t have the same health benefits, which we’ll dive into below.
But, that said, some supplements are right for some people. First, let’s look at the pros and cons of both fish and fish oil supplements.
Confused about omega fatty acids? Learn about the differences and similarities between omega-3, omega-6, and omega-9, which are each important in different ways.
If you don’t eat fish: There are other ways to get your omega-3s that don’t involve fish or fish oil.
Krill oil versus fish oil: Is one supplement better than the other when it comes to heart health?
Fresh fish vs. fish oil supplements: Pros
In addition to being a staple in many cultural cuisines, eating fish twice a week has benefits.
Heart health
Decades of research support the health benefits of eating fish. One example is a large study that looked at the connection between diet and heart disease in 80 countries and 245,000 people. The researchers found that the healthiest participants ate high levels of:
Fruits
Vegetables
Nuts
Seeds
Fish
Dairy
Those who reported eating fish 2 to 3 times per week had a 30% lower risk of death and 14% lower risk of heart attack.
Benefits beyond heart health
Beyond omega-3 fatty acids, fish also contain high-quality protein and a whole package of vitamins and minerals. For example, sardines contain:
Calcium
Potassium
Iron
Magnesium
Iodine
Choline
Read more like this
Explore these related articles, suggested for readers like you.
Research supports the health benefits of eating fish regularly, including benefits that go beyond prevention of cardiovascular disease. Several observational studies suggest a link between eating fish and better health outcomes in several areas. These include cancer prevention, brain development, and eye health, to name a few.
Affordability
Incorporating fish into your diet doesn’t have to be expensive. For less than $2, you can buy a can of tuna or sardines. Canned seafood can last up to a year in your pantry. It provides a quality source of protein in addition to omega-3s. Frozen salmon can be just as affordable as chicken breast. It can be a great way to vary your nutrients throughout the week.
Fresh fish: Cons
For some people, eating fish regularly may pose a challenge.
Mercury content
Pregnant people and young children should avoid certain types of fish because of the mercury content. The FDA recommends pregnant people and young children eat two servings of seafood a week from their “best choices” chart.
Examples of low-mercury seafood choices include:
Salmon
Shrimp
Tuna (canned light and skipjack)
Sardines
Vegan diets or food allergies
There are situations in which you’ll need or want to avoid eating fish. If you have a food allergy to shellfish or a fish allergy, you’ll, of course, need to avoid these foods. Same goes if you follow a vegan diet.
Fish with low omega-3s
Not all types of fish contain high levels of omega-3s. Lean fish, like cod and tilapia, are healthy protein sources, but don’t contain high levels of omega-3s. In order to reach the recommended omega-3 intake with two servings per week, it’s important to choose fish on the medium or high list for omega-3 content.
Fish high in omega-3 | Fish with a medium amount of omega-3 |
• Anchovies* | • Mussels |
*Indicates the best choice for low-mercury content
Fish oil supplements: Pros
There are three types of omega-3 fatty acids:
Alpha-linolenic acid (ALA)
Eicosapentaenoic acid (EPA)
Docosahexaenoic acid (DHA)
Supplements often contain EPA, DHA, and other polyunsaturated and monounsaturated fatty acids. Look at the supplement facts panel to better understand the exact amount of EPA and DHA that your supplement offers.
Even though guidelines typically recommend food-based nutrition over supplements, there are still some benefits to fish oil for some people.
Simplicity
Taking a pill is pretty simple, especially if you pair it with other pills you’re already taking. There’s no cooking or preparation required.
Vegan and allergy-friendly options
People who avoid fish will need to seek out other sources of omega-3s. Thanks to innovation in the supplement market, there are plant-based omega-3 supplements made from algae sources that contain DHA and EPA.
Health benefits
If you have high blood pressure, research supports taking fish oil in combination with other blood-pressure treatments. Experts recommend 2,000 mg to 3,000 mg per day to help manage high blood pressure.
There also has been some promising research suggesting fish oil supplements can help lower triglycerides. These are a type of fat in the blood that can increase risk of heart disease and stroke. Experts recommend taking between 2,000 mg and 4,000 mg per day of EPA and DHA for high triglycerides.
Fish oil supplements: Cons
As mentioned above, there are some downsides to fish oil supplements.
Limited health benefits
Despite evidence for improvements in blood pressure and triglyceride levels, there’s limited research for overall cardiovascular health. A large research study included close to 80,000 older adults with coronary heart disease. In the end, there was no evidence to suggest omega-3 fatty acid supplementation was linked to a decrease in major cardiac events (like heart attack). As such, supplements are no longer recommended for preventing heart disease.
This and other research suggests that the health benefits of eating fish regularly can’t be explained just by EPA and DHA alone.
More recently, research has suggested that fish oil supplements could actually increase risk for many people. In a large study, regular fish oil supplements were linked with an increased risk of atrial fibrillation and stroke in people without known cardiovascular disease. But supplements were beneficial for people with cardiovascular disease.
Inconsistent labeling
One thing to note is that dietary supplements aren’t as closely regulated as food. Poor quality dietary supplements might have added fillers that aren’t listed on the ingredients list. And the dose might change depending on the bottle you buy. It can be helpful to look for supplements that are third-party verified by companies such as NSF International, ConsumerLabs.com, or U.S. Pharmacopeia.
Also, supplements contain a wide range of doses of EPA and DHA. Many fish oil supplements come in 1,000 mg doses but provide varying ranges of EPA and DHA.
Due to incorrect labeling, there may be other types of oils in supplements beyond omega-3s.
Price
Supplements can be a pricey addition to your grocery cart. Fish oil supplements can cost between $10 and $30 dollars per month, depending on the dose. If you’re buying third-party verified and tested dietary supplements, these could cost even more.
Scent and side effects
Most fish oil pills have a fishy scent and can leave a fishy taste in your mouth. For some people, this might be unpleasant. But sometimes unflavored supplements are available.
Food waste
When processing fish to make fish oil supplements, there may be a large amount of waste. If you’re interested in minimizing food waste, how the supplements are made could be important.
Newer, innovative supplement-making practices might lead to less waste. Some supplements can be made from leftover fish skin, inedible fish parts, and damaged whole fish. But these practices aren’t widely in use.
Should you take a fish oil supplement?
If you’re eating fish a couple times per week, you don’t need to take a fish oil supplement. Because the research is conflicting on the heart health benefits of taking fish oil supplements, making other lifestyle changes is likely to be more beneficial.
Examples of lifestyle changes include:
Exercising regularly
Reducing salt intake
Managing your stress levels
An omega-3 supplement might be right for you if you:
Don’t eat fish
Have a seafood allergy
Need help managing high blood pressure or high triglycerides
Speak with your primary care provider or pharmacist before starting a new supplement because it could interact with other medications.
The bottom line
Many people in the U.S. are looking to add more omega-3 fatty acids to their diet. The best way to do this is to eat whole foods, like fatty fish, nuts, and seeds. Whole foods are generally better than supplements. Fish oil supplements have some health benefits, but only for people with existing cardiovascular conditions. Eating fish is preferable, when possible.
Why trust our experts?
References
Abdelhamid, A. S., et al. (2020). Omega-3 intake for cardiovascular disease. Cochrane Evidence Synthesis and Methods.
Alfio, V. G., et al. (2021). From fish waste to value: An overview of the sustainable recovery of omega-3 for food supplements. Molecules.
American Heart Association. (2021). Fish and omega-3 fatty acids.
Aung, T., et al. (2018). Associations of omega-3 fatty acid supplement use with cardiovascular disease risks: Meta-analysis of 10 trials involving 77 917 individuals. JAMA Cardiology.
Dietary Supplement Label Database. (2023). Fish oil classic strength 1,200 mg lemon flavor. Office of Dietary Supplements.
Food Allergy Research & Education. (n.d.). Fish allergy.
Food Allergy Research & Education. (n.d.). Shellfish allergy.
International Food Information Council. (2022). 2022 food and health survey.
Jones, J. M. (2023). In U.S., 4% identify as vegetarian, 1% as vegan. Gallup.
Mente, A., et al. (2023). Diet, cardiovascular disease, and mortality in 80 countries. European Heart Journal.
Office of Dietary Supplements. (2022). Omega-3 fatty acids.
Office of Dietary Supplements. (2023). Dietary supplements: What you need to know.
Office of Dietary Supplements. (2023). Omega-3 fatty acids.
Santos, H. O., et al. (2023). Eating more sardines instead of fish oil supplementation: Beyond omega-3 polyunsaturated fatty acids, a matrix of nutrients with cardiovascular benefits. Frontiers in Nutrition.
Seafood Nutrition Partnership. (n.d.). Which fish is the richest in omega-3s?
Skulas-Ray, A. C., et al. (2019). Omega-3 fatty acids for the management of hypertriglyceridemia: A science advisory from the American Heart Association.
U.S. Department of Agriculture. (2020). Dietary guidelines for Americans, 2020-2025.
U.S. Food and Drug Administration. (2021). Advice about eating fish.
U.S. Food and Drug Administration. (2022). Questions and answers from the FDA/EPA advice about eating fish for those who might become or are pregnant or breastfeeding and children ages 1 to 11 years.
Wang, T., et al. (2023). Association between omega‐3 fatty acid intake and dyslipidemia: A continuous dose–response meta‐analysis of randomized controlled trials. Journal of the American Heart Association.
Zhang, X., et al. (2022). Omega-3 polyunsaturated fatty acids intake and blood pressure: A dose-response meta-analysis of randomized controlled trials. Journal of the American Heart Association.
