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Fish Oil -- What Every Midlife Woman (and Man) Should Know
By Robin H. Miller, M.D.,
Author of The Smart Woman's Guide to Midlife and Beyond

One cannot read a newspaper or listen to the radio or TV without fish oil being mentioned. What, exactly, is it? Why all the hype now?  Is it really as good as it's cracked up to be?  All are important questions; you need to know the answers if you want to stay healthy in midlife and beyond.
What is it?
The healthy substances in fish oil are known as the omega 3 fatty acids. Although the highest concentration of these is found in fish, you can also find  omega 3 fatty acids in other foods such as flax seed, walnuts and canola oil.
Why all the hype now?
Nutritionists and those in the alternative health community have understood the value of omega 3 fatty acids found in fish for years.  Now that the use and value of fish oil has been extensively studied by mainstream medical institutions, more and more physicians are recommending it for their patients.
Is it really as good as it's cracked up to be?
The American Heart Association thinks so. They recommend that people consume omega-3 fatty acids from fish and plant sources to protect their hearts. Studies have found that omega-3 fatty acids do the following:
Decrease the risk of sudden death (from heart disease) and abnormal heart rhythms
Decrease the development of atherosclerosis and plaque formation
Decrease blood clots
Improve the overall health of the body's arteries
And . . .
Lower triglyceride (a type of lipid or cholesterol) levels in the blood
What else is fish oil good for?
Fish oil has been found to be of benefit in stroke prevention, Crohn's disease, lupus, prostate cancer, colon cancer, high blood pressure and rheumatoid arthritis.  Interestingly, a recent study done in England found that pregnant women who consumed 2-3 servings of fish or seafood a week throughout their pregnancy had children with higher IQ's than those pregnant women who consumed no fish or seafood.
How should you be getting your omega-3 fatty acids? Is there a difference between fish and other sources?
There are different types of omega-3 fatty acids. The active forms, found exclusively in fish, are called eicosapentaenoic acid  (EPA) and docosahexaenoic acid (DHA). Those fish that are highly recommended include herring, sardines, wild salmon and fresh tuna.  It is important to note: Farm raised salmon also contain omega 3 fatty acids. However, many of these fish are treated with antibiotics, have been genetically modified, and/or have been fed fish pellets with dye to give them a pink color. Canned salmon, which is packed in the juices of the salmon and contains bones -- a great source of calcium --  is usually made from wild salmon, and thus, may be a better option than fresh farm raised salmon.  Canned tuna can contain a fair amount of mercury, and the levels can be quite variable.
Another form of the omega-3 fatty acids can be found in plants. Flaxseed and flaxseed oil contain alpha-linolenic acid  (ALA), which is converted by the liver to the active forms, EPA and DHA.  Since the conversion to the active components can vary from person to person, fish oil is a far more potent form of omega-3 fatty acids.  It is best to use both fish and flax seed to get omega-3 fatty acids.
If you are interested in taking fish oil as a supplement, look for brands that are distilled and that test for contaminants. Taking it as a contaminant-free supplement will avoid the problem of being exposed to mercury from fish. There are a couple of common brands that do this, Nordic Naturals and Eskimo Oil.

Here is an important tip:  If you have fish oil capsules, and, after piercing, it smells like rotten fish, it is time to find a new bottle. Rancid oil isn't good for you.
Eating fish is probably the best route for getting omega-3 fatty acids. It is always best to get nutrients from whole food.
What about mercury?
There is the potential for fish oil and, of course, fish to contain mercury. Mercury can be toxic to the nervous system and is particularly harmful to the developing nervous systems of babies and small children.  Because they may contain too much mercury, there are certain types of fish to avoid or eat sparingly.  These include: shark, swordfish, king mackerel and tilefish.
Are there other risks?
Those with bleeding problems should probably avoid fish oil since it thins the blood. Those on blood thinners need to let their healthcare providers know that they are regularly getting fish oil in their diets or taking a supplement so that their bleeding time can be monitored. Some people become nauseated after taking it. Some who take it might find it elevates their LDL cholesterol slightly.  Quality issues with fish oil supplements are huge. It is really important to find a good, mercury-free brand as mentioned above.
What is the recommended dose?
There really isn't a set recommended dose. Fish oil supplements in the amount of 2-4 grams a day have been found to lower triglyceride levels in the blood.  Most doctors recommend anywhere from 1-3 grams of fish oil a day. For those patients with high triglycerides the recommendation is 2-4 grams a day.
If you are interested in taking fish oil supplements it is really important to discuss it with your doctor or health care provider first.  One more tip, if you find you are burping up fish after you take your supplement, switch to a different brand. There are many, which don't give you a fishy after-taste!!
The Bottom Line? The hype about fish oil is well-deserved. It can help you stay healthy in midlife and beyond.

©2008 Robin H. Miller, M.D.

Author Bio
Dr. Robin Miller, in addition to being an experienced Board Certified Internist, is also an Integrative Medicine specialist, having trained with Dr. Andrew Weil as a Fellow at the University of Arizona. She is the founder and medical director of Triune Integrative Medicine, an innovative medical clinic in Medford, Oregon.  She is an award winning medical correspondent on regional and national television, radio, and the internet, the author of a health book for children, Kids Ask the Doctor, and a board member of The National Association of Medical Communicators, a society of medical journalists in all media. She is also an Assistant Professor of Medical Informatics at the Oregon Health Sciences University.  She is the co-author of The Smart Woman's Guide to Midlife and Beyond, which will be available this September from New Harbinger Publications.

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