Cutting Through the Fish Oil Confusion

Has the latest news flash on fish oil and prostate cancer caused you to be confused and concerned? 

For me it has led to frustration and fatigue from having to do a significant amount of damage control. Making matters worse is that this need for damage control is due primarily to the irresponsibility of the media in their successful attempt to grab headlines without critically reading the scientific study by Brasky et al. before drawing conclusions.

Here's an example of some of the headlines:

"Fish oil may raise prostate cancer risk, study confirms" -NBC News

"Taking Omega 3 supplements may increase the risk of prostate cancer" -Daily Mail

"Men might want to shun fish oils, study shows" -Seattle Times

I presume the biggest lesson learned from the whole thing is that if you listen and apply health information delivered by the media you may be reducing your chances of a long, healthy life.

OK, I’ll step off my soapbox now. Let's dig into this and separate fact from fiction.


The Flawed, Recent Study

In the new analysis, researchers measured the levels of fats in the blood (plasma phospholipids) and concluded that men with the highest concentrations of EPA, DPA and DHA-three fatty acids derived from fish and fish-oil supplements-had an increased risk of prostate cancer. Specifically, they reported a 71 percent increased risk of high-grade prostate cancer; a 44 percent increase in the risk of low-grade prostate cancer and an overall 43 percent increase in risk for total prostate cancer in a subset of patients with the highest level of these omega-3 fatty acids.

Dr. Alan Krystal, one of the authors of the study had this to say:

"As we do more and more of these studies - and I have been involved in them most of my career - I find high doses of supplements have no effect or increase the risk of the disease you're trying to prevent. There is not really a single example of where taking a supplement lowers disease risk."

Dr. Krystal exemplifies the concept of bias here.  These researchers were quick to blame dietary supplements even though there is no evidence that anybody in this study consumed fish or fish oils from dietary supplements. 

In fact, the study demonstrates no cause and effect; it can only purport to show an association between higher plasma levels of omega-3 fatty acids and those whom the researchers advise us had an increased rate of prostate cancer. In usual circumstances, plasma levels of EPA and DHA reflect very recent intake and are considered a poor biomarker of long-term omega-3 intake. Fish and fish oil ingestion produces a big rise in plasma omega-3 levels in about 4.5 hours and washes out around 48 hours.

Biologically, there's no plausible reason to suspect that too much omega-3 could be causing cancer. In fact, a plethora of studies higher that rank higher in totem pole of evidence show mostly protective effects from the consumption of Omega 3’s:

  • Researchers investigated the effect of dietary fatty fish intake among 6,272 Swedish men who were followed for 30 years. Results showed that men who ate no fish had a two- to three-fold increase in the risk of developing prostate cancer compared with those who consumed large amounts of fish in their diet.
  • Data from the Physician’s Health Study, a study spanning 22 years, found that fish consumption (≥5 times per week) reduced the risk of dying from prostate cancer by 36%.
  • A study conducted by the Harvard School of Public Health that involved 47,882 men over twelve years found that eating fish more than three times a week reduced the risk of prostate cancer but had an even greater impact on the risk of metastatic prostate cancer. For each additional 500 mg of marine fat consumed, the risk of metastatic disease decreased by 24%.
  • In one of the best-designed studies, researchers in New Zealand examined the relationship between prostate cancer risk and EPA+ DHA in red blood cells (a more reflective marker for long-term omega-3 fatty acid intake). Higher levels of EPA+DHA were associated with a 40% reduced risk of prostate cancer.
  • In a study of 47,866 US men aged 40-75 years with no cancer history in 1986 who were followed for 14 years EPA+DHA intake at the highest levels was associated with a 26% reduced risk of developing prostate cancer.


What should you do?

Firstly, understand what not to do:

  • DO NOT consume fried fish as regular ingestion of fried fish was associated with a 32% increased risk for prostate cancer.
  • DO NOT consume fish or fish oils high in contain environmental chemicals that can contribute to prostate cancer such as polychlorinated biphenyls (PCBs), heavy metals, and other toxic chemicals.
  • DO NOT eat fish high in mercury including: shark, swordfish, king mackerel, or tilefish (sometimes called golden bass or golden snapper)
  • DO NOT listen to the media for health advice

Then understand what to do:

  • Eat one to two 3-ounce servings of fatty fish a week—salmon, herring, mackerel, anchovies, or sardines.
  • PCBs collect in the fatty parts of fish. You can take these steps to reduce PCB risks when cooking salmon, bluefish, and other fatty fish:

o Trim away fatty areas such as the belly, top of the back, and dark meat along the side. 

o Remove or puncture the skin before cooking to allow fat to drain off. 

o Broil, or steam the fish on a rack to allow fat to drain. 

o Throw away fat drippings. Don’t use them in other cooking. 

o Limit consumption of farmed raised fish.

  • Wild salmon is safer low in mercury and PCB’s but a little more pricy.
  • Consume high quality fish oil supplements from reputable manufacturers.


What about fish oil supplements?

An August 22, 2012 press release by entitled "Contamination and Other Problems Found in Fish Oil Supplements" claimed only four of 35 omega 3 supplements tested exceeded contaminations limits for PCBs. (Mercury was not detected in any of the products). The pollutant connection argues not for avoidance of fish and omega 3 supplements, but rather for more careful product selection. 

Just like not all restaurants (or wines or athletes or ...) are created equally, neither are dietary supplements, such as fish oil for example. At XY Wellness, our Members only have access to the highest quality of fish oil available: OmegAvail Ultra

Our OmegAvail Ultra is manufactured in an FDA-inspected facility with stringent internal quality control procedures and documentation systems that conform to one or more of these industry standards and/or certifications: NPA (Natural Products Association), NSF (National Sanitary Foundation), OTC (Over the Counter Drug GMPs), TGA (Australian Therapeutic Goods Administration), and the requirements of the FDA Dietary Supplement Good Manufacturing Practices (GMPs).

And our OmegAvail Ultra is molecularly distilled and filtered to ensure purity and to maximize the removal of heavy metals, pesticides, solvents, PCBs, and other contaminants. In addition, Lipase is added to enhance the digestibility and mixed tocopherols (antioxidant) is added to enhance stability and avoid oxidation.

There is simply no higher quality fish oil on the market. Choose wisely.

The Takeaway

In closing, most of my patients and many of you are taking a total of 2 grams of EPA / DHA by consuming 2 OmegAvail Ultra softgels twice per day. This is a dosage is safe and effective in protecting your body from unwanted cells and cardiovascular risk. 

It is always worth pointing out that fish oils combined with a poor diet does not improve your prognosis. Alternatively, fish oils combined with a good plant-based diet and daily exercise will significantly help you rebuild your health and reduce your risk of all-cause mortality.*

Do not be misled by faulty research and sensationalized headlines. Be smart, and be choosy on which sources of information you trust (or even pay attention to these days). It can be exhausting to wade through the noise, but it is critical to your health and well-being that you do so.


Brasky TM, Darke AK, Song X, et al. Plasma phospholipid fatty acids and prostate cancer risk in the SELECT Trial. J National Cancer Inst Online. July 10, 2013 doi: 10.1093/jnci/djt174.

Szymanski KM, Wheeler DC, Mucci LA. Fish consumption and prostate cancer risk: a review and meta-analysis. Am J Clin Nutr. 2010 Nov;92(5):1223-33.

Terry P, Lichtenstein P, Feychting M, Ahlbom A, Wolk A. Fatty fish consumption and risk of prostate cancer. Lancet 2001; 357: 1764-6.

Chavarro JE et al. A 22-y prospective study of fish intake in relation to prostate cancer incidence and mortality. Am J Clin Nutr 2008; 88: 1297-303.

Augustsson, K., et al., A prospective study of intake of fish and marine fatty acids and prostate cancer. Cancer Epidemiol Biomarkers Prev, 12(1): p. 64-7, 2003.

Norrish AE, Skeaff CM, Arribas GL, Sharpe SJ, Jackson RT. Prostate cancer risk and consumption of fish oils: a dietary biomarker-based case-control study. Br J Cancer 1999;81:1238-42.

Stott-Miller M, Neuhouser ML, Stanford JL. Consumption of deep-fried foods and risk of prostate cancer. Prostate. 2013 Jun;73(9):960-9.

Ritchie JM, Vial SL, Fuortes LJ, Robertson LW, Guo H, Reedy VE, Smith EM.Comparison of proposed frameworks for grouping polychlorinated biphenyl congener data applied to a case-control pilot study of prostate cancer. Environ Res. 2005;98(1):104-13.

Mullins JK, Loeb S. Environmental exposures and prostate cancer. Urol Oncol. 2012 Mar-Apr;30(2):216-9.


*Statements on this website have not been evaluated by the Food and Drug Administration. The products offered here are not intended to diagnose, treat, cure, or prevent any disease.