Doctor's Note

I’ve previously discussed fish oil supplements in the context of risks versus purported cardiovascular benefits:

But if the benefits aren’t there, then all one is left with are concerns over the industrial pollutants that concentrate in the fish fat (even in distilled fish oil, see Is Distilled Fish Oil Toxin-Free?).

These same contaminants are found in the fish themselves. This raises concern for adults (Fish Fog), children (Nerves of Mercury), and pregnant moms:

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  • guest

    How about the vegan DHA omega 3 oil supplements? Have there been similar studies done on these, and are there any long-term studies or science available that has measured the risk of long-term vegan DHA supplementation? Or are we just assuming these are safe to take (based on our best assessment of the available yet limited science), while knowing that the fish oils are not?

    • Veganrunner

      Good questions. I am thinking this may shake out to what we already know. Supplementation is never as good as the whole food. (Exception B12) Flax seed etc. I know mine have been sitting in the fridge untouched.

      What have you found Dr Greger? Are we wasting our money?

      • brec

        And indeed what about flax seed used as a supplement? As a CHD patient following Esselstyn’s dietary regimen I’ve also been following his recommendation of a tablespoon a day of flaxseed meal specifically for Omega-3 fatty acids.

        • Veganrunner

          Flax seed is whole food. Isn’t it? I suppose flax seed oil is different. I eat flax seed.

          • brec

            Yes, it’s whole food and I’ve been adding ground flax seeds to my oatmeal. But in other contexts Esselstyn recommends avoidance of high-fat foods such as nuts, avocados, tahini, etc. for us who have CHD.

          • DGH

            Flaxseed does not convert to DHA. (If that’s important to you).

          • Israel Navas Duran

            That’s an oversimplification. Women can transform a significant percentage of EPA into DHA:

            “The fractional conversion of ALA to EPA, estimated by measuring peak or area under the curve plasma contents of the labeled fatty acids, varies between 0.3% and 8% in men, and the conversion of ALA to DHA is ≤4% and often undetectable in males (39, 40, 44, 45). Conversion of ALA to long-chain n—3 fatty acids appears to be more efficient in women: up to 21% is converted to EPA and up to 9% is converted to DHA (38), with a concomitant reduction in the rate of ALA oxidation (

          • e

            I assume women create more due to estrogen, so possibly the DHA created is for fetal brain development, and not so important in adults, otherwise men would create as much ??

          • Roberta Peck

            Yes ,besides suggesting flax, Esselstyn, and McDougle promote no oils ,avocados,or nuts. Whereas Dr Greger and Dr Furhman both point out that about an ounce of nuts daily has proven heart healthy. Nutricianist Jeff Novak, who is a friend of all these doctors, actually recommended a patient who was not doing well under Esselstyn to Dr Joel Furhman author of the book Eat To Live, and this heart patient recovered amazingly well.

          • Roberta Peck

            Flax seed oil is notorious for going rancid quickly, fleshly ground flax seeds, as a whole food,offer other benifits as well, like lignans

          • Kim Churchman

            Flax seeds are hard to chew thoroughly enough to get benefit. There’s nothing wrong with my teeth (I’m a dental hygienist and my dental exams are fine) but when I chewed a teaspoonful and carefully spit them onto a paper towel, I was disappointed to see uncrushed seeds. I buy a flax oil brand, Barlean’s, with the label describing the manufacture being done under a ‘nitrogen blanket’. Nitrogen, a gas, is heavier than air and displaces oxygen, preventing rancidity.

        • Robert Ireland

          You need animal based omega 3, or so I’ve heard. I guess there are 3 types of omegas 3s…I don’t know why they couldn’t just name em omega 1, 2, and 3…works for me.
          Research and read Mercola’s article @

          Hope it helps.

          • brec

            Thanks, but “…or so I’ve heard. I guess…” doesn’t work for me. For dietary vegans who want to consume EPA/DHA supplements directly — i.e., in capsules, as opposed to ALA — there are algae-based sources available. Indeed, that’s where the fish get their Omega-3s.

          • Lori

            Mercola is a notorious charlatan. I wouldn’t believe anything from his site.

          • Toxins

            I agree, Mercola runs a for profit nutrition business. That alone results in a loss of credibility.

          • Alex

            The Greek letter refers the carbonyl beginning (alpha) or methyl end (omega) of a carbon chain whereas the number refers to the first double bond among carbon atoms. In the case of omega-3s we’re counting from the mythyl end and find our first double bond on the third carbon atom. Omega-6s have their first double bond on the sixth carbon atom from the methyl end of the fatty acid.

          • Carl Brandl-Salutz

            Mercola is a crackpot, avoid him like the plague.

          • Cheyenne

            nobody needs to consume any animal products in any form, that’s a myth. Animal products are actually bad for you. I have been vegan for 8 years and have several friends who have been vegan for over 30 years (!). The brainwashing by the meat/dairy/egg industry is profound.

    • Virginia Abreu de Paula

      I ask you all to forgive me for being very ignorant in this subject and also on how to post here. The only way I managed to post was by clicking on reply to a guest. I also am not proficient in English but I do what I can. I would like to know fi somebody answered the question “How about the vegan DHA omega 3 oil supplement?” Only a few days ago my doctor prescribed me oil fish suplement. As I am vegan i decided to look for alternative. A very nice American lady suggested my the vegan DHA omega 3. I looked for where to order it and found in But It seems it contains mercury. I am wrong: I hope so. It’s the Nature’s Way supplement. As my English is not perfect it’s possible I didn’t get it right. But now I discovered some people think it may be inocous. I really don’t know what to do after that. I wonder if the doctor answered. I could not find anything from him. If he answered, could you tell where? It’s very important to me because I need omega 3 and now I don’t know how to take it. I don’t want to order sucn an exoensive medication for nothing.

      • Thea

        Virginia: I feel for you concerning your confusion and frustration. You are clearly not alone on both counts.

        I am not a doctor and can not advise you on whether or not to take a DHA supplement or not. If you decide that you do want to take a vegan DHA supplement, I know that you can get them without mercury. Since I do not have personal experience with buying the DHA pills, I can’t recommend a particular brand. But for example sake, you can look at the link below to a brand I found on Amazon which contains the following ingredients (according to another website):

        “Other Ingredients: High oleic sunflower oil, carragenaan, non-GMO corn starch, vegetable glycerin, purified water, sorbitol, ascorbyl palmitate
        and tocopherols, sunflower lecithin, rosemary extract, beta carotene, caramel. (all of the ingredients are from non-animal sources)”

        The caramel is disconcerting, but it seems to me that there wouldn’t be too much in a little pill. And the good news is that the brand below also includes the EPA, which as you have seen others comment on, may be just as important if not more important than the DHA.

        I hope this helps.


        Example vegan DHA/EPA supplement. (One I am not endorsing.) You may be able to find it cheaper in a different brand or different site. This link would give you enough for about 3 months I believe.

        • e

          not just the caramel–you don’t want the sunflower oil, nor the carragenaan, nor the sorbitol, nor the corn starch– these are all questionable additives. one of the Deva products is pure.

          • sher

            strongly agree with you re the additives.

      • James

        Hi Virginia,

        I’ve been taking ‘Opti3′ omega 3 supplements, they seem to contain the most omega 3’s (especially DHA) of the various supplements I’ve seen. It’s completely vegan and as far as I’m aware doesn’t contain mercury.

      • Kim Churchman

        I get an algae-derived DHA supplement at WalMart. It’s around $10 for 30 capsules. They’re big, but I can swallow them with applesauce. Try searching again, Amazon can’t be the only vendor. Hope this helps you, good for you for staying out of fish-oil. There’s a mad rush on to strip every last fish out of the ocean for it. I heard they overfished menhaden and now they are going more for hake.

    • Ruby

      I did some study on krill oil a few years ago. Aparently it loses 50% or more of it’s freshness, once it’s gathered, even before it hits shore, and if “cracked”, way more is lost – they said 75% (I assume tested long before it got to me). I got the uncracked kind and I could tell immediately it was rancid and never took it. Omegas do not like air and light. Conversely my black walnut hull powder comes smelling delicious and aromatic and stays that way in my freezer and fridge, as does my green algae. :)

  • William

    This whole thing started several decades ago when it was reported that Eskimos seldom died of heart disease, and that they ate plenty of cold water fish. So why did the Eskimos not suffer many heart attacks when they ate an almost totally carnivore diet? Because they died early from other diseases before they could develop heart disease. Turns out that Eskimos had the shortest life expectancy of any group in North America, often suffering from premature old age or dying from brain hemorrhage from excessive omega-3s making their blood too thin. They also got plenty of nosebleeds. Another group, the Masai in Africa, who don’t get much heart disease, are a big meat eaters and they die at the ripe old age of 43 on average, the lowest life expectancy of any people group in the world. We have no nutritional requirement for the EPA or DHA, the long preformed omega-3 fatty acids found in fish; we do however have a nutritional requirement for ALA, the omega-3 fatty acid found widely distributed in plant foods.

    • brec

      Whenever I read about low life expectancies I’m cautious about concluding that few in the population reached elder status, because the low average may have been largely a result of high infant and child mortality.

      I’m not saying that’s the case with the Inuit and Masai, because I don’t know.

      • Alex

        I lived in Greenland for four years and studied the history of the Arctic extensively from my arm-chair. It is indeed true that the Inuit population had high infant mortality but also high mortality among those who survived childhood. The life expectancy rose significantly over the past 100 and 50 years although is still relatively low compared to global averages. After the age of five, the largest ten-year block of mortality was 35-45 followed by 45-55 followed by 25-35 year olds. After the age of five, only a quarter of the population was expected to live beyond 60. Today while on average, the Inuit live longer, the largest mortality blocks are much lower aged (teens and twenties) primarily due to shockingly high suicide and homicide rates which were almost non-existant 75 years earlier. Today in Canada the life expectancy of the Inuit are almost exactly ten years shorter than the Canadian average for both men and women.

    • Mike

      The Masai keep their cholesterol low by consuming food high in saponins. Perhaps that’s part of the reason for low cardiovascular disease, in spite of their early demise. Just the same, we can learn from them by including saponin in our diet too. Perhaps that’s why beans are heart-smart; they contain saponins. Those Masai who have left their tribal lands to become urban dwellers, no longer raising cattle or hunting but instead eating more plant foods, are now living longer lives.

    • Graham

      Autopsy data on pre-westernised Inuit shows lots of data for atherosclerosis in the Inuit.

      • Thea

        Graham: Great find! Thanks for sharing this link. I read that paper with much interest.

  • Curious

    Aren’t the patients in later studies on statins and other drugs that negate/mask any benefit from supplements?

  • wow

    This makes me think I should stop taking vegan DHA. Anyone else sense the logic?

    • Paddycakes

      Me too.



  • Paddycakes

    I’ve read that DHA should be taken to help prevent Alzheimer’s. The brain needs fat. Now…I don’t know and I am not so sure. : (

    • Thea

      Paddycakes: Dr. Barnard wrote a helpful book called Power Foods for the Brain.

      The book contains a very nice discussion of Omega 3s and vegan DHA supplements, etc. I highly recommend the book if this concerns you.

      I don’t have time to re-write all the info from the book, but I will share two highlights:

      “What should you do? The first step is to have ALA-rish foods in your diet. Have plenty of vegetables, fruits, and beans, and if you like, top your salad with slivered walnuts or gran flaxseed, for example.” He also explains why it is important to avoid not just animal fats (including fish oil), but to avoid vegetable oils too.

      When talking about DHA supplements, he writes “… That said, omega-3 supplements have not yet provided their worth for preventing dementia.” And he goes on to explain why/quote studies.

      Jeff Novick also has an *excellent* video on nuts and oils that may help you. Let me know if you need a link to that.

      Hope that helps.

      • Paddycakes

        I am a 95% vegan, and I take vitamin D and DHA. I eat plenty of nuts and veggies. Please see this link and advise:

        • Thea

          Paddycakes: I believe that Dr. Greger addressed part of the article you pointed to in his video above.

          The other part of the article, concerning Alzehimers, I can’t comment on. In order to comment on it, I would have to look at the studies they referenced and compare it to the studies that Dr. Barnard references and do some analysis. I don’t have the time or interest in doing so.

          All I can say is that I trust Dr. Barnard as a source for this type of information. When he writes a book, Dr. Barnard does a lot of careful research. Dr. Barnard’s his own clinical studies (in the area of diabetes) have been clinically proven to be effective and helped so many people. So, if I was going to choose a source of information that I consider to be valid, I would go with Dr. Barnard.

          I recommend reading the relevant portion of his book to get a better idea of what he does and does not recommend. My *interpretation* of Dr. Barnard’s writings is that he does not seem to think that a vegan DHA supplement would hurt, but he doesn’t think they are vital either if you are eating an oil-free whole plant food based diet.

          Hope that helps.

          • Paddycakes

            OK, thanks, but the sources, about five of them were cited in the last reply. There were done by scientist/doctors.

          • HemoDynamic, M.D.

            is something I have wanted to post for a long time but haven’t had the time so here goes:

            To anyone who reads this the jury is still out whether or not we really should be taking Vegan EPA and DHA supplements. But the reason this started was because of an Enzyme called Delta-6-desaturase (D6d) (see the image below out
            of Michael Colgan, PhD’s book “You Can Prevent Cancer”).

            This enzyme converts both the essential fatty acids Linoleic acid (LA, Omega 6) and Alpha-linolenic acid (ALA, Omega 3) to important
            intermediates in fatty acid synthesis. Too much Linoleic acid in the diet uses up the D6d enzyme and now we cannot convert enough ALA to the important anti-inflammatory EPA and DHA molecules.

            Also our old world (unprocessed-whole food) diet used to have an Omega 6 to Omega 3 ratio of 1:1 but now is between 10:1 and 25:1.
            This imbalance tips the scales for processing Omega 6 rather than Omega 3 leaving us even more deficient in EPA and DHA and increasing the substrates available for formation of too much of the pro-inflammatory molecule Arachidonic acid (PGE2). A side note is we must have arachidonic acid in our bodies because without it we would die, but our bodies make all we need and we don’t need more—the more arachidonic acid we get the more inflammation we have leading to a chronic low level of inflammation (meta-inflammation) which is the underlying problem of all chronic disease.

            Furthermore, the D6d enzyme is also inhibited by dietary Saturated fats, Cholesterol, Trans-fat, Zinc Deficiency and Excess alcohol consumption which further limits the bodies ability to manufacture the
            anti-inflammatory prostaglandins PGE1 and PGE3 (again see the image).

            PGE1, PGE3 and DHA also inhibit the activation and production of Arachidonic acid reducing
            inflammation in the body.

            Add this to the bodies very poor (limited) ability to convert Alpha-linolenic acid to EPA and DHA (as Israel Navas Duran was so kind to post above. ALA to EPA conversion 0.3% and 8% and ALA to DHA is <4% and often undetectable in males, although higher in females with up to 21% for EPA and 9% for DHA) and now we can see why there
            is a recommendation to take EPA and DHA. The theory (I think) being since EPA and DHA are so good at being anti-inflammatory and we don’t make a lot or get enough of them in our diet anymore we should add them back.

            The one thing I have observed is that nearly every time we (as humans) try to add something back to our diet in pill form instead of from the whole food it tends to make the human body system unbalanced and tends to do more harm than good. Two exceptions seem to be Vitamin B12 and vitamin D. And really sun exposure is better than Vitamin D supplementation.

            I, for one, try to keep my Alpha-Linolenic acid intake high from whole foods (eg: Flax Seed, Chia Seed etc.) and minimize the omega 6 and saturated fat and arachidonic acid intake; ergo, I eat a varied, whole food, plant based diet.

            Do I take EPA and DHA supplements, no, and I
            haven’t for over 3 years. Maybe I’m missing out but for now I am still alive, practicing medicine and racing mountain bikes. :)

          • HemoDynamic, M.D.

            for whatever reason the image was taken out of the last post.

          • mike at the river

            HemoDynamic MD, I believe in what you say on DHA, EPA and vegan supplements, but the one group I hear that can’t, or mostly, make the conversion fr ALA, even with a excellent low fat, plant based diet, with good ration Omega 6 and Omega 3; is male Diabetics, particular older male Type I Diabetics. Any ideas on this?

          • HemoDynamic, M.D.

            You are correct inflammatory disease states (Diabetes, CAD etc) also seem to inhibit Delta 6 and Delta 5 Desaturase limiting not only DHA and EPA formation but also Arachidonic Acid formation.

            In some disease states (Type one diabetes) it appears that Supplementation with DHA and EPA would be helpful and maybe even some Arachidonic acid as well.


          • Thea

            Dr. HemoDynamic: That was SUCH a helpful post!! Thank you very much for taking the time to weigh in.

          • e

            yes,both posts by HemoDynamics have excellent info–very helpful–
            many thanks HD
            this whole thread is good…

          • e

            you and others speak of the body’s limited ability to elongate to DHA and EPA; this is usually said (written) in a way in which limited is taken to be a fault–but what if the body wisely has this brake because too much DHA/EPA could be damaging? Quite possibly, we need very little, and that little I would think should be made by the body as needed.

          • e

            sorry, meant to add that it appears that would be wiser to limit omega-6 rather than add DHA/EPA…

          • HemoDynamic, M.D.

            I agree! That is what I spoke about earlier. The omega 6/3 ratio has changed and it appears for the worst. From Old World 1:1 to New World 10-25:1. Getting back to the 1:1 ration would appear to be ideal. Watch this informative but older lecture (2002) on how and where EPA and DHA play their roles in squelching the Inflammatory Fire.

    • Don Forrester MD

      I would echo Thea’s point. If you are concerned about Alzheimer’s I too would recommend Neal Barnard’s most recent book, Power Foods for the Brain. He does a terrific job of pulling together the science in an understandable fashion. As usual he cites the literature to support his opinions.

      • Paddycakes

        Thank you, I will do this. You reply is appreciated.

  • Belette

    What about the beneficial effects of Omega3 (fish oil) on the brain? True of false?

    • Thea

      Belette: Here is a news update that I got some time ago from PCRM:

      Fish Oil Supplements No Help to Heart or Brain

      Two new studies found that omega-3 supplements, often sold in the form of fish oil, do not improve the health of the brain or heart.

      After following more than 12,500 type 2 diabetes patients over the age of 50 for an average of 6.2 years, researchers saw no difference in heart health between those taking an omega-3 supplement versus a placebo. Diabetes patients are two to four times more likely to suffer from heart disease or a stroke, compared with people without diabetes. Another recent meta-analysis came to the same conclusion for people with a history of heart problems.

      Additionally, in a new review looking at omega-3 supplementation for brain health, researchers found no link between omega-3 supplements and the prevention or improvement of dementia.

      Bosch J, Gerstein HC, Diaz R, et al. n–3 fatty Acids and cardiovascular outcomes in patients with dysglycemia. N Engl J Med. Published online June 11, 2012.

      Kwak SM, Myung SK, Lee YJ. Efficacy of omega-3 fatty acid supplements (eicosapentaenoic acid and docosahexaenoic acid) in the secondary prevention of cardiovascular disease: a meta-analysis of randomized, double-blind, placebo-controlled trials. Arch Intern Med. Published ahead of print, April 9, 2012.

      Dangour AD, Andreeva VA, Sydenham E, Uauy R. Omega 3 fatty acids and cognitive health in older people. Br J Nutr. 2012;107:S152-S158.

      • wow

        Thea, this same logic implies, to me, that we should not be taking vegan DHA supplements…that they are a waste of money (and possibly health).

        • Thea

          wow: I don’t know. I’m not a doctor.

          Here’s my thoughts: There could be aspects of fish oil (like contaminants?) which interfere with health outcomes and which are not present (in a good way) in the vegan DHA supplements. Also, as some people have pointed out, the studies done here are on people eating a SAD diet. Is there a reason to believe that vegan DHA supplements would help someone on a whole plant food based diet? I think the theory is there to believe so, but my guess is that we don’t have enough hard evidence. I’m hoping that Toxins and Darryl and others might chime in. But my bottom line so far is: We just don’t know. With that, then you have to go with what feels right to you.

          Here are the types of questions I ask myself when I am faced with a decision like this that does not have as much data I would like: Is there something lacking about my personal diet for which a DHA supplement would fill in a hole? Or do I have a particular condition/health problem for which a DHA supplement would provide benefit? (And is there some evidence to back it up, even if just a carefully designed personal experiment?) While whole plant foods are better as a rule of thumb, are DHA pills one of the exceptions? Is there any evidence that it would hurt me to take DHA pills? Would I feel better emotionally if I took them? Is my budget healthy enough that taking DHA pills would not mean giving up something else that is maybe more likely to help with my health? If I took the pills, would it change my behavior to the worse, relying on those pills to make me healthy instead of just eating healthy (say flax seed)? If I bought the pills, am I going to actually (remember to) take them? If we don’t have a lot of evidence about whether or not a substance is worth eating, can I come up with a reasonable/sensible dosage to take?

          Again, I hope more knowledgeable people will jump in with some hard data if it is available. But regardless of this particular issue (DHA), we are constantly faced with nutrition questions for which we do not have a solid answer. So, it is helpful to have a framework of questions to help us evaluate how to proceed.

          How do other people decide how to proceed when we don’t have all the scientific data we need to be confident in our choice?

          • wow

            Thea, well said. Your words are appreciated. This is a topic that Dr. Greger put a video out on, but I think some people on this website have raised some very important questions and concerns over the past months, as well as today, regarding taking vegan DHA supplements, and Dr. Greger has chosen so far not to comment, yet he comments on other issues of apparently far less interest amongst his viewers. This seems to be an issue that holds, arguably, the most interest, it seems, amongst his viewers. That alone, I would hope, would get him to reply to someone here about this.

          • Thea

            wow: I hear you!

            Note: I am just a volunteer on this site. I do not converse with Dr. Greger any more than anyone else. So, I can’t speak for Dr. Greger.

            *My* opinion is that Dr. Greger rightly keeps a reasonable focus/scope for this site. *I* (I’m not speaking for NutritionFacts) define this scope as: NutritionFacts is reporting the relevant new science as it becomes available. As a general rule, Dr. Greger doesn’t speculate. So, if we don’t have a study specifically on vegan DHA, then he isn’t going to spend time trying to guess about it. Especially since people might take such a speculation as gospel. However, Dr. Greger has said before that he reads these comments and uses them, in part, to pick what subjects to cover when covering the new studies. So, I’m sure these questions posted here will be at the back of Dr. Greger’s mind and should relevant, well-done studies become available, Dr. Greger is likely to cover that in a future video because of the interest by people like you and me.

            That said, I think Dr. Greger has already answered this question well enough. Dr. Greger has a page on this site where he lists his nutritional recommendations:
            These recommendations include DHA supplements. Dr. Greger hasn’t changed his opinion on his recommendations according the postings on this site to date. (Dr. Greger did hint a bit ago that he would be updating his recommendations, so we may see a change.) This says to me that Dr. Greger feels that there is strong enough evidence to support taking a DHA supplement despite what we see about fish oil. Given how many supplements that Dr. Greger does *not* recommend, I think the inclusion of DHA on his recommendation page shows strong support for it by Dr. Greger.

            I understand you wanting to get some direct answers. This reply is just my 2 cents. I hope you get the answers you are looking for.

          • Veganrunner

            Thea am I making this up or do I remember hearing dr Greger was coming out with a revised supplement list? I would think he would following the new meta-analysis and systematic review. I may have been dreaming.

          • Thea

            Veganrunner: I remember some hint about posting a revised set of nutrition recommendations, which would include relevant supplements. I don’t know if that plan got scratched due to no changes or if it is still in works for the near future.

            Bottom line: I don’t think you are making it up. Your brain is in good working order regardless of your fat intake situation. ;-)

          • guest

            Thea, you mention that Dr. Greger doesn’t speculate. Well, in many of his videos he actually does, as he offers his opinions based on possibilities. I do not have the time to list links in his videos for this but if you go back in the archives you will find many such comments of his where he does give hints of speculation. And this is normal. Dr. Greger’s silence on this issue is raising red-flags on the vegan DHA issue. He has a video saying don’t take vitamin E in supplemental form yet all vegan DHA has vitamin E added to it. You see the red-flag?

          • Thea

            guest: I’m sorry, but I’m not sure what you are getting at. Red flag as in something fishy (ha ha) or underhanded???

            What I do see is that we don’t have an easy answer. So, some people may quite reasonably decide to not take a vegan DHA pill based on the latest information. In that sense, I guess you could say that this study pops up a red flag about older recommendations suggesting people take DHA pills.

            From my perspective: We don’t have perfect information on this topic yet. We even have some contradictory information. Even if we had a clear picture of what to do right now, we probably don’t have the access to the perfect solution (like say access to a vegan DHA supplement without vitamin E). So everyone will have to weight the various contradictory information and make your best guess. Dr. Greger may be in the process of revising his nutrition recommendations – or not. For now, his recommendation is to take a vegan DHA pill, but not extra, separate vitamin E.

            If you are confused or frustrated by the situation, I don’t blame you. I just plan for myself to be extra patient on the issue. Dr. Greger has to be very careful when making his official nutrition recommendations, because lots of people listen to him. I doubt one study either way would be sufficient reason to change a recommendation. When the body of evidence becomes more clear, then I suspect we will hear from Dr. Greger. (Note: This is just my guess/my understanding of the situation. I do not have any insider information or conversations with Dr. Greger.)

          • Einstein

            Maybe they should release a book “Oils for dummies” People who consume oil die

          • Einstein

            Animals never worry about diet and some NEVER eat Fish Oils or vegetable oils, and look how healthy they are !!! Basically all animals that hunt, eat meat and some green foods have their eye’s to the front same as humans, our tooth structure is what they call Omniverous, we are designed to eat anything.

            Fish and vegetable oils are pushed by companies that just want to sell Crap.

            Lard, Dripping and butter are animal fats and far healthier and more easily absorbed by the human body, eat these and you will be healthier and happier, Just don’t overdo it with your diet, everything in moderation.

        • HemoDynamic, M.D.

          Wow (This is a repost I left from above)

          This is something I have wanted to post for a long time but haven’t had the time so here goes:

          To anyone who reads this the jury is still out whether or not we really should be taking Vegan EPA and DHA supplements. But the reason this started was because of an Enzyme called Delta-6-desaturase (D6d) (see the image below out
          of Michael Colgan, PhD’s book “You Can Prevent Cancer”).

          This enzyme converts both the essential fatty acids Linoleic acid (LA, Omega 6) and Alpha-linolenic acid (ALA, Omega 3) to important
          intermediates in fatty acid synthesis. Too much Linoleic acid in the diet uses up the D6d enzyme and now we cannot convert enough ALA to the important anti-inflammatory EPA and DHA molecules.

          Also our old world (unprocessed-whole food) diet used to have an Omega 6 to Omega 3 ratio of 1:1 but now is between 10:1 and 25:1.
          This imbalance tips the scales for processing Omega 6 rather than Omega 3 leaving us even more deficient in EPA and DHA and increasing the substrates available for formation of too much of the pro-inflammatory molecule Arachidonic acid (PGE2). A side note is we must have arachidonic acid in our bodies because without it we would die, but our bodies make all we need and we don’t need more—the more arachidonic acid we get the more inflammation we have leading to a chronic low level of inflammation (meta-inflammation) which is the underlying problem of all chronic disease.

          Furthermore, the D6d enzyme is also inhibited by dietary Saturated fats, Cholesterol, Trans-fat, Zinc Deficiency and Excess alcohol consumption which further limits the bodies ability to manufacture the
          anti-inflammatory prostaglandins PGE1 and PGE3 (again see the image).

          PGE1, PGE3 and DHA also inhibit the activation and production of Arachidonic acid reducing
          inflammation in the body.

          Add this to the bodies very poor (limited) ability to convert Alpha-linolenic acid to EPA and DHA (as Israel Navas Duran was so kind to post above. ALA to EPA conversion 0.3% and 8% and ALA to DHA is <4% and often undetectable in males, although higher in females with up to 21% for EPA and 9% for DHA) and now we can see why there
          is a recommendation to take EPA and DHA. The theory (I think) being since EPA and DHA are so good at being anti-inflammatory and we don’t make a lot or get enough of them in our diet anymore we should add them back.

          The one thing I have observed is that nearly every time we (as humans) try to add something back to our diet in pill form instead of from the whole food it tends to make the human body system unbalanced and tends to do more harm than good. Two exceptions seem to be Vitamin B12 and vitamin D. And really sun exposure is better than Vitamin D supplementation.

          I, for one, try to keep my Alpha-Linolenic acid intake high from whole foods (eg: Flax Seed, Chia Seed etc.) and minimize the omega 6 and saturated fat and arachidonic acid intake; ergo, I eat a varied, whole food, plant based diet.

          Do I take EPA and DHA supplements, no, and I
          haven’t for over 3 years. Maybe I’m missing out (and maybe I'm wrong) but for now I am still alive, practicing medicine and racing mountain bikes. :)

      • Aviel Livay

        Yes, but where is the study that says fish oil doesn’t improve the health of the brain? Where is the specific study?

        • Thea

          Aviel: Based on the title, I would say that the following citation from my post above answers your question:

          Dangour AD, Andreeva VA, Sydenham E, Uauy R. Omega 3 fatty acids and
          cognitive health in older people. Br J Nutr. 2012;107:S152-S158.

          Making sense of science means never putting all your eggs into one study. You have to look at the body of work. So, make of this particular study what you will.

          It’s my understanding that overall we don’t have much evidence showing that adding fish oil to our diet improves brain health. All we had originally was a study of brains of older people and saw that those who had more dementia also had less omega 3s in the cells of their brains. So, that led to speculation that eating/consuming more omega 3s in the form of fish oil would be protective. Now, as I understand it, the studies which had tested that theory are showing the theory/speculation to be false.

          That’s just my interpretation based on what I know, which is probably not enough.

  • Paddycakes
  • mrmourning

    Does that mean vegan DHA also provides no benefit? And if so, how should a vegan get the necessary DHA? Seaweed?

    Thanks for all you do

  • Guest

    It totally saddens me that they can’t just sell us some factory-grown, fresh, safe algae instead of having to extract the oil and preserve it with “vitamin E” (not good for us). I mean, just gives us the algae and leave the pill and the additives out of the product. Some of the brands are even adding vitamin A (synthetic).

    • Guest

      What about fish oil for vitamin D and joint protection? That is another benefit they claim. I would rather get vitamin D from supplements or mushrooms.

      • HemoDynamic, M.D.

        Or the Sun! :)

  • pm

    It’s not surprizing that a journal that is heavily funded by the pharmaceutical industry puts out research condemning the use of omega 3 fish oil. The reason is that their sponsors can’t make any money telling people to take omega 3 supplements, while they can reap in billions selling statins instead. Jama accordingly recommends taking statins to prevent heart disease, despite admitting that possibly only 1 out a 100 prescribed may see some benefit. The rest are subject to side effects adversely affecting brain, muscle, kidney and pancreatic health.

    “For every 100 patients with elevated cholesterol levels who take statins for five years, a myocardial infarction will be prevented in one or two patients,” they write. “Preventing a heart attack is a meaningful outcome. However, by taking statins, one or more patients will develop diabetes and 20% or more will experience disabling symptoms, including muscle weakness, fatigue, and memory loss.”
    I don’t care how prestigious JAMA is, I refuse to take seriously anyone offering advice like that.

    Omega 3 are vital to brain and cardiovascular health. They are a very powerful free radical scavenger and I will continue to take them daily.

  • Ariel Gail MacLean

    what about high-Omega3 from a regular consumption of high levels of omega 3 seeds and nuts?? any benefit from that source of omega 3?

    • Thea

      Ariel: NutritionFacts *does* have several videos showing the benefits of eating nuts and seeds.

      I don’t think we know for a fact whether or not those benefits are due to a particular aspect of the nut/seed (say a type of fat) or the whole package (my vote for this one). For me, it doesn’t matter. I just enjoy the nut. I hope I’m not what I eat. ;-)

  • Louis

    Be careful not to be blinded by science though …

  • Paul Paez

    What ’bout the supposed anti-inflammatory benefits of fish oil or more specifically Omega 3? As an MS patient, I’m more concerned about inflammation (although their may be a direct–and certainly is an indirect–connection). Nonetheless, I’ve taken a lot of drugs (I’m also a cancer survivor); and I pretty in tune with what works and what does not. (Most have not). Yet, I must say that I DO feel better when I take an Omega 3 supplement. So when Dr. Greger says “doctors should stop highly marketed fish oil supplement use in ALL of our patients,” is that a suggestion there is not value in Omega 3 supplementation or just Fish Oil supplementation?

    • Thea

      Paul: I’m sorry you have to deal with those ailments.

      I can’t address whether or not a vegan DHA or fish oil can help with inflammation (because I don’t know). However, just in case you were not aware, I wanted to let you know that Dr. Greger does have some great videos on NutritionFacts which address MS.

      You might also want to search the web for videos from Dr. McDougall on his research into MS. (I don’t have a link handy myself or I would share it.) He still needs to publish the latest information from the latest study, but I saw at least one video with some great info about how well MS patients do on his diet.

      Good luck with your health issues.

      • Paul Paez

        Thanks for the information. And for the record or anecdote, I should note that 3 years ago, I could only walk with a cane and since adopting a plant-based diet; I am now able to run (albeit painfully and slowly) 5K races at the weekends. Much of my inflammation has been reduced naturally through diet (not supplements nor medication). This was unexpected as I went Vegan to fight my stomach cancer, not my MS, but I still do swig a tablespoon of Flaxseed every morning and wondering if its worth it.

        • Paddycakes

          Please, don’t give the FLAX, it’s healing your body. Take it the rest of your life which I hope is a long one.

          • Paul Paez

            Thanks Paddycakes. But curious? What’s the basis of your Flaxseed oil recommendation? I understand that while fish and flax both contain Omega 3, it’s the EPA/DHA of fish (or algae) that is (allegedly) the key beneficial component. So, do we convert the ALA from flaxseed oil; OR is there value alone in the ALA from flaxseed that is either equal or better?

          • Paddycakes

            There are many more benefits, just google ‘benefits’ of flaxseeds.

            The Benefits of Flaxseed

            Is flaxseed the new wonder food? Preliminary studies show that it may help fight heart disease, diabetes and breast cancer.

            Save This Article For LaterWebMD Archive

            Some call it one of the most powerful plant foods on the planet. There’s some evidence it may help reduce your risk of heart disease, cancer, stroke, and diabetes. That’s quite a tall order for a tiny seed that’s been around for centuries.

            Flaxseed was cultivated in Babylon as early as 3000 BC. In the 8th century, King Charlemagne believed so strongly in the health benefits of flaxseed that he passed laws requiring his subjects to consume it. Now, thirteen centuries later, some experts say we have preliminary research to back up what Charlemagne suspected.

            Flaxseed is found in all kinds of today’s foods from crackers to frozen waffles to oatmeal. The Flax Council estimates close to 300 new flax-based products were launched in the U.S. and Canada in 2010 alone. Not only has consumer demand for flaxseed grown, agricultural use has also increased. Flaxseed is what’s used to feed all those chickens that are laying eggs with higher levels of omega-3 fatty acids.

            Although flaxseed contains all sorts of healthy components, it owes its primary healthy reputation to three of them:

            Omega-3 essential fatty acids, “good” fats that have been shown to have heart-healthy effects. Each tablespoon of ground flaxseed contains about 1.8 grams of plant omega-3s.

            Lignans, which have both plant estrogen and antioxidant qualities. Flaxseed contains 75 to 800 times more lignans than other plant foods.

            Fiber. Flaxseed contains both the soluble and insoluble types.

            The Health Benefits of Flax

            Although Lilian Thompson, PhD, an internationally known flaxseed researcher from the University of Toronto, says she wouldn’t call any of the health benefits of flax “conclusively established,” research indicates that flax may reduce risks of certain cancers as well as cardiovascular disease and lung disease.


            Recent studies have suggested that flaxseed may have a protective effect against breast cancer, prostate cancer, and colon cancer. At least two of the components in flaxseed seem to contribute, says Kelley C. Fitzpatrick, director of health and nutrition with the Flax Council of Canada.

            In animal studies, the plant omega-3 fatty acid found in flaxseed, called ALA, inhibited tumor incidence and growth.

            The lignans in flaxseed may provide some protection against cancers that are sensitive to hormones without interfering with the breast cancer drug tamoxifen. Thompson says some studies have suggested that exposure to lignans during adolescence helps reduce the risk of breast cancer and may also increase the survival of breast cancer patients.

            Lignans may help protect against cancer by blocking enzymes that are involved in hormone metabolism and interfering with the growth and spread of tumor cells.

            Some of the other components in flaxseed also have antioxidant properties, which may contribute to protection against cancer and heart disease.

          • Paddycakes

            Years of research to help with diabetes maintenance and cancer prevention.

        • Thea

          Paul: Thank you for sharing your story! I LOVE stories like that. I’m guessing that you may not learn much from the sources I pointed to. You already sound like a pro.

          On the topic of swigging flaxseed oil, I think that Paddycakes is suggesting that you take the actual ground flaxseed instead of the oil. Dr. Greger has several great videos on the many benefits of ground flaxseed and I believe that all of those reasons would still be valid. Dr. Greger recommends about 2 Tablespoons a day. I put it in my morning oatmeal/buckwheat. Other people put it in their smoothies. If you are interested, Paddycakes listed some good info about ground flaxseed, but if you want the information in the format of this site, check out:

          I wish you all the best.

          • JoAnn Downey

            I too use ground flaxseed, which is very stable, even when heated. Not so flaxseed oil which is very unstable and cannot be heated.


    From the DHA algae videos here it seems that the focus is on brain and eye health. Assuming those benefits still stand for the algae and plant derived DHA, should we stop taking supplements sourced from algae given the continuous ocean contamination with radiation from the crippled Japanese reactors? Not many sources reporting it but the problem isn’t just that the radiation is now reaching the US pacific shores, it’s that the contamination is not contained and continues daily. So I wonder if I should buy another bottle of algae DHA pills when my current bottle runs out.

    • Thea

      MBGLIFE: I can’t comment on whether or not you should take DHA pills as I think that is an open question for a lot of people.

      I did want to address your concern for contamination, however. It is my understanding (perhaps incorrectly) that the companies who sell the vegan DHA pills grow the algea in carefully controlled environments. They are not harvesting from the ocean. So, I do not think you need to be concerned that the vegan DHA is contaminated.

      You could check with the company you buy from to verify if this is a big concern for you.

      Hope that helps.

      • mbglife

        That does help. Thanks. I guess we just have to wait and see if there is any info on whether algae DHA supplements are helpful.

        • DGH

          I tend to buy into a line said once by a vegan RD that “if there is a 1% risk that being completely deficient in DHA could lead to dementia, it’s a 1% risk I’m not willing to take”. In other words, there’s no harm with DHA, and it’s been studied in hundreds of thousands of patients, and if being totally deficient in DHA could lead to cognitive dysfunction in my old age, then that’s a risk I’m not willing to take. I don’t see any downside other than the cost.

  • Alicia Townsend

    Most of the providers with whom I work recommend fish oil for brain function, not for heart health. Is there also research debunking this? Thanks for all you do!

    • Thea

      Alicia: Yes, there is at least one study showing no benefit between fish oil and brain health. See my reply above for the citation.

  • guest

    If there is any way Dr. Greger can personally get involved on this comment page today, I think many of us would appreciate it. Today’s video really shakes up the belief that vegans should be supplementing with vegan DHA. I have spoken with several people, and we are very in doubt regarding both the need and safety of vegan DHA supplementing, in light of today’s video.

  • Coacervate

    Fish oil does not equal 0mega-3 fatty acids. Please take a minute to think it through. Whats that Essey? Oh, “NO OIL”.

    • guest

      I think I get it. Get your omega 3 fatty acids from foods, not supplements. Right?

      • Coacervate

        Yes thanks! Whole plant foods. Fish oil is a refined food and it is not plant sourced.

        • guest

          The same goes for factory-derived vegan DHA oil, right? A refined food?

  • Wendy

    There are many ways that life expectancy are affected besides what you eat. In “the olden days” We didn’t have clean areas. Was there enough water to wash your hands and brush your teeth? Were there sewers? So it is a lot about sanitation and how much that has helped us.

  • JoAnn Downey

    I wonder if Dr. Ornish still recommends a fish oil supplement? I’ll see if I can get an answer on Backplane.

  • guest

    Dr, Greger,

    In some presentation in the early 2000’s when you found vegetarians do not live longer than omnivores you suggested that was because of inadequate Vit B12 and omega 3 intake. While, I have benefitted in several ways going predominately vegan, it doesn’t seem that simply Vit B12 would be the sole factor separating longevity between omnivores/meateaters and vegetarians.

    • Roberta Peck

      Dr Greger please answer this paradox from early 2000 when you reported it was inadequate B12 and poor ratio of omega 6 to 3 ratio that cost vegans on longer life expectancy. Flax does not convert easily especially as one ages. So how is a vegan to improve the omega 6 to 3 ratio? My understanding is that the fish oil provided in many of these studies was too meager to balance the outrageous omega 6 levels the SAD provides.

      • Thea

        Roberta: re: “…how is a vegan to improve the omega 6 to 3 ratio?”

        Here’s my understanding: A vegan can improve the ratio by cutting back on omega 6 rich foods while maximizing whole plant food omega 3 rich foods. This includes all of the following:

        1) no oils
        2) eat whole plant foods

        3) limit nut *a lot* or at least stick to the right kind of walnut
        4) eat lots and lots and lots and lots and lots of greens.
        5) consider adding some ground flax or chia seeds to your diet.

        My understanding is that if you truly did all of the above, then you would automatically have the perfect ratio of omega 6 to omega 3. Jeff Novick’s lecture, From Oil to Nuts does an **excellent** job of explaining all this, including with tables and graphs that help you see how it all works and which foods have which types of fats, etc.

        Of course, many of us (myself included) fall short of such an ideal diet. I try to improve all the time, but I’m still not “there”. So, it might behoove us to consider an algea-based DHA supplement. Just a thought.

        Good luck.

        • Roberta

          I hope the steps you gave work in the long run. Dr. Greger’s videos inspired my husband and me (both 65) to go totally plant based based on greens,beans,mushrooms,and colorful fruits and vegetables,plus recommended d and B12. However I continued with my 3 capsules of high quality Omnipure-brand fish oil, whereas my husband did not.

          Next we ordered the $70. Home finger prick test from Zonediagnostics. Mine came back a desirable 2 to 1 omega 6 to omega 3ratio, my husband’s came back a mediocre 6 to 1. I talked to Dr Harris who runs the lab for Dr Barry Sears, my results revealed that 99.5 of Dr Barry Sears patients who follow his meat eating zone diet, tested at a higher level of omega 6 to omega 3 ratio.

          • Thea

            Roberta: Congratulations on making the shift (mostly) to a plant based diet. That is a hard thing for many people to do, but it sounds like you and your husband have made great strides.

            I can’t comment on the particular situation between you and your husband since there are so many factors involved. Are you both still consuming oils? How much nuts? How good is that home prick test? What might the effect of your diets have been on your bodies prior to this change? etc. There are just too many factors involved to draw any conclusions from your anecdote. (Though thank you for sharing it. I find people’s stories to be very interesting.)

            As for the Zone diet, it is easy to see how someone on such a diet could have a better omega 6 to 3 ratio depending on what they are really eating and depending on who else we are comparing them to. Another factor would be, “what does ‘better’ mean”? And how scientific is this statistic? Is there a control group? etc.

            Even if we want to believe that the 99.5 number actually means something, that doesn’t mean that the people on the diet are healthy or that the Zone diet is one that leads to healthy outcomes. The omega 6 to 3 ratio is just one factor/indicator.

            As an example to illustrate my point: Think of the people who claim that their bad cholesterol went down when they went on the ___ diet. (Fill in the blank with any of the following: paleo, aktins, wheat belly, eat for your blood type, etc) However, what we all know is that people can loose weight on just about any diet. At least when people start a diet, most people tend to loose weight, initially. And when you loose weight, your bad cholesterol goes down. But bad cholesterol is just one factor of health. And we have a TON of evidence that those high-meat/high-fat/low complex carb diets are extremely bad for people’s overall health.

            Those are just some thoughts for you on how you might think about the Zone data.

            One other thought is: If you think that the fish oil is helpful for you, you might consider following Dr. Greger’s recommendation to take a plant-based DHA supplement instead. That would give you several advantages: knowing you aren’t getting toxins that are often found in fish oils, skipping the middle man and getting the DHA directly (the point of omega 3 fats is so that your body can convert them to DHA), and not contributing to the collapse of the oceans. Just a thought.

            I hope you and your husband experience great health going forward.

        • Seri

          thanks for the understandable suggestions Thea. :-)

  • Don

    Thanks for this video I just
    received from a friend of mine I’m
    left wondering, since it is stated in prior studies if omega 3 still
    benefits for those suffering from an inflammatory process, (i.e. not heart and or
    cardiovascular related).

  • Steveonline

    I recall from way back when, a Nutritionfacts piece about how population death rates among vegans was no better than the general population and that was attributed to deficiencies of dietary omega 3 fatty acids and vitamin B-12 among many vegans and vegetarians. I hope you follow-up today’s piece with useful guidance for maintaining adequate omega 3 status, perhaps flax as many commenters have speculated.

    • vardarac

      To my knowledge, flax contains omega-3 mostly in the form of ALA, which does not readily convert to DHA or EPA. Maybe Atlantic seaweed or algae would be a better approach?

  • lucidvu

    “Long-term effect of high dose omega-3 fatty acid supplementation for secondary prevention of cardiovascular outcomes: A meta-analysis of randomized, double blind, placebo controlled trials.”

    “Overall, our results supply evidence that long-term effect of high dose omega-3 fatty acid supplementation may be beneficial for the onset of cardiac death, sudden death and myocardial infarction among patients with a history of cardiovascular disease.”

    Casula M, Soranna D, Catapano AL, Corrao G.

    Atheroscler Suppl. 2013 Aug;14(2):243-51. doi: 10.1016/S1567-5688(13)70005-9.

  • Aviel Livay

    Omega 3 oil supplements are good for the brain! It’s an absolute must. you can read here why –

    As for this video – it is sooo misleading as it is talking only on the benefit to the heart while the true benefit is for the brain… It is well known that there’s no evidence for the benefit of omega-3 to the heart – it’s not a big discovery here. But this video sounds like wow – ‘throw your omega 3 supplements out the window guys’ which is so untrue!

    The recommendation at the end of this video is misleading as well – the cardio vascular doctors are talking about not recommending these supplements to THEIR patients. THEIR patients are having a heart disease. All they care about is THEIR patients heart problems. But some of the same patients and other patients are slowly dying from Dementia, Alzheimer’s and cognition problems because they are not taking the pills….

    So make sure you supplement today with your favorite DHA supplement.


    • EP_2012

      The video was reporting on the alleged benefits of fish oil for reducing heart, stroke and mortality rates, which it doesn’t.

      It had nothing to do with brain function and Dr. Greger still recommends DHA, which is different from just “omega-3 supplements”, and he does so for brain health (not heart, stroke or lower mortality).

  • Coacervate

    OK, I will say it again. Fish oil is not the SAME

  • Gary Scearce

    It seems that the studies that purportedly discredit the benefit of fish oil were horribly designed “recollection” interrogations and not valid double blind placebo controlled studies. There were other studies that used ridiculously low levels of Omega 3’s and trumpeted that there were no improvements in heart health. Even with small doses of DHA/EPA, there were statistical improvements in mortality. The truth is that science can be bought and there are powerful forces that want to discredit anything that is not patented by a pharmaceutical company.
    Gary Scearce, OD

    • EP_2012

      “It seems that the studies that purportedly discredit the benefit of fish oil were horribly designed “recollection” interrogations and not valid double blind placebo controlled studies.”

      I take it you didn’t look at the studies?

      “14 randomized, double-blind, placebo-controlled trials (involving 20 485 patients with a history of CVD) were included in the final analyses”

  • Evan

    So does this negate all the benefits of flax in ones diet with regarding the heart ?

  • HemoDynamic, M.D.

    Great Update! One thing I have noted in my new multi-physician practice is that it is hard to break learned habits. I have been giving the research and information to the providers in my practice for over six months (in a gentle, informative and positive way) and they are having a difficult time changing their fish-oil prescribing practice. Even after showing them it is now a grade A recommendation to STOP prescribing Omega 3 for cardiovascular protection, (The Journal of Family Practice August 2013) I still get patients that have recently been put on Omega 3’s for primary, secondary and tertiary cardiac protection.

    Bottom line keep up these pertinent updates to make sure the most recent information continues to be disseminated among the general population; for many patients are, and continue to be, the driving force for change in the medical world.

  • nfk

    many baby formulars contain DHA so I guess it is proven helpfull ingredients as baby milk powder safety and effieciency is not something that big pharma like JNJ abbort would lightly handle

  • Marie

    You are absolutely, totally wrong, Doctor! The so-called “evidence” you quote from is flawed. There is always some body or laboratory or other trying to denigrate the supplement companies. My deep-sea lipid source arose from 35 years of research into fish oils, and has been proved to work by millions of people over the last 34 years! (The 35 years of research happened before the 34 years that I quote here). Please contact me for the research from which I take my advice.

    • Mike

      Can you post some papers here?

    • vardarac

      I second this notion – Please provide some info!

  • chuck

    I would suggest reading this article. Proper dosage is very important.

  • Robert Ireland

    Fish oil can go “rancid” very quickly and easily unless it is sheltered from oxygen, light, and heat. And it will one day be unsustainable. Krill oil should be researched more so than fish oil because that will be the future of American omega 3 consumption (in animal derived omega 3). Krill is supposedly very resilient to oxygenation and heat/UV damage because of its high level of astaxanthin. Check out Mercola’s article @

    Please prove me wrong!!! …because I’m about to buy some krill oil…

  • Mike

    What about this recent publication about omega-3’s role in brain wiring?
    It was conducted in rhesus macaque, but does this mean that we should ignore any possible implications for humans? Certainly we need omega-3’s in our diet. However, omega-3 in the form of supplementation or prescribed for treatment for disease, maybe not.

  • Chuck

    Dr. Greger has a long video on why vegans die before they should. The 2 main reasons was lack of vitamin B-12 and too low a ratio of omega-3 to omega-6. Vegetable oils (not including olive oil that is high in omega-9) is high in omega-6. The reason for consuming fish oil is the high amounts of omega-3 in them.
    Also there are too many studies that are done wrong based on false assumptions. Before Albert Einstein there was a major contradiction in physics so all they could do was ignore it. It was based on the false assumption that time always moves at the same rate (it cannot speed up or slow down). Also they assumed that lengths could not contract.

  • Dr Paul Stevens

    ALL of our patients?? Not all of my patients have CVD risk, but many have autoimmune/inflammatory disease. What about the benefits for chronic inflammatory diseases, Rheumatoid, Lupus, major depression??

  • larry johnston

    This doctor is as uninformed as Dr Marcola. Give me a break. Ever wonder why heart disease is the number one killer in the US? It is because of bad information like this so called doctor. The medical community has lowered the cholesterol number to low. The reason they did that was so they could sell cholesterol medication. Now it is to low. We need healthy number of the good cholesterol, but not the bad LDL. Our bodies need the oils for many reasons like cleaning out bad LDL, and for our brain membranes . just to name only two. He puts a dollar figure on what he claims unnecessary fish oil sales, yet you can bet your “you know what” he’s getting huge kick backs on pushing real unnecessary pharmaceutical drugs instead of telling his patients to eat a healthy diet, exercise or take good whole food supplements. Typical doctor with a small d in front of his name. Jesus fed the five thousand ( FISH ) and ( BREAD ). WHY? Because of the OILS He created for our bodies and the LIPEDS and STEROLS that were in bread then which are not now because they have been removed so bread last longer on the store shelves. Do the research.

  • Sven

    video isnt working for me

  • Ruby

    I’ve heard anectdotal info that an ADD kid on fish oil 3 days showed a whole different balanced personality, immediately. Heart issues notwithstanding, I wonder about brain and nerve health from this story, though I opt for plant based sources en mass, for my own body.

  • SecularAnimist

    Hemp oil?

  • roberta

    Dr. Barry Sears, (whose Zone diet errors in considering plant protein nonbioavailable, except for soy) is the biggest source of the importance of fish oil,
    My husband and I left thThe Zone to become 100 % plantbased. I continued to take the high potency 3 capsuels of molecularly distilled fish oil Dr Sears has made convincing arguments for. My husband stopped the fish oil.
    When we took the pin prick Omega 6 tp 3 ratio home test purchased from Zone Diagnostics my ratio was an ideal 2 to 1, my husband’s 6 to 1. A swollen- ointed friend I bought a test kit for had a ratio of 39 to 1,yes a whopping 39 to 1 in a 40some normal wieght woman eating the SAD.
    Dr Sears response to the recent test Dr Greger noted is that the average Americans being so high on the Omega 6 side of ratio that it is no wonder the small fish oil dose given in this study proved ineffective.

  • Roberta Peck

    John, Not only I, but Dr. Barry Sears agrees with your assumption that average Americans are so inflamed by high omega 6 to omega 3 fats that it is no wonder fish oil had no effect in this study. It would be like pouring cups of water on a raging fire then concluding that water is not effective in putting out fire.

    Also, most fish oil is the “the sewer of the sea” and often rancid to boot, as Dr. Barry Sears claims. Even Dr Furhman in good character stated that his customers were originally receiving rancid fish oil,

    • Jeff

      Flax converts what??

  • Roberta Peck

    John, Great observation about the omega 6 to 3 ratio in these patients being missing from this flawed study. The sick people in this JAMA study,on a cocktail of drugs, were probably so inflamed with processed omega 6 fats that the very meager amount of fish oil would hardly balance them back to a healthy ratio.

    Also, of what quality was this meager amount of fish oil they received? Did they ingest the “sewer of the sea “type, or the ignorantly unrefrigerated and rancid type? Even Dr Furhman had the good character to report that his customers were receiving rancid oil before he used refrigeration in transport.

    High potency molecularly distilled fish oil with a very small amount of vit E as a preservative are a result of resent processing ,after initial dates provided in this study, so I am assuming theses patients got very meager amounts of the standard swill of the sea.

  • Fish oil fan

    I think the problem with the meta-analyses on fish oil supplementation, which concluded omega 3 fish oil wasn’t effective, used a placebo size dose of fish oil or fish oil of inferior quality. Just like with a drug, if you don’t take enough of a medication, it won’t do you any good. It is too bad that these studies did not use an effective dose of highly purified fish oil, because it could cause people to avoid something that could really help them. Almost all fish contains PCB’s and other contaminants. The advantage of highly refined fish oil is that it is pure – the toxins have been removed. The quality of fish oil varies among brands. I have been using it for years and when I upped the dose, the improvement in my physical and mental health was amazing.

  • Mindaugas Raulinaitis

    Fish Oil Prevents Brain Shrinkage in Eight-Year Study

    Can an abundance of fish oils in the diet keep your brain from shrinking?

    A new study published in the January 2014 issue of Neurology says yes.

  • BenzoSt

    According to a recent column in the Science Times of the New York Times, consumption of fish but not fish oil was related to greater volume of gray matter in seniors. However, there seemed to be no benefit of consuming more than 1 serving of fish per week.

  • Jo Ann

    These analyses do not consider either the quantity nor the quality of the supplementation. That capsules were used instead of liquid tested by FDA laboratories for potency, freshness, and minimal contaminants. (One refrigerates the oil after opening.). Also, did participants take Vitamin E along with the fish oil to deal with oxidation. I would test the validity of these analyses without an examination of the products used.

  • Eric Woods

    I think that the evidence is still out, largely because there are such wide disparities of supplement quality, chain of custody, etc. Since I am male, I eat two ounces of canned wild Pacific salmon, a teaspoon of cod liver oil, and two tablespoons of ground flaxseed every morning. The cod liver oil is refrigerated in transit and in my own house, and has been independently evaluated by the two best independent labs in the supplement industry. My omega-6 consumption is generally less than 16g / day. Even then, it’s extremely hard to keep n-6:n-3 PUFA ratio less at 3:1, much less 2:1.

  • Daniel

    I love how the admins post just the studies that support their beliefs. For example, kefir has so much benefits, the same with sardines and other small cold water fish. But zero talk about those here.

    • Rami_RD2B

      Food is a package deal, if there are more harmful components to a food, some small benefit would not be acceptable. In the case of kefir, xenoestrogens and elevated IGF-1 are major downsides and are inherent of dairy.

    • Joseph Gonzales R.D.

      Hi Daniel. You are happy to post studies here that you feel we may be missing.


      • Tina Willis

        Great answer.

  • Marice

    Where will I get omega 3 if i don’t eat fish or take fish oil? I do eat about 1 TB of flax seed a day. I s that enough. My fish oil is from wild salmon.

    • Rami_RD2B

      If you eat a tablespoon or 2 of ground flaxseed and your diet is generally lower in fat, then you will have sufficient omega 3. Dr. Greger recommends Algae derived omega 3 if you really wish to supplement it, although it likely is not necessary.

  • Alex

    Surprising findings. I’m having trouble reconciling this with much else posted on this site about omega-3s. I understand the studies cited all used fish and fish oils rather than vegan sources, but nothing here suggests any vegan advantage (although one might suspect other fats, animal proteins, and toxins could be reduced or eliminated). Is there any study linking flax or ALA to heart benefits? EPA and DHA? Why is flax a worthy food: fiber, anti-inflamation, …?

  • Dr. Al

    In review of the selected research papers did the authors state the quality and dosage? As quality highly varies from different manufacturers. Dosage also plays a role. It’s all to easy to build a study or studies with a predetermined outcome.

  • alexih

    I am vegan, and recently very excited that my mother became vegan. HOWEVER… she has suffered from dry eyes and perhaps the onset of arthritis. Her doctor told her to take a specific brand of fish oil at a higher dose than typically taken. Amazingly, she had relief from her dry eyes and aches the next day and ever since. So… why? Could she switch to flax and have the same results? I wouldn’t want to have her switch to flax if she is going to have the problems she had before.

  • Charlie Ross

    “Pesco-vegetarians in the community, who ate a plant-based diet with up to one serving of fish a day, lived longer than vegan Adventists.” This sentence has circulated on the internet recently. Is this true? If so…how might we account for why eating fish is better than strict vegan? Could it be that the vegan Adventists are more junk food vegans as to more whole food plant based? Or maybe the Adventists are not taking their Vit B12 or Omega 3’s? Curious as to your thoughts…..

  • Tina Willis

    Do you believe in the “no oil” plant-based diets? Or is some fat okay? Trying not to eat any oil, or even nuts or avocado, has been nearly impossible for us. We eat limited but some oil & fats. Do you think very low fat (and non-saturated) is okay, for an otherwise healthy person? Or do you agree with those eating plans?

    • Thea

      Tina: Before I can answer you, your first two questions make me think need to come to agreement on terms. I try to use the terms this way:
      >>> “fat” = one of the three macronutrients (fat, protein, carbohydrates) which can be found in whole plant foods (broccoli, beans, etc) or as an oil.
      >>> “oil” = a heavily processed product that is pretty much nothing but fat (ex: olive oil, coconut oil, etc). oil is what you get when you take a whole food and remove everything but the fat.

      If we can agree on those terms, then the question, “Is some fat okay?” is easy to answer. No one advocates a fat-free diet. There are two types of fat that are essential to have in the diet. But getting enough essential fat is easy to get in whole plant foods. Even broccoli is something like 8% fat I believe. If you include a few nuts and seeds, you can increase the amount of fat in your diet significantly. The hard part is to keep yourself from getting too much fat, which is why you often hear of a healthy diet being described as “low fat….”

      NutritionFacts/Dr Greger recommends a whole plant food based diet, which naturally includes fat. But this site does not recommend oil as a health food. Here are Dr. Greger’s nutrition recommendations, which I believe will be expanded upon (and maybe even tweaked?) when his book comes out in December:

      Nuts and seeds are whole plant foods that have lots of fat in them. Dr. Greger has a bunch! of videos showing that nuts and seeds are health-promoting foods. (Especially check out videos on flax). But I seem to recall that Dr. Greger recommends about the same amount of nuts/seeds that other respected nutrition experts recommends, about 1 to 2 ounces a day. So, not a large part of a diet. But definitely part of a healthy diet.

      So, are oils really out?!? Say it isn’t so! Here is how I put this into perspective. Jeff Novick has a GREAT talk called “From Oil to Nuts”. (I highly recommend it.) Part of that video is available free on youtube. The following clip compares olive oil to sugar.

      Sugar = junk food = empty calories. and Oil = junk food = even more empty calories (since oil is twice as calorie dense as sugar). This comparison really helped me. While I understand that it is best to avoid sugar, that doesn’t mean that I never eat sugar. I just try to limit sugar as best I can. A person who occasionally eats some sugary treats or a sauce with sugar in it is probably going to be fine. I just don’t kid myself that sugar is healthy. That’s my personal decision. I take the same approach for oils. I don’t think a *tiny* amount of oil would really hurt me in the context of a truly healthy whole plant food based diet. Personally, I try to limit oils to desserts since it is so easy to get rid of oil from main dishes.

      Does that help?