What can be said more definitively is that there’s no good evidence that the supplements can prevent coronary heart disease, heart failure or stroke, according to the advisory.
But even for people with coronary heart disease, newer and better treatments introduced in recent decades have affected studies of fish oil supplements, which before 2002 showed stronger benefits than studies conducted more recently.
For example, more patients now take cholesterol-lowering statin drugs, blood pressure medications, and other drugs before and after a heart attack, Kris-Etherton said. New studies are dealing with an entirely different patient population, she said.
The supplement debate aside, eating fish such as salmon and tuna remains the best way to get enough omega-3s, experts said. Other foods that provide omega-3s include crab, mussels, flaxseed, chia seeds and canola oil.
“People are not getting enough omega-3 fatty acids,” Kris-Etherton said. “Of course, people should eat fish first, but if they can’t meet those recommendations with fish, fortified foods or supplements are OK.”
In 2012, Americans spent $12 billion overall on natural supplements, including over-the-counter fish oil supplements. Although Medicare does not cover over-the-counter supplements, it does cover prescription omega-3 fish oil pills.
Eckel said he doesn’t prescribe fish oil supplements to people who have had coronary events, and the new science advisory won’t change that.
“It’s reasonable, but reasonable isn’t a solid take-home message that you should do it,” he said.