A new, first-of-its-kind systematic review of fish oil supplement research in athletes has demonstrated broadly positive effects in the areas of cognition, heart health, muscle recovery and immunity.
This is welcome news for all athletes whether weekend warriors, professional athletes or somewhere in between.
Published May 8th by the American Society for Nutrition’s Advances in Nutrition, the study reported “consistent effects for fish oil supplements on reaction time, mood, cardiovascular dynamics in cyclists, skeletal muscle recovery, the proinflammatory cytokine TNF-a, and post-exercise NO (nitric oxide) responses.”
On the flip side, the researchers further advised “no clear effects on endurance performance, lung function, muscle force, or training adaptation were evident.”
The study shows benefit for omega-3 fish oil for athletes across a wide range of sports, from soccer to rugby and from cycling to swimming and offers promising results in an avenue of omega-3 supplement science that is considered to be in its infancy, despite almost 25 years of research, as compared to the benefits for omega-3s in more established areas such as heart, brain and prenatal health.
The systematic review identified 137 papers on the topic, with the researchers narrowing their final review to 32 randomized placebo-controlled trials (RCTs) that met the inclusion criteria. The review included RCTs with male (70%) and female athletes, whether recreational, well-trained, elite or professional. No inclusion restrictions were placed on the type of sport and the review inclusion criteria did not discriminate between EPA and DHA, or fish oil dose and duration.
That being the case, omega-3 doses ranged from 300 to 2400 mg/daily of EPA (eicosapentaenoic acid) and 400 to 1500 mg/daily of DHA (docosahexaenoic acid).
The researchers not only were interested in determining whether omega-3 benefits for athletes exist, but also whether there were side effects or risks to be found with omega-3 supplements for athletes. The bottom line to the latter query: there weren’t.
Diving Deeper into the Safety of Fish Oil for Athletes
When it came to adverse effects of fish oil in this population, the literature reviewed showed only one RCT reported adverse effects of fish oil—and those were mild and affected only a small proportion of the study population.
In addition, the study authors noted they were not aware of any RCTs that demonstrated a negative effect of omega-3 and sports performance.
Said the researchers: “Thus, given the wide range of fish oil used, doses administered, and time frames, fish oil appears to be safe in athletes.”
They did advise, however, that at least anecdotally, athletes may subscribe to the “more is better” mantra when it comes to fish oil. Because they suggest that excessive fish oil doses over time can lead to an increased risk of bleeding, “athletes should be educated to avoid excessively high doses of fish oil.”
Still, the fish oil/bleeding dilemma is far from conclusive. A November 2018 study published in Circulation showed that in fact high-dose fish oil did not affect bleeding at all when they investigated surgery patients. In fact, paradoxically, higher blood omega-3 levels were associated with a lower risk of bleeding.
Summing up the findings, OmegaQuant’s Dr. Bill Harris commented: “The researchers in this study concluded that these findings support the need for reconsideration of current recommendations to stop fish oil or delay procedures for people on fish oil before cardiac surgery. In other words, bleeding in surgery (and in normal life) is not a safety concern for omega-3 supplements.”
Future Research Should Include Focus on Omega-3 Status
The study authors were keen to see additional research on fish oil in athletes, especially to further understand the impact of the nutrient on neuromuscular performance, bone metabolism, rehabilitation from injury, risk of illness, and more.
They also emphasized that future research on both fish oil supplements and omega-3 fatty acid-rich diets “should measure biomarkers of omega-3 fatty acid status, to allow the proper investigation and understanding of the impact of omega-3 fatty acid status and the dose-response on outcomes.”
The call by the researchers for measuring omega-3 biomarkers is welcomed by OmegaQuant who developed the Omega-3 Index to test and assess omega-3 EPA and DHA status for individuals and in clinical research.
There is a growing consensus by scientists and other experts who understand that knowing your starting point for omega-3s (whether in individuals or study populations) is key to determining the appropriate omega-3 dose for anyone—including athletes— interested in accessing the multitude of benefits from omega-3s EPA and DHA.
Why Do Athletes Take Omega-3?
Omega-3 benefits athletes for several sports-related reasons. In a previous blog, we laid out five of those reasons, including review of some studies that demonstrated those positive results for omega-3 for athletes.
1) Omega-3s have been shown to reduce muscle soreness and swelling, as well as increase range of motion after damaging exercise. In one study of rugby players, researchers concluded that adding fish oil to a protein-based supplement significantly reduced both fatigue and muscle soreness.
2) Omega-3s help fuel muscle growth and what athlete wouldn’t want to build stronger muscles? Here’s how it works. Your body processes the protein you eat into the fuel your muscles need to grow and stay strong. This process is known as protein synthesis—and omega-3 fatty acids help facilitate that process.
INFOGRAPHIC: 5 Reasons to Take Omega-3s Before Your Next Workout
3) Omega-3s are known for their heart healthy benefits and athletes, in particular, stand to win from the science in this area. One example is a study of 16 male cyclists that demonstrated that fish oil reduces heart rate and oxygen consumption during exercise. Specifically, the study concluded that fish oil “may act within the healthy heart and skeletal muscle to reduce both whole-body and myocardial oxygen demand during exercise, without a decrement in performance.”
4) Omega-3s are good for your brain, with some researchers suggesting these nutrients might offer an innovative approach to preemptively protecting the brain where traumatic brain injury is a high concern. Further, while omega-3s are already well-established as cognitive function supporters, scientific research is also studying whether omega-3s can improve reaction time. One such study in 24 female soccer players showed a significant improvement in the neuromotor function.
5) Many athletes find a mean and lean physique highly desirable and omega-3s can feed the body’s furnace and burn the fat. One study of 44 men and women concluded that omega-3s can help burn fat by using it as energy. The researchers discovered that those who supplemented with fish oil significantly increased lean mass and decreased fat mass.
What About Runners?
In April 2019, researchers published a study looking at runners and how much they run, and then compared that to changes in their Omega-3 Index and AA/EPA ratio.
This retrospective, observational, cohort study included 257 non-elite runners who consumed no fatty acid supplements and provided a blood sample for analysis.
Researchers noticed a gradual decrease of the Omega-3 Index with higher weekly running distance. At the same time, they noticed a progressive increase of the AA/EPA ratio in subjects who ran greater weekly distances. These findings suggest that distance running training and its weekly volume may negatively contribute to changes in the Omega-3 Index and AA/EPA ratio.
In particular, the data demonstrated that the level of Omega-3 Index decreased progressively with increased weekly running distance in a dose-response manner. The observed decrease was evident at the lowest running distance and progressing in the subjects with the highest running distance. In other words, as they ran longer and harder, their Omega-3 Index went down.
These associations, researchers believe, suggest that prolonged running activity may negatively influence someone’s fatty acid profile. Therefore, they think future studies could assess whether regular or high intake of omega-3 rich foods may be effective to counteract the effects of running and other endurance activities on fatty acid status. However, further large-scale cohort studies will be needed to confirm the influence of running activity on the Omega-3 Index and AA/EPA ratio.
What if You Just Want to Stay Fit and Healthy?
Even if you don’t consider yourself an actual athlete, but you do want to be in good physical health, omega-3s EPA and DHA should be part of your game plan.
The Omega-3 Index is a great tool that athletes and those who lead active lifestyles can use to make sure they are getting enough of these nutrients in the first place. The test is personalized and your results factor in a number of things that influence your baseline for omega-3s, including genetics, gender, age, exercise, lifestyle habits, and your diet including how much EPA and DHA you get whether from food or supplements.
You know the saying you have to walk before you run? That’s analogous to the Omega-3 Index. Think of getting your baseline number as learning to walk—that’s your starting point. Then you can make informed decisions about how to run, meaning you’ll know how much fish oil to need to add to your diet.
For example, in a paper published in March of 2019 by OmegaQuant researchers William S. Harris, Ph.D. and Kristina Harris Jackson, Ph.D., R.D., they found that those who ate three fish meals per week and took an omega-3 supplement were the most likely to hit a target Omega-3 Index of 8% or higher.
Or, you may already be in the sweet spot. But if you’re not, the good news is, you can raise your score by adjusting your diet, adding more fatty fish or omega-3 EPA and DHA supplements, or a combination of the two.