A Medical Student Blog

Unofficial thoughts on medicine and medical school

What fish and what fish oil should I eat?

Dear All, 

Again, apologies for taking so long to update the blog.  Right now, we’re in the midst of finals week, preparing for dermatology, rheumatology, orthopedics, respiratory and cardiovascular pathophysiology.  It’s going to be a fun week of studying in the snow!  (There’s a snow storm in Boston right now).   

Going back to the fish story and omega-3’s — apparently it’s a lot more complicated than what I originally anticipated.  There are two extreme views on fish.  One side, argued by many nutrition professors, is that fish is really good because of the omega-3’s, and the more you eat, the better for your heart and brain, and the better you feel, so eat your fish at every meal! (Okay, that’s a bit of an exaggeration, but you get the gist).  Another side, argued by environmentally-oriented scientists, and a few nutrition professors like Marion Nestle, is that fish is for the most part, a dangerous food.  Big fish are loaded with mercury and all farmed fish—big and small—are loaded with PCBs and dioxin.  So unless you can buy fresh wild coho salmon that costs 15 dollars per pound at Whole Foods, or unless you live in Alaska – you should pretty much just forget about seafood.   

Huge fights have erupted between both sides – nasty language thrown about back and forth, words that you thought would only be in political campaigns.  One side has said that telling people fish is dangerous is equivalent to causing the premature deaths of hundreds of thousands of people.  The other side retorted by saying that these “scurrilous attacks” don’t help anybody and that instead of blaming the fish truth-tellers, the real problem is the industrial polluter who poisons our earth. 

There have even been serious conflict of interest issues, with the tuna and fish industry influencing researchers and FDA fish safety policy.  I was surprised to read about this (Marion Nestle talks about this in-depth in her book, What to Eat) but in hindsight, I guess I shouldn’t have been… 

It’s a tough story to figure out because both sides have written several articles published in top medical and science journals arguing that fish is good and that fish is bad.  I took about 15 hours trying my best to sort through the data.  What I concluded is that, somewhere in the middle of both extremes is where the answer lies: fish is truly a healthy, “power” food, if you eat the right kinds of fish, and the right amounts.    So how much should I eat?  When, and what should I eat?  What kind of fish oil supplements are the safest?  To answer some of those questions, I made two handouts (Fish and Fish oil Recommendations, Fish recommendations part II), with references, that hopefully will help guide your shopping in the future.   

Happy Eating!



December 16, 2007 - Posted by | Health news, Nutrition | , , , , , ,


  1. Luckily the only fish I can eat (salmon and trout) is relatively safe. Do you have any info on baltic and scandinavian fish?

    Comment by anjasmith | January 6, 2008 | Reply

  2. Thanks for this post. So many issues have so many opinions no one knows what to eat. i just bought some red snapper and wonder if it is safe. I have lost my taste for meat after reading about the meat industry. When are we going to fix our planet?

    Comment by Kirstin Boncher | January 8, 2008 | Reply

  3. Most salmon sold as “wild” is really farmed. According to a Norwegian paper, only 2% is deemed “wild”. Also, some salmon maybe sprayed with carbon dioxide to preserve the fresh look. COHb = CO + Hemoglobin (Hb) = Carboxyhemoglobin (COHb). But overall, salmon is good for you.


    Comment by foodaroo | January 17, 2008 | Reply

  4. It’s refreshing to watch your video on Fish Oil and see the exuberance and excitement of a medical student explaining the benefits of a nutrient.

    I have Multiple Sclerosis and it has been a driving force in my quest for knowledge about nutrition and how it powers and shapes our bodies. You truly are what you eat.

    There are many other natural sources for getting Omega 3 other than fish oil. Like you mentioned, farmed fish and large fish can contain mercury, pcb’s and dioxins. Flax seed, walnuts, avocados and other foods do not and can be an excellent source of Omega 3.

    The reason I take it is because of the part it plays in repair of damaged myelin. The fact that I might be preventing heart disease in the process is just icing on the cake. It really is a miracle nutrient.

    A website you might be interested in for information on healthy foods and the nutrients they contain is:
    http://www.worldshealthiestfoods.com. I found a lot of good info there.

    I’m bookmarking your blog and will follow along. The world needs more doctors with your positive attitude and willingness to approach treating conditions with more than just pharmaceutical responses.

    Comment by Jeri | February 5, 2008 | Reply

  5. Hi Jeff,

    Kudos to you for working to educate the public about this important information. I watched your video which reminded me of myself a few years ago when I began to mine all the research about these amazing omega 3 fatty acids. I had been an Alaskan salmon fisherman for many years but had never even heard of them before starting my company to provide folks with access to TRULY wild and pure omega-3 rich seafood. I don’t mean to plug my site but feel a great affinity with you and wanted to let you know at least about our newsletter, which provides weekly science based articles on this topic. I invite you and anyone else interested to go to our website and sign up. If you’re skeptical take a stroll through the archives and I think you’ll see we’re about a lot more than your typical fish monger.

    Thanks for the info and good luck with your studies!


    Randy Hartnell

    Comment by Randy | February 13, 2008 | Reply

  6. hi jeff,
    thanks so much for your informative thoughts, anyway i have a question for you, i have heard that you can also get omega 3 fatty acid from consuming olive oil, true or false?

    Comment by Si | February 17, 2008 | Reply

  7. Hi Jeff!

    I found your blog and youtube videos today while trying to read up more on medical issues (a hobby during my non-existent free time) and I just wanted to say – you’re great! I really hope you keep up with this work because I will most definitely continue reading what you publish. Best wishes for your med school studies!

    =) Grace

    Comment by Grace | February 17, 2008 | Reply

  8. Hi Jeff: Kudos to you for taking on such a large project!

    I am a great supporter of Omega 3 Fish Oil. I have had Multiple Sclerosis since 1976 and treat with only diet, supplements and homeopathic aids. I do not take any MS drugs – injections or pills. In the 1970’s, plasmaphoresis was a treatment that was being pushed, but after two years, I ditched it because it wasn’t helping.

    I take 3 grams of Omega 3 Fish Oil per day, in addition to many other supplements, vitamins and diet restrictions. The Omega 3 Fish Oil is beneficial in helping to repair the mylein sheath, helps the immune system overall and I believe helps with anti-inflammatory properties.

    I cannot eat fish products at all anymore, so that is why I am up to 3 grams a day. I started out with 1200 mg a day in the 1970’s, upped it as my diet was changed to one to two grams a day and just last year I increased it to 3 grams per day.

    With MS, I also suffer major swallowing issues so that almost everything I eat goes through a blender first. All the supplements that are softgels go down very easily; almost everything else in tablet form is crushed and blenderized.

    I believe that the Omega 3 Fish Oil has been of great benefit to me because my MRI’s show almost NO active lesions for the last nine years. I am 54 years old now and when I was diagnosed, not much was known about MS and it was hinted that I had about ten years to live before progression.

    I firmly believe that the supplements have kept the MS in check. Thank you for your research and I will stop back here again soon to check for updates. Continued success to you. Anne

    Comment by Anne | March 2, 2008 | Reply

  9. Hi Jeff,
    Great video presentations! I wondered about which probiotics help with eczema. I’ve used several different kinds for my son and have used omega 3’s but his eczema still flares up. I am going to try a diet called specific carbohydrate diet soon. I have heard it reduces food available for pathogens. I was wondering what you have learned about detox for children and adults as well

    Thanks, Lisa

    Comment by Lisa | April 23, 2008 | Reply

  10. Salmon is awesome. And yummy.

    Comment by Dragonfly | June 8, 2008 | Reply

  11. Hi Jeff,

    Excellent information on fish oils and there benefits. I have also been hearing a lot lately on the good that fish oil’s can have on the body. Keep up the good research.

    Comment by Curtis | June 21, 2008 | Reply

  12. Hi Jeff,

    Thx for your info. abt omega 3, but i learnt from a chinese book years ago that seal oil is better than fish oil.
    Please take a look at this website: http://omega3-drho.blogspot.com/ and if possible let me have your comment.

    Comment by Alan | October 28, 2009 | Reply

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