Hi friends,
I’m trying something a little different this time.
For the past few months I’ve been quietly working on a series of short videos. The idea is simple: take the health topics we cover here and see whether they land more easily when you can watch them instead of only reading them.
So consider this an experiment. The written takeaways are below as always, and there’s a video version too.
Take-home points
Fish oil isn’t one-size-fits-all. Whether it helps your heart depends on three things most labels never mention: the type of omega-3, the EPA:DHA ratio, and your genetics.
The trials disagree for a reason. GISSI, JELIS and REDUCE-IT showed real reductions in heart risk; VITAL, ASCEND and STRENGTH showed none. The difference comes down to the form and dose used.
Ratio beats grams. The trials that lowered heart risk used high EPA formulas. So for cardiovascular benefit, favor EPA over DHA.
Your genes change the math. A gene called FADS1 controls how well you convert plant omega-3s (flaxseed, walnuts) into EPA and DHA. The same gene influences how well you respond to the supplement.
Who Benefits:
People who've had a heart attack or stroke
People on a statin who still have high triglycerides (≥150)
People with a coronary calcium score ≥100
People with established heart or vascular disease
Know your number. The Omega-3 Index is a simple blood test; the target zone is about 8–11%. It’s the most direct way to know whether what you’re taking is actually working. For a healthy person without risk factors, raising your omega-3 index from less than 5% to above 8% decreases overall mortality by approximately 34% based on Framingham study.
Bottom line: don’t just grab the cheapest bottle. If you’re higher-risk, check the EPA:DHA ratio and ask your doctor about testing your Omega-3 Index.
Watch the video
This video is for general education only and isn’t medical advice. Talk to your doctor before starting, stopping, or changing any supplement or medication.
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References
Innes & Calder, Int J Mol Sci 2020 Elagizi et al., Nutrients 2021 Weinberg et al., JACC 2021 O'Keefe et al., Mayo Clin Proc 2019 von Schacky, Proc Nutr Soc 2020 Harris et al., Am J Clin Nutr 2008 Harris et al., Atherosclerosis 2017 Franco et al., J Clin Lipidology 2025 Nicholls SJ et al., JAMA 2020 Nissen SE et al., JAMA Cardiol 2021 Sherratt SCR et al., Cardiovasc Res 2024 Sheppard JP et al., JACC Adv 2025 Chapman MJ & Mason RP, Pharmacol Ther 2022 Sherratt SCR et al., Curr Atheroscler Rep 2022 Schulze MB et al., Lancet Diabetes Endocrinol 2020 Al-Hilal M et al., J Lipid Res 2013 Juan J et al., Am J Clin Nutr 2018, Doi T, European heart Journal, 2021. Sheppard JP, JACC 2025.