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Attention Athletes: Take Your Fish Oil and Call me in the Morning

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As a serious athlete, you may be battling multiple challenges. This may include muscle and joint soreness from hard training or injury; recovery and improving your performance from the physical stress of strength and conditioning, practice and/or competition; psychological stress and pressure to perform at the highest level – all while fulfilling real-world obligations to your family, friends and profession.

You also realize, along the way, that you are not completely immune to the same health issues that afflict the general population: cardiovascular disease, arthritis, diabetes, weight management, immune system disorders, eye health, depression and anxiety, brain and nervous system function to name a few. What if there was one safe and effective nutrient that could directly or indirectly support all the challenges and health issues mentioned above? Would this nutrient be too good to be true? Well, look no further because fish oil and the essential fatty acids fish oil contains is that super nutrient!

Fats 101

Lets explore how a fat can be an essential component for superior health, vitality, performance and longevity to keep athletes at the top of their game both on and off the field or court. Essential fatty acids (EFAs) are considered “essential” because these fats cannot be produced in sufficient amounts by the body, and must be consumed in the diet. They are required for good health and optimal structure and function of every cell in the body.

EFAs are typically divided into two primary categories, namely, omega-3 and omega-6. Proper cell function and overall health are dependent on striking a balance between the omega-6 and omega-3 fats. Research shows that the standard American diet consists of an omega-6:omega-3 ratio of up to 20 to 1, compared to what scientists consider to be an ideal 3:1 to 2:1 ratio. Omega-6 fatty acids are found in overabundance in the Western diet from refined vegetable oils (soy, corn, safflower, etc.), grains, processed foods and grain-fed meat.

The three main culprits in an imbalanced omega-6 to omega-3 ratio are excessive omega- 6 intake, insufficient omega-3 intake and a combination of the two.

Fish oil is rich in the long chain omega-3 fatty acids Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA). They are found abundantly in cold-water fin fish such as salmon, albacore, sardines, anchovies, mackerel and herring, to name a few, and most shellfish. A high-quality, concentrated fish oil supplement can also be a convenient, safe and effective method of increasing your consumption of these multifunctional essential fatty acids.

The omega-3 essential fats, EPA and DHA, can perform their diverse health functions when they are incorporated as building blocks of cell membranes that make up the “wall” of every cell in the human body. As you can imagine, in order for cells to work optimally, the membrane must also be in great working order to control everything from hormone and chemical signaling between and within cells, to regulating nutrient metabolism, oxygen uptake and waste-product elimination.

Body Composition and Muscular Performance (Muscle to Fat ratio)

The inflammatory response plays a critical role in the short-term recovery process, as well as the development of long-term muscular strength and size from high-intensity exercise. Fish oil is known to influence the inflammatory response by providing long chain omega-3 EPA/DHA fatty acid precursors that compete with the omega-6′s, utilized during a stress or injury response, to synthesize hormone-like chemicals within the tissue. These chemicals known as eicosanoids (e.g., prostaglandins and leukotrienes) and specialized, pro-resolving mediators (i.e., resolvins, protectins, maresins) help to orchestrate, control, and resolve a successful anti-inflammatory process.

A study published in 2009 by Tartibian et al. showed that 1.8g of fish oil improved range of motion and pain from delayed, onset muscle soreness after strenuous strength training. Multiple studies have demonstrated the ability of fish oil to alter inflammatory cell signals. Since excessive inflammatory signals (e.g., cytokines like Interleukin-6 and the stress hormone cortisol) have been shown to increase muscle protein breakdown and impair strength, it follows that the natural anti-inflammatory properties of fish oil may help in maintaining muscle tissue, while losing fat during strenuous training and/or dieting.

Interestingly, professor Eric Noreen from Gettysburg College in Pennsylvania published a study in 2010 that showed six weeks of supplemental fish oil with 2.4g of EPA/DHA daily significantly increased lean mass (i.e., muscle) and significantly reduced cortisol levels and fat mass in healthy adults who did not alter their diet or exercise regimen.

According to the work of Hill et al. published in 2007 in American Journal of Clinical Nutrition, it appears that combining exercise with fish-oil supplementation has an even more powerful, almost synergistic, effect on fat loss, while maintaining muscle mass. In addition, that study also demonstrated superior improvements in blood lipids and blood vessel function in the fish oil group vs. placebo.

Two recent studies completed at the Washington University School of Medicine in St. Louis, Missouri, have provided evidence of fish oil’s ability to restore and amplify protein synthesis pathways within muscle cells in healthy individuals, both young and elderly. There is also emerging research showing that supplementing with fish oil may enhance the strength and functional capacity of muscles along with exercise.

This means fish oil may decrease muscle breakdown, increase muscle protein synthesis, neuro-muscular and functional capacity; effects that create an ideal physiologic environment for the athlete or fitness enthusiast. These are exciting findings because we now have some solid evidence of fish oil’s ability to enhance physical performance. After all, this is one of the major objectives of serious athletes in every sport!

Joint and Orthopedic Health (Arthroprotection)

We’ve already covered how fish oil can support the body’s natural anti-inflammatory response. Inflammation is at the root of joint, spine, tendon and connective tissue injury, pain and swelling. Increasing fish oil intake has improved mobility in multiple studies in patients with rheumatoid arthritis, and even osteoarthritis. Increasing the amount of long-chain omega- 3 fatty acids in the body via diet at an earlier age may have a “protective” effect by maintaining optimal joint structure and function, hence the term Arthroprotection (from Greek arthron = joint). Imagine being able to improve function and decrease pain, all while also improving the health of just about every other organ in the body!

Brain and Nervous System Health (Neuroprotection)

Normal brain and neurological functions are heavily dependent on the health and integrity of cell membranes that cover neurons (nerve cells), and the thick fat-rich sheath (myelin) that envelopes nerves throughout the body. The omega-3 EFAs, EPA and particularly DHA are essential, structural components in addition to being energy substrates for neurons in the brain, spinal cord and peripheral nerves. This provides an excellent rationale for investigating the effects of fish oil supplementation as both a preventive and therapeutic strategy in any athlete, young or old, involved in a contact-sport with risk for developing a traumatic brain injury or concussion. Although the scientific research in this area has enormous potential, it is still relatively young compared to the effects of fish oil on cardiovascular risk. Emerging studies show that fish oil may decrease nerve damage in brain, spinal and peripheral nerves from trauma or injury, while speeding up recovery of function. Particularly, when fish oil is used prior to the injury; as if athletes, particularly those in impact-sports, needed yet another reason to supplement with fish oil!

Cardiovascular and Pulmonary Health (Heart, Blood Vessel and Lung Function)

Healthy heart and blood vessels are critical to withstand the incredible demands imposed by high-intensity training or competition. Research shows that fish oil reduces triglyceride levels, improves blood pressure, circulation and inflammation and may even support a healthy heart rhythm.

Omega-3 fatty acids from fish oil might help to optimize lung function of athletes during and after exercise. Researchers from the Urima University in Iran examined the effects of omega-3 fatty acid supplementation on lung function during wrestling training demonstrated improvements in lung capacity, including lung volume with fish oil supplementation. Athletes understand the importance of a healthy pulmonary system for peak performance. This is another “notch in the belt” for fish oil.

General Health and Well-Being (Body, Mind and Spirit)

Fish oil is known to turn on genes responsible for improving insulin sensitivity, as well as carbohydrate and fat metabolism. Fat cells are more than just storage closets for excess energy and fat; they are important hormonal organs that secrete many different factors (i.e., adipokines) which affect obesity, type II diabetes, arthritis, Metabolic Syndrome, certain cancers and immune disorders.

The omega-3 fatty acids found in fish oil also help to make fat cells “healthier” by improving the profile of chemical factors, thereby shunting calories and nutrients such as amino acids and glucose toward lean body mass and away from fat. Hence, there is a strong link between omega-3 fatty-acid status and risk for diabetes and metabolic disease.

Although fish oil may support a healthy body and brain, it can also help with mental well being, mood and psychological conditions. Research indicates that people who consume more DHA over their lifetime have clearer thinking, better processing and memory with aging. Regular fish oil consumption has also been associated with reduced depression, anger, and anxiety.

What to look for in a fish oil supplement?

The Western diet is notorious for being omega-3 insufficient. In addition, growing concerns over the presence of environmental toxins in fish makes a high-quality fish oil supplement the most reliable and safe source of EPA and DHA. The supplement should be fresh, molecularly distilled, pure, and supported by third-party testing. The triglyceride form appears to be superior to the ethyl esterified form with respect to absorption and bio-availability. I also encourage supporting companies that invest in science and sponsor clinical research on their finished products.

Omega-3 EFA can be obtained by consuming plant-derived as opposed to marine-derived fish oil, e.g., flax or chia seeds. However, the body is not efficient at converting the shorterchain omega-3 alpha-linolenic acid (ALA) found in plant sources into EPA and DHA. For this reason, consuming marine-derived omega-3 EFAs, which already contain the EPA and DHA, the real business end of fish oil, preformed and readily available, is the most efficient means of increasing tissue levels of EPA and DHA. Serious athletes should also consider using a fish oil that is certified-free of athletic-banned substances by an independent organization that minimizes risk of dietary supplements containing banned substances, such as NSF Certified for Sport®.

The acceptable intake (AI) for omega-3 fatty acids is 1.1 to 1.6 grams daily, but most of the benefits discussed in this article require higher dosing in the range of two-to-four grams of EPA and DHA daily. The Food and Drug Administration (FDA) has designated 3 grams daily of EPA and DHA which is generally regarded as safe (GRAS). Athletes should seek the advice of a qualified, health care professional who is knowledgeable in nutrition and dietary supplementation before deciding to use high-intensity, therapeutic doses.


Often times, athletes neglect their long-term health and wellness in exchange for being productive on the court or field. We’ve reviewed some of the ways fish oil may support not only improved athletic performance and longevity, but also the health and integrity of every organ system in the body. I often call it the “anchor” in my nutritional prescriptions for patients. I suppose you could call it my “MVP” of dietary supplements.

Fish oil may very well be the ultimate dietary supplement “teammate” to get athletes through the many rigors of staying in peak condition every season in sport and in life. Remember to take your fish oil and call me in the morning!



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About Hector L. Lopez

Hector L. Lopez, MD, CSCS, FAAPMR is recognized for applying his uniquely diverse background in spine and sports medicine, nutrition and exercise science, and clinical research by improving not only the health and quality of life in his patients, but also athletic performance in recreational and elite athletes. Dr. Lopez is currently a principal & the Chief Medical Officer of the Center for Applied Health Sciences, a multi-disciplinary clinical research organization, and Supplement Safety Solutions a Nutravigilance Consulting Company. He is a product developer and consultant for the nutritional supplement industry and to professional athletes in the NFL, NBA, and MLB. Dr. Lopez has been interviewed on over 100 radio shows and by various media outlets. He has published in lay popular press magazines, peer-reviewed medical journals, and presented internationally to leading physicians, scientists, and strength and conditioning professionals.

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