Podcast Summary

Episode Overview

Podcast: What's That Rash?
Episode: Should we all be taking fish oil?
Date: February 3, 2026
Hosts: ABC News team

This episode dives into the evidence behind fish oil supplementation, fueled by a listener's question about the daily use of fish oil tablets for general health. The conversation unpacks popular claims about fish oil and omega-3s in relation to heart, brain, joint, and eye health, exploring historical context, scientific studies, and current dietary recommendations with humor and clarity.

Key Discussion Points & Insights

1. Cod Liver Oil: History & Origins

(00:14 – 04:26)

• Both hosts recount childhood memories of being made to take foul-tasting cod liver oil.
• Cod liver oil was historically administered for vitamin A and D to prevent rickets and boost health, despite being "disgusting."
• A describes the traditional production method: "They would just put the cod livers in barrels and let it rot. That's it." (04:43)
• In the 19th and early 20th centuries, cod liver oil was recommended for ailments like rickets, rheumatism, gout, and tuberculosis.
• Discovery of vitamins confirmed some of these benefits weren't just folklore.

2. Fish Oil vs. Cod Liver Oil

(03:47 – 04:26)

• Important distinction: Fish oil capsules generally do NOT contain the high vitamin A and D found in cod liver oil.
• Cod liver oil’s historical benefits mainly stemmed from these vitamins, not the oil itself.

3. The Inuit "Fish Oil Paradox" and Foundational Research

(04:26 – 06:13)

• The claim that Inuit diets (rich in fish and seal fat) led to low heart disease is questionable due to unreliable medical records from remote regions.
• A: "The underlying assumption is flawed ... probably what the case wasn't that they weren't dying of heart attacks, it was that they were and they weren't being recorded..." (05:22)
• While early research popularized the idea that fish oil is heart protective, the evidence base was shaky.

4. Epidemiology and the Omega 3 Story

(06:13 – 08:03)

• Studies like Framingham suggested people eating two fish meals per week had reduced heart disease.
• Raises question: Is it the fish, or the fact that people aren’t eating red meat?
• Focus shifts to omega-3 polyunsaturated fatty acids—specifically EPA and DHA—which are believed to be beneficial.

Omega 3s Explained:
B: “The omega is one end of a fatty acid … an omega 3 is three carbons in, then there's a double bond ... an omega 6 is six carbons in...” (07:00)

5. Evaluating the Health Claims for Fish Oil

A. Heart Disease

(08:03 – 12:37)

• Early studies: strong support for fish oil preventing heart attacks and strokes.
• Larger, higher-quality studies: much smaller benefit or possibly no effect.
• Recent meta-analyses: modest protection from higher omega-3 (especially EPA) in blood.
• High-risk groups (history of heart disease or dialysis): greater relative benefit.
• Caveat: Some studies link fish oil to increased risk of atrial fibrillation (heart rhythm abnormality)—but most recent nuanced data shows no increased risk after correcting for confounders.

Notable Quote:
B: "If there's only a small effect of fish oil, but you're at high risk, a small effect can have a big impact on your health." (11:38)

B. Brain Health (Mental and Cognitive Function/Dementia)

(12:39 – 13:56)

• Little to no evidence for benefit in preventing cognitive decline or dementia.
• Fish oil may offer a tiny improvement in mood, but not a clinically meaningful one.
• Not recommended as a primary treatment for depression or other psychiatric conditions.

B: "There's very little evidence of cognitive benefits from fish oil. So you can put that to one side..." (12:51)

C. Joints & Arthritis

(13:56 – 15:57)

• High doses (10+ capsules/day) may reduce inflammation and help with arthritis, but that’s significantly higher than typical supplement use.
• At normal supplement doses, evidence is equivocal.

A: "Wow, okay. That's a lot more ... people who ... take fish oil ... they're probably not taking anywhere near that much." (14:50)

D. Eye Health (Macular Degeneration)

(16:28 – 16:49)

• Fish oil supplementation shows almost no effect on preventing or slowing macular degeneration.
• Some benefit from specific vitamin combinations, not fish oil.

E. Recommended Intake & Dietary Guidelines

(15:57 – 16:28)

• Australian guidelines do NOT recommend fish oil supplements for the general population.
• Eating oily fish twice a week is recommended.
• Fish oil pills remain popular: up to 45% of people in some studies report use.

Memorable Quotes

• A: "It is as disgusting as if you think about, like, the grossest way you could imagine to make cod liver oil. You're probably bang on, pretty much. They would just put the cod livers in barrels and let it rot. That's it." (04:43)
• B: “This is where this whole complicated story that can be quite confusing is there are various benefits touted for omega 3 fatty acids.” (07:52)
• A (on current evidence): “Maybe a very small effect around protecting your heart, probably not much when it comes to…protecting your brain from either dementia or mood disorder.” (13:56)
• B: "I'm just happy to be going on. I'm doing pretty well on a couple of fish meals a week, not too much red meat and in general the Mediterranean diet baby. Correct. And I just don't take any supplements at all." (17:21)

Specific Recommendations & Takeaways

(17:00 – 17:53)

• For the general population: evidence for fish oil supplements is weak.
• If you’re at high risk of heart disease, discuss with your doctor whether high-EPA fish oil makes sense for you.
• Supplements are not a substitute for a balanced diet.
• For cod liver oil: No reason to take it, and in Australia, may risk vitamin overdose due to abundant dietary vitamin A and D.

Listeners' Questions and Mailbag

(18:17 – 20:58)

• Briefly divert theme to listener emails, mostly about retirement and cognitive function rather than fish oil.

Important Timestamps

• Historical background & anecdote: 00:14 – 04:26
• Distinction between cod liver and fish oil: 03:47 – 04:26
• Inuit heart disease myth: 04:26 – 06:13
• Introduction to omega-3s: 06:13 – 08:03
• Heart disease evidence: 08:03 – 12:37
• Brain health evidence: 12:39 – 13:56
• Joint health debate: 13:56 – 15:57
• Eye health: 16:28 – 16:49
• Dietary guidelines & summary advice: 15:57 – 17:53

Tone & Language

• Conversational, humorous, and accessible, yet always evidence-focused.
• Hosts confidently challenge industry myths yet acknowledge scientific uncertainty.

Summary Table

| Health Claim | Evidence Strength | Notes | |--------------------------|-----------------------------|----------------------------------------------------------| | Heart disease prevention | Modest (mainly EPA) | Biggest benefit in high-risk groups; small effect overall| | Cognitive decline/dementia | Weak/None | No solid evidence | | Mood disorders | Very small or non-clinical | Not a primary therapy | | Joint pain/Arthritis | Only at high doses (>10 caps) | Typical supplement doses too low | | Eye health (macular) | None | Other vitamins may help, not fish oil | | General supplementation | Not recommended | Eat oily fish instead; follow Mediterranean diet |

Final Takeaway

If you eat fish a couple of times a week and have a balanced diet:

• “I just don't take any supplements at all.” - B (17:21)
• Before considering fish oil supplementation, especially at high doses or for specific health goals, talk to your doctor. The evidence isn’t there for most healthy people, but may be for those with specific heart risk profiles.

For most people, oily fish on your plate remains the best bet.