Is there a correct fish oil arthritis dose? Can you be too heavy for fish oil to work? Keeping with the deep dive into fish oil this past few days, an interesting article just came out in PLos One. It looked at many different anti-inflammatory and pro-inflammatory behaviors in patients who were normal weight and heavy. They studied about 10,000 records from a government heath study looking at things like dietary fiber intake, saturated fat intake, physical activity, smoking, alcohol, and use of certain supplements and medications (glucosamine, chondroitin, fish oil, vitamin E, statins and aspirin). All of these factors were compared against serum high-sensitivity C-reactive protein (hsCRP) concentrations. What is hsCRP? It’s a general blood marker for inflammation which is elevated in patients with more arthritis and more heart disease. For the latter, it’s believed that having more widespread inflammation in the body is the thing that hurts the walls of the arteries, thus leading to blockages in the heart. What did they find? While several factors were significantly associated with decreased hsCRP among the normal weight or overweight groups (increased fiber intake, lower saturated fat intake, physical activity, not smoking, and use of chondroitin, fish oil and statins), only increasing dietary fiber intake and moderate alcohol consumption were associated with reduced hsCRP among the obese. This means that the big effects of fish oil may be much less pronounced when you’re significantly overweight. How overweight is obese in this study? They used a BMI cut off of 30. How heavy is that? Here’s a link to a BMI calculator, so you can test your own height and weight to get to your BMI. Realize that if you lift weights and are carrying a good deal of muscle mass, your BMI will show higher than it should be, as this tool was designed for medical studies. What’s obese in real world terms? A normal muscle mass man who is 5′ 9″ and 210 pounds has a BMI of 31 and a 5′ 4″ woman who is 180 pounds has the same BMI. The upshot? If you’re very heavy, until you lose weight, fish oil may not be your anti-inflammatory. Having said that, since you’re also at higher risk of a heart attack by carrying extra weight, NSAID drugs like Mortin, Aleve, and Celebrex is also a bad idea-all of which will double to triple your heart attack risk. Perhaps the solution is to get your BMI down? In the meantime, I suspect that this study measured everyday fish oil use which are doses far too low to lower CRP based on my clinical experience. Many of our Eskimo cousins have a BMI of >30 and very low heart disease risks and they eat about 10 times the fish oil dose of the average American buying fish oil capsules at Costco. The link to the left tells how to get to those same doses. So if you’re heavy and want to avoid deadly NSAID drugs for your arthritis, either drop the weight or use fish oil like the Eskimos do!