Flaxseed Oil & Fish in OMS

Within OMS, omega-3 intake is considered important for supporting an anti-inflammatory balance.

Daily Omega-3 Principle

OMS traditionally recommends a regular source of omega-3, most commonly:

• Flaxseed (linseed) oil or

• Fish oil (EPA & DHA) was recommended for the first six months in the early days but as flaxseed oil (ALA) was shown to be more efficacious in the Holism Study, it is now the recommended form of omega-3 .  There are a very few, very small local populations whose people don’t have the genes to reliably metabolise ALA into EPA & DHA. Mostly people with those genes know that’s the case and for them the OMS diet should use high quality fish oil or algae oil for EPA and DHA but should include some Flaxseed oil for ALA.

Flaxseed oil is favoured because it is:

✔ Plant-based
✔ Extremely low in saturated fat
✔ Rich in ALA (alpha-linolenic acid)

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What Happens on Fish Days? 

When oily fish is consumed, it provides:

• EPA (eicosapentaenoic acid)

• DHA (docosahexaenoic acid)

These are the biologically active long-chain omega-3s.

Because oily fish already delivers EPA/DHA some  OMS practitioners and clinicians consider that  flaxseed oil supplementation may not be essential on that day

Reasoning:

• You are still achieving strong omega-3 intake

• Avoids excessive calorie/oil load

• Maintains dietary balance

📘 HOLISM Study – Short Precís

The HOLISM study was a large international observational research project that analysed lifestyle factors in people with multiple sclerosis (MS), including diet, exercise, supplement use, and disease outcomes such as disability, quality of life and relapse rate. It wasn’t a randomized clinical trial but rather a large cohort survey that looked at associations between these behaviours and MS health outcomes.

The study found strong associations between several healthy lifestyle factors — including diet quality, fish consumption, and omega-3 supplementation — and better MS outcomes such as quality of life, lower disability scores, fewer relapses, and more stable disease activity.

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🧠 Key Findings on Omega-3 (Flaxseed Oil vs Fish Oil)

1️⃣ Omega-3 Supplementation Associations

• Participants who reported taking omega-3 supplements had significantly better outcomes in measures of quality of life, disability, and disease activity compared to those who did not take omega-3s.

2️⃣ Flaxseed Oil vs Fish Oil

• When the data were analysed by type of omega-3:

  • Flaxseed oil supplementation was more strongly associated with improved quality of life, reduced disability, and reduced disease activity than fish oil alone.

  • Fish oil supplementation also showed associations with better outcomes, but the measures were generally less strong than for flaxseed oil.

  • Taking both fish oil and flaxseed oil together also showed beneficial associations, but flaxseed oil alone often showed the strongest link.

3️⃣ Relapse and Disease Activity

• Flaxseed oil use was associated with a significant reduction in the odds of increasing disease activity (after controlling for age and gender) — suggesting less worsening of disease activity compared to those not using flaxseed oil.

• The data showed trends toward fewer relapses with flaxseed oil supplementation, though exact relapse rates depend on self-reported data.

4️⃣ Fish Consumption

• Independent of supplements, more frequent fish consumption (1–2 times/week and 3+ times/week) was strongly associated with better quality of life and physical health scores in a dose-response pattern.

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📊 Summary Comparison (from HOLISM)

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📌 Interpretation & Context

• The study is observational (self-reported diet/supplement use), not a randomized trial — so it shows association, not definitive causation.

• Flaxseed oil may have been associated with stronger links to better outcomes — possibly reflecting broader dietary patterns (e.g., those choosing flaxseed oil may also follow other healthy behaviours) or specific effects of ALA.

• Fish consumption itself also showed strong health associations, which reinforces the value of both sources of omega-3 in a wholesome diet.

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🧾 Very Short Study Precis

The HOLISM study, led by researchers linked with the Overcoming MS (OMS) Program, analysed an international cohort of people with MS to investigate how lifestyle factors — especially diet quality, omega-3 supplementation and fish consumption — correlated with quality of life, disability, disease activity and relapse rates. The study found that higher fish consumption and omega-3 intake were linked with better outcomes overall; among omega-3 supplements, flaxseed oil showed a stronger association with positive health outcomes than fish oil alone, though both sources were associated with benefits