Omega-3 supplements offer a small benefit in lowering the risk of heart disease for some people. Dietary changes may be more important though such as eating whole fish rather than taking supplements and eating more in line with a Mediterranean-style dietary pattern. This consensus is based on 14 experts answers from this question: Do omega-3 supplements help lower the risk of heart disease?
Omega-3 fats are essential for health and they need to be obtained from food. The three main types of omega-3 fats are alpha-linolenic acid (ALA) which is found in plant foods such as walnuts, soy and canola; eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Fish and fish oil are key dietary sources of EPA and DHA. Having more omega-3s in the diet is promoted as a way to help lower the risk of heart disease by their effects on blood clotting, blood pressure, cholesterol and heart muscle function. Fish oil capsules are now one of the most common over-the-counter supplements used to boost omega-3 intake.
Diet, exercise, not smoking and in some cases, medications are the cornerstone of reducing the risk of heart disease. One common piece of advice is to consume more fish or to consider taking fish oil capsules. Fish oil is high in the long-chain omega-3 fatty acids of EPA and DHA.
What does the evidence say?
So, how strong is the evidence for omega-3s supplements in helping to lower the risk of heart disease? Many of our experts were in agreement that there is good clinical evidence to support the beneficial effects of omega-3 supplements on cardiovascular health; however, clinical trials results have been mixed at times. There may likely be specific factors that influence whether someone derives a significant benefit from taking omega-3 supplements. Factors such as dose, the form of supplement (EPA versus DHA), background diet, and genetics also impact response.
Dr George Billman from Ohio State University noted that despite a strong association between fish consumption and a reduced incidence of adverse cardiovascular events and earlier mortality, clinical trials that investigated the effects of omega-3 fatty acid supplements on these cardiovascular events have not always confirmed this initial observation.
A recent Cochrane review meta-analysis of 79 randomised placebo-control clinical trials with 112,059 patients concluded that “increasing EPA and DHA had little or no effect on mortality or cardiovascular health”. The Cochrane Library is a collection of high-quality, independent reviews to provide evidence to inform healthcare decision-making. But some nuance is needed in this conclusion.
Dr William Harris from the University of South Dakota noted that 40 years of research on long-chain omega-3s has largely supported the cardiovascular benefits of these marine-derived nutrients. While there have been several failed clinical trials with omega-3 supplements, the reason is likely due to small numbers of participants or insufficient dose or in some cases, both.
Furthermore, nutritionist Dr Aleix Sala-Vila writes that recent large trials questioning the long-believed protective effects of omega-3 supplements could be masked by the use of almost universal statin treatment after the first heart attack, and by the fact that, in contrast to participants from early trials, these subjects are no longer deficient in omega-3s. However, the American Heart Association states that “even a potential modest reduction in coronary heart disease mortality in this population would justify treatment with a relatively safe therapy.”
The American Heart Association also recommends that people eat fish at least twice per week. Supplements are not a replacement for a healthy diet, but they can be important when attempting to bridge the gaps from the diet.
Learn more with Consensus AI Academic Search Engine:
💪🏻What are the three main types of omega-3 fats? 🧐What are the primary dietary sources of EPA and DHA? 🕵Is there strong evidence supporting the cardiovascular benefits of omega-3 supplements? ❤️Do omega-3 supplements provide a significant benefit in reducing heart disease risk for everyone? ✨ What factors can influence the effectiveness of omega-3 supplements in lowering heart disease risk?How omega-3s work
The mechanisms by which omega-3 supplements reduce heart disease risk are various. Potential mechanisms include antiarrhythmic effects, anti-thrombotic effects, anti-inflammatory effects, lowered blood pressure, improved endothelial function, triglyceride-lowering effects in people with high triglyceride levels, and retarded growth of atherosclerotic plaques. However, there is variability in response to omega-3 supplementation between individuals on heart disease risk factors so this in part explains the mixed results with clinical trials.
So, what is the bottom line: do omega-3 supplements reduce the risk of heart disease? The answer may depend on both the patient population studied and the dose used. In high-risk people with abnormally high blood triglycerides, a high dose of purified EPA may protect against adverse cardiovascular events. But the greatest benefits accrue from living a healthy lifestyle by not smoking, enjoying regular exercise, and eating a heart-healthy diet such a Mediterranean-style diet.
Takeaway: Omega-3 supplements appear to offer benefits in reducing the risk of heart disease, but their benefits may be small and not apply to everyone equally. Whole dietary changes such as eating more in line with a Mediterranean-style dietary pattern may offer greater advantages than just relying on fish oil supplements.
Learn more with Consensus AI Academic Search Engine:
💊Can omega-3 supplements replace a healthy diet in reducing the risk of heart disease? 🔥Is there evidence that omega-3 supplements have anti-inflammatory effects? 🩸Can omega-3 supplements lower blood pressure in some individuals?