The benefits of fish oil supplementation on cardiovascular health are well established and ubiquitous in the medical literature. In previous articles, we highlight the many roles that fish oil supplementation - specifically omega-3 (n-3) polyunsaturated fatty acids (PUFA) EPA and DHA - play, such as lowering heart rate, supporting eye health, and improving heart function post-heart attack. Most recently, however, a meta-analysis published September 30th in the Journal of the American Heart Association provides the most updated evidence concerning n-3 supplementation and cardiovascular disease (CVD) risk.
The purpose of the meta-analysis study was to elucidate the long-held controversy between fish oil supplementation and lowered risk of CVD. Evidence from 13 different randomized clinical trials (RCTs) involving over 120,000 participants was used to support their findings, including three recent large RCTs that increased the sample size of the study by 64%. The n-3 fish oil dose ranged from 376 to 4,000 mg/d with various proportions of EPA and DHA; however, most trials tested at doses around 850 mg/d.
The study found that, compared with the placebo group, daily n-3 fish oil supplementation significantly lowered risk for most cardiovascular events, including an 8% reduced risk for myocardial infarction and death from coronary heart disease. It is important to note that no benefits were found for the reduced risk of stroke. Moreover, even after excluding the REDUCE-IT trial from the analyses, which tested with very high doses supplementation, marine-derived n-3 PUFA, nevertheless, reduced risk for CVD and related endpoints. There was a linear dose-response relationship, meaning the higher the dose of n-3 PUFA, the greater risk reduction for most CVD outcomes. According to the present study, the dose-response analysis based on 58 RCTs predicted that total triglyceride levels reduced by 5.9 mg/dL for every 1 g/d increase of n-3 fish oil.
Another very recent review published in early October of this year in the Journal of Atherosclerosis and Thrombosis similarly examined large-scale clinical studies from the last 50 years on n-3 PUFAs for CVD prevention and elucidated the molecular mechanisms involved. In addition to providing antiarrhythmic, cell membrane stabilization, anti-inflammatory, and cardioprotective benefits, this review determines that omega-3 PUFA are essential for physiological homeostasis and optimal health.
Clinically, this is exciting news given the high incidence rates of CVD globally! This updated research is promising for practitioners with patients who are suffering from CVD and/or other related metabolic conditions. It is important to note that fish oil supplementation is not a cure-all or only way to support heart health, and inversely the cardiovascular system isn’t the only system that benefits from omega-3 fish oil supplementation. Patients with cardiovascular-related and metabolic diseases may benefit from a variety of other nutrients that support cardiovascular health. Additional nutrients beneficial for patients with CVD include CoQ10, magnesium, carnitine, and ribose. Coupled with a heart-healthy food plan (e.g. the Mediterranean diet) high in dietary n-3 PUFA as well as daily movement, supplementing with these nutrients may lower the risk of developing comorbidities, such as type II diabetes and Alzheimer’s disease, and other CVD events.