Omega-3 Fatty Acids & Cardiovascular Disease

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Background

Since the original American Heart Association (AHA) Science Advisory was published in 1996,¹ important new findings have been reported about the benefits of omega-3 fatty acids on cardiovascular disease (CVD).

Omega-3 fatty acids are obtained from two dietary sources: seafood and certain nut and plant oils. Fish and fish oils contain the 20-carbon eicosapentaenoic acid (EPA) and the 22-carbon docosahexaenoic acid (DHA), whereas canola, walnut, soybean, and flaxseed oils contain the 18-carbon α-linolenic acid (ALA).

ALA appears to be less potent than EPA and DHA. The evidence supporting the clinical benefits of omega-3 fatty acids derive from population studies and randomized, controlled trials, and new information has emerged regarding the mechanisms of action of these nutrients.

These are outlined in a recent Scientific Statement, “Fish Consumption, Fish Oil, Omega-3 Fatty Acids and Cardiovascular Disease.”²

What Do Epidemiologic and Clinical Studies Show?

Large-scale epidemiologic studies suggest that people at risk for coronary heart disease (CHD) benefit from consuming omega-3 fatty acids from plants and marine sources.

Although the ideal amount to take is not firmly established, evidence from prospective secondary prevention studies suggests that intakes of EPA+DHA ranging from 0.5 to 1.8 grams per day (either as fatty fish or supplements) significantly reduce the number of deaths from heart disease and all causes.

These data support the 2000 AHA Dietary Guidelines recommendation to include at least two servings of fish (particularly fatty fish) per week. For ALA, a total intake of 1.5 to 3 grams per day seems beneficial, although definitive data from prospective, randomized clinical trials are still needed.

In randomized clinical trials (RCTs) that enrolled patients with coronary heart disease, omega-3 fatty acid supplements significantly reduced CV events (death, nonfatal heart attacks, nonfatal strokes). Omega-3 supplements can also slow the progression of atherosclerosis in these patients.

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