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More Evidence that Omega-3 Benefits the Heart

Omega 3 healthy fats food salmon avocado on butchers blockThe latest studies provide solid evidence for the benefits of omega-3 (fish oil) in improving overall health and longevity. An expert meta-analysis of well-designed, randomized placebo-controlled trials is considered the most reliable (highest level) evidence in modern medicine for determining the efficacy of a drug or other therapy.
Benasconi, Lavie, and colleagues very recently performed such a meta-analysis, which included 42 randomized placebo-controlled trials with approximately 150,000 participants in total. This definitive meta-analysis showed that omega-3 supplementation conferred cardiovascular (CV) protection, including a highly significant 35% reduction in risk of fatal heart attack, and a statistically significant decrease in all heart attacks. These authors concluded that omega-3 specifically in the form of EPA and DHA, is an effective lifestyle intervention for protection against cardiovascular disease.
Another impressive new meta-analysis, this one published in the American Journal of Cardiology, showed that the combination of omega-3 and a statin is effective for reducing atherosclerotic plaque in the coronary arteries. The study found that when omega-3 supplementation was combined with a statin cholesterol-lowering medication, it was better than the statin alone for regressing atherosclerosis (melting plaque) and decreasing the vulnerability of the plaque to rupture (the usual cause of a heart attack). The omega-3 + statin combination was also more effective for reducing inflammation than a statin alone.
My good friend, William Harris, PhD, also known as the “cod-father” of omega-3 research, recently published a comprehensive meta-analysis. This one was comprised of 17 prospective cohort studies examining the associations between blood omega-3 levels and risk for death during 16 years of follow-up. This study, which was published in one of the prestigious Nature journals, included 42,466 individuals, and found that having a high level of omega-3 in one’s cell membranes was associated with a 15 to 18% lower risk of death from any cause.
Yet another new study by Dr. Harris and colleagues, based on the famous Framingham Offspring study, reported that the decrease in life expectancy due to a low omega-3 blood level, was about equal to the life-shortening effects of chronic cigarette smoking—about five years for either one. It’s important to point out that unlike many risk factors for death or heart attack such as age, gender, diabetes, and family history, your omega-3 level is very easy to change for the better. Just eat more fish and/or take an omega-3 supplement.
One potential downside of omega-3 is a possible increase in the risk of developing atrial fibrillation (AFib). In a recent large, randomized placebo-controlled trial, the REDUCE-IT study, 3% of the group receiving 4 grams per day of EPA (one of the major omega-3 fats) had AFib during the study compared to 2% of the patients in the placebo group.
Importantly, even with this increase in AFib occurrences, the omega-3 patients had a 29% lower risk of stroke and a 25% lower risk of major adverse CV events, like heart attack or death. This increase in risk of AFib from omega-3 appears to be dose dependent, with minimal effects on AFib at doses of 1 to 2 grams/day of EPA + DHA.
For most individuals, the benefits of omega-3 far outweigh the risks, especially if you don’t consume oily fish like salmon or sardines at least two or three times per week. Keeping your omega-3 levels in the high-normal range appears to increase life expectancy, reduce risk of heart attack and stroke, and improve brain health. If you have AFib, talk to your doctor about whether omega-3 is right for you; and discuss what dose of EPA + DHA is best for your issues.
By James H. O’Keefe, MD