William S. Harris, PhD, is a professor at the Sanford School of Medicine at the University of South Dakota. Harris is also the co developer of the Omega3 Index, which measures the amount of EPA and DHA in red blood cells, and is the founder of OmegaQuant, a company that markets a minimally invasive test to measure the index.
Omega-3s for treatment of fairly rare condition
The science advisory was published in the journal Circulation and is the work of Harris and other researchers who are Fellows of the American Heart Association. Titled “Omega-3 Fatty Acids for the Management of Hypertriglyceridemia,” the advisory summarizes the research, safety and dosing information for physicians seeking to treat patients with these substances.
Harris emphasizes that the recommendations in the paper are aimed at physicians treating patients who are already suffering from hypertriglyceridemia, which affects about 2 in every 10,000 people, though the rate is higher for patients with diabetes or alcoholism.
Triglycerides are naturally present in the blood and are the major component of human fat tissue. Too many of these molecules in the blood, however, can predispose a subject toward developing cardiovascular disease, so finding ways to lower these levels when they are too high has become a common treatment goal.
“We say many times in this document that patients should not use dietary supplement to treat lipid disorders because they are not approved by FDA for that purpose,” Harris said.
Harris, who done a great deal of research into omega-3s in their dietary supplement forms, said the committee that put together the advisory was diverse and included individuals with more allegiance to the drug side of the coin.
So while Harris emphasized that the paper makes clear the difference between drugs and supplements, he also resisted moves to try to add in disparaging language toward dietary supplements.
“There were people on the committee who wanted to say nasty things about supplements from the drug side,” Harris said.
Harris said that the dosages discussed in the advisory—4 grams of omega-3s a day—are well in excess of what most supplement users are willing to take or to pay for, the action of these molecules is the same whether they were put on the market by a drug company or a dietary supplement formulator.
Bolstering the supplement case
In the case of supplements, all that can be said about the actions of these molecules are structure/function claims relating to heart heath or a few other conditions, Harris said. But it does speak to the prophylactic potential of these ingredients, i.e., while the high 4 gram doses might be needed to show an effect when a subject is already ill, lower doses given chronically and started much earlier have been shown to cut the risk of developing troubling blood chemistry aberrations in the first place.
“We have shown that omega-3 dietary supplements do reduce lipid levels,” Harris said.
Harris said hypertryglyceridemia in absence of other factors is fairly rare. For consumers who are genetically predisposed to the condition, the common recommendations about omega-3s consumption to support overall health are unlikely to cut it. And in any case, the condition is of concern mostly because of the elevated risk of developing pancreatitis, not because of the link to cardiovascular disease per se.
“For those people, eating fish once a week is probably not going to help,” he said.
Harris said that communications like these for doctors on omega-3s (this was one of three position papers, he said), can only help to fix in physician’s minds the power of these substances in supporting cardiovascular health.
“As I’ve said many times, these are the same molecules,” he said.
2019 Aug. 19 [epub ahead of print]
Omega-3 Fatty Acids for the Management of Hypertriglyceridemia: A Science Advisory From the American Heart Association
Authors: Skulas-Ray AC, et al.