Meta analysis finds strong support for cardiovascular health benefits of omega-3s

By Hank Schultz

- Last updated on GMT

GOED photo
GOED photo

Related tags omega-3 EPA and DHA cardiovascular health Cardiovascular disease Triglyceride levels Triglycerides Myocardial infarction

A new meta analysis further underscores the efficacy of omega-3s in cardiovascular health, and emphasizes the importance of higher dosages in achieving these results.

The research paper was published today in the journal Mayo Clinic Proceedings​.  Among the authors is Aldo Bernasconi, PhD, vice president of data science for the Global Organization of EPA and DHA Omega-3s (GOED). Other authors are associated with institutes and universities in Idaho, Louisiana and Finland.

GOED executive director Ellen Schutt said the research  provides the most comprehensive analysis of the role of omega-3 dosage on cardiovascular prevention to date. The meta-analysis, which is an in-depth review of 40 clinical trials, provides authoritative evidence for consuming more EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) omega-3 fats. 

Significant results

The researchers concluded that EPA and DHA omega-3 intake is associated with reduced risk of coronary heart disease (CHD) events, the cause of 7.4 million deaths globally each year, and reduced risk of myocardial infarction (heart attack), including fatal heart attack. 

One of the study’s authors, Carl “Chip” Lavie, MD, a cardiologist at Ochsner Health in New Orleans, said, “The study supports the notion that EPA and DHA intake contributes to cardioprotection, and that whatever patients are getting through the diet, they likely need more.”

The meta analysis found that supplementation with omega-3s was associated with reduced disease risk in the following categories:

  • Fatal myocardial infarction (35% risk reduction) 
  • Myocardial infarction (13%) 
  • Coronary heart disease events (10%) 
  • Coronary heart disease mortality (9%)

The researchers noted that past recent meta analyses of the effects of omega-3s in relation to cardiovascular disease have been inconclusive.  While the precise reasons for this are unknown, the researchers said some reasons could be the fact that earlier trials tended to be more positive than more recent studies, while the lower statistical power of all omega-3 trials until just recently tends to increase the variability of results.

Huge increase in data available in just past three years

This latter issue has been put to rest with the publication of a number of recent trials, some of which have been carried out by pharmaceutical companies, Schutt said.

“Between the ASCEND​, REDUCE-IT​ and VITAL​ trials, that doubled the number subjects overall that have been studied,” ​Schutt said. “We couldn’t have done this meta analysis three years ago because there wasn’t enough data to analyze the effect of the dosages.”  

The 40 trials included in the meta analysis totaled 135,266 subjects.  The dosages ranged from less than 800 mg a day up to 5.5 grams a day. The weighted average across the 40 studies came out to 1,221 mg of omega-3s per day.

“The combined results of our meta-analysis and meta-regressions provide strong evidence of the effectiveness of EPA+DHA intake in the prevention of adverse CVD outcomes, particularly CHD events and MI,”​ the authors concluded.

Higher dosage recommendation

Schutt said the results of the research may lead GOED to alter its recommendations on dosage. Past recommendations have in part focuses on what was considered achievable and a dosage level that would still provide some benefit.

“When I started at GOED nine years ago we were saying people should take between 250 mg and 500 mg of EPA and DHA daily.  When the average American was getting 100 mg or less a day, the idea was let’s just get them to take something,”​ she said.

In the past there didn’t seem to be much point in recommending a dosage with the knowledge that few consumers would get there or that might dissuade some consumers from even trying in the first place. But now, with the advent of higher concentration dietary supplements, Schutt said higher dosages are possible with one or two softgels.  It’s no longer necessary to have to persuade consumers to take six or eight large softgels a day as might have been the case previously. 

“We are going to go back and think about whether we should change the recommendation to 1,000 mg for that reason,”​ she said.

Source:​  Mayo Clinic Proceedings
DOI:https://doi.org/10.1016/j.mayocp.2020.08.034
Effect of Omega-3 Dosage on Cardiovascular Outcomes
Authors: Bernasconi AA, et al.

Omega-3s webinar

This conundrum is one of the things that a NutraIngredients-USA webinar later this month will delve into.  Harris will join an all star panel of omega-3s experts that includes Dr Jeffrey Bland, ND, of the Personalized Lifestyle Medicine Institute and Dr Philip Calder, PhD, of the University of Southampton in the UK.  The panel will look at the latest research, where future research is headed, and how the industry might get health authorities more firmly on board with the story of the efficacy of these important ingredients.  For more information and to register for this FREE event, scheduled for 11:30 AM Central time on Sept. 24, visit the event website​.

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