Omega-3 fatty acids in fish and dietary supplements are associated with lower odds of heart disease even in higher-risk populations with elevated triglyceride or LDL cholesterol levels, a new research review suggests.

The American Heart Association recommends eating at least two servings of fish a week and considering supplements of omega-3 fatty acids when that’s not possible.

For the current study, the researchers examined previously published research on two omega-3s: EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid).

They found that consumption of omega-3s in food or supplements was associated with a 16 per cent lower risk of heart disease in people with high triglyceride levels and a 14 per cent lower risk for patients with elevated LDL cholesterol.

“The collective evidence from all studies supports a beneficial role of EPA and DHA on coronary heart disease, and stronger associations were observed among those who may benefit acutely from EPA and DHA, such as those with elevated triglyceride levels and those with elevated low-density lipoprotein cholesterol,” said lead study author Dominik Alexander of EpidStat Institute, with offices in Seattle, Washington, and Ann Arbor, Michigan.

Omega-3 fats are very important for health and well-being, especially for the heart

To examine the connection between omega-3s and heart disease, researchers analysed data from 18 trials that randomly assigned about 93,000 people to get a certain amount of these nutrients. Across these randomised trials, they found omega-3s associated with a six per cent lower risk of heart disease, but this was too small to rule out the possibility it was due to chance.

The study also reviewed results from another 17 previously published trials that observed about 732,000 people over long periods of time while they followed their usual diets. Over all of these studies, omega-3s were tied to a statistically meaningful 18 per cent reduction in the risk of heart disease.

The study was funded by the Global Organisation for EPA and DHA Omega-3s (GOED), an advocacy group with manufacturers and sellers of omega-3 dietary supplements among its members. Several study authors have also served as consultants to manufacturers of omega-3 supplements.

Limitations of the study include the wide variation in study designs for the randomised trials, which included patients with a range of eating habits and heart disease risk factors and tested omega-3s over different time periods, the authors note in their report in Mayo Clinic Proceedings, online January 3.

Some studies in the current analysis also did not track heart health or the amount of omega-3s in people’s diets at the start, making it harder to determine how much these nutrients might directly influence heart disease risk over time, the authors also point out.

Even so, the results from an analysis of data on close to one million patients suggest many people may benefit from boosting the amount of omega-3s they get from eating fish or taking supplements, said Chip Lavie, of the Ochsner Clinical School-University of Queensland School of Medicine in Australia.

Very few people in the US or other countries who follow a typical Western meat-and-potatoes diet eat enough fish, so they might need to take dietary supplements to achieve close to 1,000 mg a day of EPA and DHA, Lavie said.

“Omega-3 fats are very important for health and well-being, especially for the heart,” James O’Keefe, director of preventive cardiology at the Mid America Heart Institute at Saint Luke’s Hospital in Kansas City, Missouri, said.

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