Limited Support for Omega 3 Supplementation for Heart Disease Prevention, Claims AHA

17 Mar 2017 --- Omega-3 fish oil supplements prescribed by a healthcare provider may help prevent death from heart disease in patients who recently had a heart attack and may prevent death and hospitalizations in patients with heart failure, according to a new science advisory from the American Heart Association. 

However, the report suggests that there is a lack of scientific research to support clinical use of omega 3 supplements to prevent heart disease in the general population.

“We cannot make a recommendation to use omega-3 fish oil supplements for primary prevention of cardiovascular disease at this time,” said David Siscovick, M.D., M.P.H., chair of the writing committee of the new science advisory published in the American Heart Association journal Circulation.

“People in the general population who are taking omega-3 fish oil supplements are taking them in the absence of scientific data that shows any benefit of the supplements in preventing heart attacks, stroke, heart failure or death for people who do not have a diagnosis of cardiovascular disease,” Siscovick said.

Omega 3 supplementation is very popular. Approximately 18.8 million US adults reported taking omega-3 fish oil supplements in 2012, and according to Innova Market Insights, launches of omega 3 supplements rose 8% from 2015 to 2016 in the vitamins and minerals sector.

Outi Armstrong, Global Head of Marketing Communications DSM, told NutritionInsight: “The recommendation of the American Heart Association provides input for medical doctors, HCP and consumers. We expect that this recommendation will generate and stimulate higher awareness for the role and benefit of eating regularly fish or take a fish oil capsule or a EPA/DHA supplement. The American Heart Association is a well trusted source for information on health, for this reason we also assume that the statement will generate broad media coverage and reporting and by this generate interest in people on the role and benefits of omega-3s in a broader way.”

“Omega-3 fatty acids provide critical lifelong benefits. DHA is an essential nutrient for the brain and eyes and DHA and EPA together promote cardiovascular health. DSM’s MEG-3 and the vegetarian life’sDHA and life’s OMEGA omega-3s are essential ingredients in helping customers innovate health-focused products,” she explains.

“We rate the benefits for omega-3s as relevant for primary prevention of CHD events and healthy people can have a benefit in taking supplements. Next to this a recent meta-analysis demonstrated a statistically significant reduction of CHD risk of 16% in people at risk and high triglycerides or LDL cholesterol levels.”

Armstrong adds: “These risk factors are often connected, so a combined application of drugs, like statins with omega-3s may provide the best benefit for people. It was also demonstrated recently in another study, that the combination of omeg-3s and drugs has a synergistic benefit. So in summary, omega-3s have a potential in the general and healthy population for risk reduction of CHD events and provide a significant benefit in secondary prevention alone or in combination with drugs.”

The New Science Advisory

The advisory’s writing group reviewed all randomized clinical trials that evaluated a potential role for fish oil supplements to prevent cardiovascular diseases, including two studies published before 2002 and 13 published since 2002, when the association last issued a scientific statement focused on fish and omega-3 fish oil supplements.

The studies rigorously assessed the clinical impact of omega-3 fish oil treatment on outcomes such as heart attacks, strokes, atrial fibrillation (a heart rhythm disorder) and others.

“Scientific findings from the past two decades that focused on the prevention of cardiovascular diseases continue to show that among people who are at risk of dying from heart disease, the potential benefit of omega-3 fish oil supplements is still useful for people who have had a recent heart attack, which is consistent with the 2002 statement,” Siscovick said.

“What is new is that people with heart failure also may benefit from omega-3 fish oil supplements,” Siscovick said.

The scientific evidence for the heart failure recommendation comes from a large, randomized, clinical trial that showed a low dose of omega-3 fish oil supplements reduced death and hospitalization by 9 percent in patients with heart failure, which led the authors to determine that healthcare providers could consider omega-3 fish oil supplements reasonable for these patients.

To determine whether scientific studies since 2002 found additional evidence on the usefulness of omega-3 fish oil supplements, the authors focused on studies related to preventing a first heart attack in the general population, or in patients who were at high risk for heart disease, and preventing recurrent events and death in patients who had a prior heart attack, congestive heart failure, stroke, or atrial fibrillation.

The advisory focused only on the use of omega-3 fish oil supplements of approximately 1,000 mg/day doses to prevent cardiovascular diseases and death and did not address the potential benefits of consuming fish, given the differences in dietary fish intake and omega-3 fish oil supplements.

“Physicians should use this advisory as a guide to make decisions on whether omega-3 fish oil supplements might be appropriate for some patients,” Siscovick said.

“The advisory concludes that supplementation with omega-3 fish oil may benefit patients with specific, clinical, cardiovascular disease indications, including patients with a recent prior heart attack and heart failure.”

Comments from the industry

Andrea Wong, Ph.D., and vice president of scientific and regulatory affairs at Council for Responsible Nutrition (CRN), commented on the findings: “Science demonstrating the benefit and safety of omega-3 fatty acids for heart health is well-established and this science advisory from the American Heart Association (AHA) reaffirms this fact. Coronary heart disease (CHD) is a serious condition, and we support the AHA’s recommendation that people with CHD use omega-3 fatty acids in consultation with a doctor.”

“Even though this advisory focused on major disease endpoints, we should not discount the significant amount of research that supports the role of omega-3s on other relevant endpoints, such as reducing triglycerides and blood pressure, which potentially help healthy adults prevent cardiovascular disease.”

“Omega-3 fatty acids are important for overall health and the benefits of this nutrient from food and dietary supplements go beyond cardiovascular health, providing support for perinatal health, inflammation, and cognitive function.”

“Ideally people should strive to eat a diet high in fatty fish, such as salmon and sardines, in order to obtain omega-3 fatty acids, but realistically, as data show, most people are not doing this. If you do not eat fatty fish on a regular basis, supplementing with omega-3s, along with eating a healthy diet and exercising, is a viable option for maintaining a healthy heart and for the other benefits the omega-3 supplements can provide.”

by Hannah Gardiner