The meta-analysis concluded that supplementing with omega-3 fatty acids does not have an impact on coronary heart disease or major vascular events. It looked at 10 clinical trials with nearly 78,000 participants.
However, there are a number of serious problems with the analysis. First of all, a minimum dose of EPA or DHA was never specified, which the University of Guelph’s Dr. Bruce Holub cites as being problematic. He said that mixing low doses can complicate meta-analysis and pointed out that some of the doses were as low as 400 milligrams per day, falling short of the 500-milligrams-per-day recommendation.
The paper does say that there was a 7 percent lower risk of a major vascular event and a 10 percent lower risk of coronary heart disease with omega-3 supplementation. Dr. Holub takes issue with the researchers dismissing this finding, saying: “...I don’t think one can dismiss and disregard a 7 percent reduction in the risk of coronary heart disease.”
Moreover, he pointed out: “We know that many of the conventional prescription medications for coronary disease often don’t provide any more benefit than 7 percent even though they’re very important and do offer a significant impact.”
Experts defending omega-3’s benefits
The National Products Association (NPA) issued a statement defending the role that omega-3s can play in lowering cardiovascular risk. The NPA’s Dr. Daniel Fabricant wrote that even the FDA seems to hold a different view than the researchers as they have already given approval to a prescription medication containing fish oil to benefit those with cardiovascular problems. In addition, he points out that the FDA has approved a qualified health claim for cardiovascular diseases on Omega-3 fatty acids.
The study had a few other limitations. For example, the study designs of the randomized trials assessed varied widely. In addition, there was a lack of data on the cancer history and smoking status of the individual participants, which would have impacted the person’s chances of developing heart disease or dying as a result of it.
Dr. Carl Lavie, the University of Queensland School of Medicine’s Preventive Cardiology Medical Director, said that he feels omega-3 supplements remain a reasonable choice because of their safety, low cost, and lack of serious side effects. He was not involved in the study, but he said that the evidence for omega-3 does not need to reach the same threshold as expensive and risky drugs. He said the supplements are especially useful for patients who prefer to avoid medications.
EpidStat Institute’s Dr. Dominik Alexander agrees. He said that those who take these supplements should not stop, and he also pointed out they offer a host of other health benefits that make them worthwhile. For example, they can help in areas like eye health, cognition and memory. He suggests that people avoid smoking, maintain a healthy body weight, exercise regularly, and eat fatty fish or use high-quality omega 3 supplements for optimum health.
Four large trials on the topic are set to be completed next year, nearly doubling the number of subjects whose data could be used to make a more comprehensive meta-analysis.
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