Protect Your Heart with Fish Oil

This review highlights the use of fish oil for heart disease prevention.

"The American Heart Association (AHA) has endorsed the use of omega-3 fatty acids for secondary prevention of cardiovascular (CV) events in people with documented coronary artery disease (CAD)," write John H. Lee, MD, from the Mid America Heart Institute and University of Missouri-Kansas City, and colleagues. "The recommendation calls for approximately 1 g/d of a mixture of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Although the AHA statement identifies oily fish as the ideal source, fish oil (in capsules or liquid form) is also an acceptable option."

This recommendation is the first time that the AHA has recommended a nutritional supplement for heart attack prevention, and it is supported by a large and growing body of evidence. Even the US Food and Drug Administration (FDA) has approved an omega-3 fatty acid ethyl ester formulation, at a dosage of 4.0 g/day, for addressing very high triglyceride levels.

To date, the strongest evidence showing heart protection from omega-3 fatty acid intake comes from 3 large controlled trials in which a total of 32,000 participants were randomized to placebo or fish oil. In these trials, the supplemented group had a 19% to 45% reduction in heart attacks vs the control group. To put this in perspective, cholesterol-lowering medications only decrease heart attack deaths by 1.4% (see "Cholesterol Medications").

Two meals of oily fish per week can provide enough fish oil to protect the heart as can 2 capsules of fish oil or 1 teaspoon of a liquid fish oil) daily.

One tablespoon of standard liquid fish oil twice weekly contains approximately the same amount of omega-3 fatty acids as 6 oz of salmon consumed twice weekly (500 mg/day of DHA and EPA).

"Omega-3 fatty acid supplements can be taken at any time, in full or divided doses, without raising concerns for interactions with any medications," the reviewers conclude. "Omega-3 fatty acids persist in cell membranes for weeks after consumption, and thus intermittent dosing—i.e., twice weekly intake of fish or fish oil, provides the same benefits as daily consumption of lower doses."

Fish oil may also decrease the risk of abnormal heart rhythms and sudden cardiac death.

References:

Mayo Clin Proc. 2008;83:324-332.

"Omega-3 fatty acids: antiarrhythmic, proarrhythmic or both?" von Schacky C, Curr Opin Clin Nutr Metab Care, 2008; 11(2): 94-9.