Are Omega-3 supplements worth it?
I hope you are safe and well. Millions of people around the world take daily Omega-3 supplements in the hope they help healthy hearts. But what’s the evidence on Omega-3 supplements? Are they worth it?
We asked 11 cardiologists and nutritionists on Metafact. We found a 91% expert consensus suggesting Omega-3 supplements are likely to lower the risk of heart disease - but there was a big caveat - the benefits are not universal and only come to a select small proportion of the population. Here’s more details of what we found.
What is Omega-3 and what does it do?
Omega-3 fats are essential for health and only come from food. The three main types of omega-3 fats are alpha-linolenic acid (ALA) which is found in plant foods such as walnuts, soy and canola; long-chain omega-3 fatty acids of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Fish and fish oil are key dietary sources of EPA and DHA.
Having more omega-3s in the diet has been suggested as way to help lower the risk of heart disease by their effects on blood clotting, blood pressure, cholesterol and heart muscle function. One common piece of advice is to consume more fish or to consider taking fish oil capsules, which are now one of the most common over-the-counter supplements used to boost omega-3 intake.
What do experts say on Omega 3 and a healthy heart?
Diet, exercise, not smoking and in some cases, medications are the cornerstone of reducing the risk of heart disease. So, how strong is the evidence for omega-3s supplements in helping to lower the risk of heart disease?
The majority of the 11 experts we asked were in agreement that there is good clinical evidence to support the beneficial effects of omega-3 supplements on cardiovascular health; however, they say clinical trials results have been mixed.
Several individual factors seem to influence whether someone gets a benefit from taking omega-3 supplements. Dr George Billman from Ohio State University noted that despite a strong association between fish consumption and a reduced incidence of adverse cardiovascular events and earlier mortality, clinical trials that investigated the effects of omega-3 fatty acid supplements on these cardiovascular events have not always confirmed this initial observation. The form of supplement (EPA versus DHA), background diet, genetics and heart disease risk factors impact the response.
Evidence is mixed and not universal for everyone
A recent Cochrane review meta-analysis of 79 randomised placebo-control clinical trials with 112,059 patients concluded that “increasing EPA and DHA had little or no effect on mortality or cardiovascular health”. The Cochrane Library is a collection of high-quality, independent reviews to provide evidence to inform healthcare decision-making.
A recent large multiyear trial was completed called Vitamin D and Omega-3 Trial (VITAL) with 25,871 healthy adults who had no history of cardiovascular disease. Overall daily Omega-3 supplements didn't help protect healthy people against future heart problems “but some groups tended to benefit, while other groups didn't” said Dr. JoAnn Manson, the lead scientist of the study from Harvard Medical School. In particular, those who seemed to benefit were those people who don’t eat enough fish (1.5 fish servings a week is the recommended amount). For these people, there was a “40% reduction in heart attacks," Dr. Manson told Harvard Health.
Supplements don’t replace a healthy diet
As cardiologist Dr Suzanne Steinbaum from Mount Sinai Hospital in New York writes
Supplements aren’t a replacement for a healthy diet, but they can be important when attempting to bridge the gaps in your diet.
Overall for healthy people with good diets - the evidence suggests omega 3 supplements aren’t likely to help much. But for those with poor diets and high-risk of cardiovascular disease, there could be some benefit.
The greatest benefits experts say, come from living a healthy lifestyle by not smoking, enjoying regular exercise, and eating a heart-healthy diet such a Mediterranean-style diet. Getting your omega-3 fatty acids from food is always preferable to a supplement But always ask your doctor to determine if a supplement makes sense for you.
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Stay safe and may the facts be with you!
Ben McNeil, Founder of Metafact
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