Heart health: higher doses of omega-3s are needed to reduce cardiovascular risk. Largest study on the role of EPA and DHA says so.
New research confirms the efficacy of omega-3s on the cardiovascular system and highlights the importance of higher dosages, compared with those currently recommended, to achieve better effects on heart health. Daily consumption of supplements containing at least 1,000 milligrams of EPA and DHA, would be associated with a reduced risk of coronary heart disease and stroke, with the protective effect increasing with quantity. The huge amount of data taken into account for the research suggests how omega-3 supplementation is an excellent strategy for the prevention of disease conditions, which cause millions of deaths worldwide each year, and the need to revisit the amounts of DHA and EPA recommended to date.
The study was published today in the journal Mayo Clinic Proceedings and led by Aldo Bernasconi, vice president of GOED (Global Organization for EPA and DHA Omega-3), together with a team of American, Russian and Finnish researchers.
Omega-3 and heart health. What do the studies say?
Despite significant progress in the prevention and treatment of diseases of the heart and blood vessels, they remain the leading cause of mortality worldwide. According to the Istituto Superiore di Sanità, in Italy cardiovascular diseases are responsible for 44% of all deaths; in particular ischemic heart disease, which is the leading cause of death. The main weapon of defense against such conditions, is the adoption of a correct lifestyle: a diet low in saturated fats, the elimination of alcohol and cigarette smoking, and the regular performance of physical activity. The consumption of EPA and DHA of marine origin, represents a promising strategy for the prevention of cardiovascular disease, as found in animal and epidemiological studies. Regarding the protective effect of omega-3s, however, some research has reached divergent conclusions. The reasons for this variability are not well understood, and although a number of possible explanations have been proposed, definitive data are lacking. Hypotheses range from natural variability in insufficiently large studies to interference in the mechanisms of action of omega-3s toward cardiovascular disease prevention and treatment strategies (particularly statin use). Furthermore, with regard to EPA and DHA supplements, previous meta-analyses have compared the effect of dosages slightly greater or less than 1,000 mg per day, using what is an arbitrary limit that would not allow for a proper assessment of the dose-effect relationship. In 2006, one study observed that a much higher dosage was associated with greater cardiovascular protection.
Are more than 1000 mg per day of EPA and DHA needed to reduce the risk of myocardial infarction?
The new study unveiled that omega-3 supplementation is associated with a reduced risk of cardiovascular events; specifically a 35% reduction in the risk of fatal myocardial infarction, 13% reduction in myocardial infarction, 10% reduction in coronary artery disease, and 9% reduction in coronary mortality. Unlike previous studies, this paper considers the totality of available studies on the effect of EPA and DHA amounts. The larger number of data and wider range of dosages allowed more precise and more robust estimates of dose-effect relationships. In fact, the meta-analysis included as many as 40 studies, analyzing data from 135,266 individuals. Dosages ranged from less than 800 milligrams per day up to 5.5 grams per day, with an average of 1,221 mg of omega-3. This is an update of a previously conducted meta-analysis covering all studies linking EPA and DHA supplementation with cardiovascular events published before August 2019. The issues considered for the study were myocardial infarction, coronary artery disease events, angina, stroke, heart failure, peripheral arterial disease, sudden death, unplanned cardiovascular surgery, and heart attack mortality. According to the authors of the research, the findings provide scientific evidence of the effectiveness of EPA and DHA in preventing cardiovascular events, particularly myocardial infarction, arguing that people who follow the diet, may be at greater risk of omega-3 deficiency. For Ellen Schutt, executive director of GOED, the study represents the most comprehensive analysis of the role of omega-3 doses on cardiovascular prevention to date, and lays the groundwork for revising recommendations on EPA and DHA amounts.
Will it be necessary to increase the recommended doses of omega-3s?
These results highlight that the protective effect of omega-3 supplements appears to increase with dosage, and recommendations on EPA and DHA intake should take the new data into consideration. Taking into account the relatively low costs, the lack of side effects of omega-3 supplementation, and the low interactions with other standard therapies used in cardiovascular prevention, the GOED itself could modify its dosage recommendations, recommending intake of at least 1,000 mg per day of omega-3. Currently, the recommendations call for between 250 and 500 mg of EPA and DHA per day, even given the fact that an average American in years past was taking 100 mg or less. It did not, therefore, seem to make much sense to recommend too high a dosage with the knowledge that few consumers would get there. Currently with the marketing of dietary supplements with higher concentrations of omega-3, higher dosages are achievable by taking one or two capsules a day.
Achieving high doses of omega-3 can be achieved by taking a highly concentrated supplement such as Omegor Vitality 1000, which contains as much as 900 milligrams of omega-3 in each capsule. This ultra-pure fish oil product has a mixture of EPA and DHA in a 2:1 ratio in the form of triglycerides, the form that best allows absorption in the intestines. Also in each capsule are 10 mg of Vitamin E, a powerful natural antioxidant.
Another omega-3 supplement with a very high intake of EPA and DHA is Meaquor 1000: each capsule contains 1080 milligrams of omega-3. This product is particularly good for maintaining normal levels of triglycerides and blood pressure.
Source: Bernasconi AA, et al, 2020. "Effect of Omega-3 Dosage on Cardiovascular Outcomes." Mayo Clinic Proceedings
