Abstract
Background Omega-3 (n-3) fatty acids have previously been shown to reduce the risk of cardiac events, cardiac death, and all-cause mortality in randomized controlled trials. However, recent data have challenged the benefits of n-3 fatty acids in the current era of optimal medical therapy.
Methods We performed a literature review indicating important limitations that must be considered when interpreting the recent negative n-3 fatty acids trials.
Results Our review found relative strengths and weaknesses of both the older and more recent studies, along with many possible explanations for the disparate results. The principal difference between the older and the more recent n-3 studies was a greater use of background optimal medical therapy that may have reduced the benefit from n-3s. Additionally, some of the more recent n-3 trials used relatively low doses or tested n-3 supplementation on top of a relatively high baseline intake of n-3s.
Conclusion Despite the recent negative data about n-3 fatty acids, the overall evidence still supports the American Heart Association recommendation of 1 gram of eicosapentaenoic acid/docosahexaenoic acid per day for patients with coronary heart disease.
Footnotes
Financial Disclosure: Dr DiNicolantonio works for a company that sells omega-3 products, but he does not personally profit from the sales. Drs O>'Keefe and Lavie have both served as speakers and consultants to GlaxoSmithKline. Dr Lavie is also a speaker and consultant for Amarin. Mark McCarty is owner and science director of a small nutraceutical company that sells, among other products, a fish oil supplement. Dr O'Keefe is the founder and has major ownership interest in CardioTabs, a company that markets omega-3s. Dr Meier and Asfandyar Niazi disclose no conflicts of interest.
- © Academic Division of Ochsner Clinic Foundation
