Should You Give Up on Fish-Oil Pills?
Fish, not fish-oil pills, are your best source of heart-healthy omega-3 fatty acids. Alice H. Lichtenstein, DSc, director of Tufts’ HNRCA Cardiovascular
Nutrition Laboratory, advises: "It is better to rely on dietary sources of omega-3 fatty acids, fish, than pills. Not only will one get the benefit of the omega-
3 fatty acids, but eating fish means it is less likely that the entrée will be steak or quiche, both high in saturated fat."
That advice comes after another new study casting doubt on the cardiovascular benefits of fish-oil pills. The analysis by Greek scientists found no significant association between omega-3 supplementation and reduced risk of stroke, heart attack, all-cause mortality, cardiac death or sudden death. The findings come only months after the ORIGIN study, a large clinical trial, failed to report any benefits from fish-oil supplements compared to placebo (see the October newsletter).
POOLING 20 STUDIES. In the new meta-analysis, published in JAMA, Moses Elisaf, MD, PhD, of the University Hospital
of Ioannina and colleagues pooled results from 20 randomized trials totaling 68,680 participants. All the trials lasted at least a year, with an average of two years. The average dose of omega-3s was 1.51 grams daily, about the amount in four or five commercial fish-oil pills.
Combined, the studies included 7,044 deaths, 3,993 heart-related deaths, 1,150 sudden deaths, 1,837 heart attacks and 1,490 strokes. The analysis found no statistically significant association between omega-3 supplementation and any of these outcomes.
Researchers concluded that the findings "do not justify the use of omega-3 as a structured intervention in everyday clinical practice or guidelines supporting dietary omega-3 polyunsaturated fatty acid administration."
A spokesperson for an omega-3 industry trade group called the review "flawed," citing the possibility of confounding
by heart medications that make it difficult to detect a benefit from adding any single new factor such as fish oil. The trade association also argued that dosages
in the trials were too low and/or the durations too short.
FISH TWICE A WEEK. The American Heart Association recommends eating at least two 3.5-ounce (cooked) servings a week of fish, preferably the fatty fish high in omega-3s—salmon, mackerel, herring, lake trout, sardines and albacore tuna. According to the association, “Omega-3 fatty acids benefit the hearts of healthy people, and those at high risk of—or who have—cardiovascular disease. Research has shown that omega-3 fatty acids decrease risk of arrhythmias (abnormal heartbeats), which can lead to sudden death. Omega-3 fatty acids also decrease triglyceride levels, slow growth rate of atherosclerotic plaque, and lower blood pressure (slightly).… Increasing omega-3 fatty acid consumption through foods is preferable."
When increasing your omega-3 intake by eating more fish, Tufts’ Lichtenstein says, "Adding a few vegetables to the plate is a good idea. And remember, breaded deep-fried fish fillets don’t count. Other types of fish do count, leaving the cream sauces and cheese behind."