Fish oil pills with heart shape

American Heart Association says fish oil works—for some people

But the group hesitates to recommend omega-3s for everyone.

The omega-3 fatty acids from fish oil represent a rare example of a nutritional compound that’s so effective, it became a pharmaceutical drug. So it should come as no surprise that the American Heart Association said fish oil supplements may help some people with heart disease.

The scientific advisory said there is a lack of evidence to recommend broad use in preventing heart disease in the general population, but said it may help prevent death from heart disease in patients who recently had a heart attack and may prevent hospitalizations and death in patients with heart failure.

“People in the general population who are taking omega-3 fish oil supplements are taking them in the absence of scientific data that shows any benefit of the supplements in preventing heart attacks, stroke, heart failure or death for people who do not have a diagnosis of cardiovascular disease,” said David Siscovick, MD, chair of the advisory committee in a report published in the AHA journal, Circulation.

The group reviewed randomized clinical trials that evaluated a potential role for fish oil supplements to prevent cardiovascular diseases, including two studies published before 2002 and 13 published since 2002, when the association last issued a scientific statement focused on fish and omega-3 fish oil supplements. The studies assessed the clinical effect of omega-3 fish oil treatment on outcomes such as heart attacks, strokes, atrial fibrillation (a heart rhythm disorder) and others.

While the AHA recommendation did not change since 2002 with fish oil helping people who had a recent heart attack, it made a change to note that people with heart failure—when the heart cannot adequately pump blood—can also benefit from fish oil supplements.

“Science demonstrating the benefit and safety of omega-3 fatty acids for heart health is well-established and this science advisory from the American Heart Association reaffirms this fact,” said Andrea Wong, PhD, vice president of scientific and regulatory affairs at the Council for Responsible Nutrition. “Coronary heart disease is a serious condition, and we support the AHA’s recommendation that people with CHD use omega-3 fatty acids in consultation with a doctor.”

Media reports of the published announcement were largely positive, even though the study fell short of the widespread acceptance of the omega-3s as being beneficial for the heart. Indeed, the pharma drug Lovaza has been approved by the FDA, at 4 g/dose, for reducing triglyceride levels—a condition seen as being important for heart disease prevention. Organizations from the March of Dimes to the American Academy of Pediatrics recommend pregnant and breastfeeding women consume adequate levels of DHA.

But of course the reason so many people supplement with the omega-3s DHA and EPA—from fish oil, yes, but also from krill, algae and plant sources—goes far beyond heart health. Omega-3s are a veritable Swiss Army Knife ingredient, with demonstrated efficacy on brain and eye health (especially in neonates) as well as joint health and even weight management.

The importance of DHA and EPA supplements—they’re not called essential fatty acids for nothing—is especially acute given that most people do not eat the recommended amount of fatty fish multiple times a week.

“Omega-3 fatty acids are important for overall health and the benefits of this nutrient from food and dietary supplements go beyond cardiovascular health, providing support for perinatal health, inflammation, and cognitive function,” said Wong. “Ideally, people should strive to eat a diet high in fatty fish, such as salmon and sardines, in order to obtain omega-3 fatty acids, but realistically, as data show, most people are not doing this. If you do not eat fatty fish on a regular basis, supplementing with omega-3s, along with eating a healthy diet and exercising, is a viable option for maintaining a healthy heart and for the other benefits the omega-3 supplements can provide.”

The Global Organization for EPA and DHA Omega-3s (GOED) recommends people consume 500 mg of EPA and DHA every day for general health, and higher quantities for specific life stages or health conditions. Most of the population consumes significantly less EPA and DHA than recommended.

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