Many people, especially those over 60, take fish oil supplements with the hope of preventing heart disease, the leading cause of death in the United States.
Fish oil is rich in omega-3 fatty acids, which our bodies cannot produce naturally.
These supplements are quite popular, but their actual effectiveness in protecting the heart is still a subject of debate. Research so far has shown mixed results, and some recent studies even suggest that taking these supplements might not be entirely risk-free.
This has led experts to believe that the benefits of fish oil for heart disease prevention are not as straightforward as once thought.
One major study called the VITAL trial aimed to address this question. It was the largest randomized, placebo-controlled study to examine how omega-3s impact heart health in adults without a history of heart disease, stroke, or cancer.
The study involved nearly 26,000 people aged 50 and older and followed them for five years. Participants took 1 gram of omega-3 supplements daily.
The primary results, published in 2018, showed no significant reduction in the overall risk of major heart-related events, which included heart attacks, strokes, and deaths from cardiovascular disease.
However, when researchers dug deeper into the data, they found interesting results. People who ate less fish before the study and then took omega-3 supplements showed a 19% reduction in major cardiovascular events.
When they focused specifically on heart attacks, the reduction was even greater—28% overall and 40% among those with a low fish intake.
The researchers also identified three groups that seemed to benefit the most: people with low fish intake, those with two or more risk factors for heart disease (like smoking or high blood pressure), and African American participants.
Dr. JoAnn Manson, a lead investigator of the VITAL trial, explained that omega-3s appear to offer heart benefits, but not everyone experiences the same effects.
For instance, African American participants saw a 77% reduction in heart attacks, which led researchers to suspect that genetic differences might play a role in how people process omega-3s. However, the study did not find a similar benefit for reducing strokes, and the reasons for this are still unclear.
Another notable study, the REDUCE-IT trial, examined a prescription omega-3 medication called icosapent ethyl (EPA) in high-risk individuals who were already taking statins.
This trial involved 8,000 participants with high triglyceride levels and other heart risk factors like diabetes or a history of heart disease.
Over five years, the study found that taking 4 grams of this medication daily reduced the risk of major cardiovascular events by 25%. The positive findings led the FDA to approve icosapent ethyl for certain high-risk patients.
Despite these findings, experts agree there are still many unanswered questions. Researchers don’t fully understand which specific components of fish oil or omega-3s are most beneficial for heart health. There is also uncertainty about how these components work to protect the heart.
Furthermore, studies indicate that there may be risks associated with taking fish oil supplements. For example, fish oil capsules can sometimes be contaminated with heavy metals like mercury or might become oxidized, leading to potential problems with clogged arteries.
High doses of omega-3s can also raise the risk of atrial fibrillation (a condition that causes a rapid heartbeat) and bleeding.
Dr. Lawrence Fine from the National Heart, Lung, and Blood Institute emphasized that all this research is important in understanding omega-3s.
However, he advises anyone considering these supplements to consult their healthcare provider to decide if it’s suitable for them. He and other experts agree that a heart-healthy diet rich in fish is generally a better way to get omega-3s than relying on supplements.
Dr. Manson is hopeful that ongoing research, like extending the VITAL trial, will clarify the effects of different omega-3s, including EPA, and whether findings like the benefits seen in African Americans can be confirmed.
She urges people not to worry too much about using fish oil supplements but strongly advises against taking them in high doses without medical supervision.
Her bottom line: Aim to get omega-3s from a balanced diet that includes fish, rather than depending on supplements. This approach not only provides omega-3s but also other nutrients and benefits from whole foods, contributing to overall heart health.
If you care about heart health, please read studies that vitamin K helps cut heart disease risk by a third, and a year of exercise reversed worrisome heart failure.
For more information about heart health, please see recent studies about supplements that could help prevent heart disease, stroke, and results showing this food ingredient may strongly increase heart disease death risk.
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