AHA Releases New Fish Oil Supplementation Guidelines

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The American Heart Association has released new direction regarding fish oil supplementation that is inclusive of an updated 2002 Scientific Science Statement, Fish Consumption, Fish Oil, Omega-3 Fatty Acids and Cardiovascular Disease. The new advisory that has been published, Omega-3 Polyunsaturated Fatty Acid (Fish Oil) Supplementation and the Prevention of Clinical Cardiovascular Disease: A Science Advisory From the American Heart Association, encloses up to date guidance on the use of fish oil supplementation.

In the report, it was stated that patients with prevalent coronary heart disease (CHD) may take omega-3 supplements as a secondary prevention of CHD. However, based on a lack of evidence, the AHA does not recommend that omega-3 supplements be used as a primary prevention method for atrial fibrillation (a-fib), CHD or heart failure.

The Global Organization for EPA and DHA Omega-3’s (GOED) is advising that although omega-3 supplementation has not be reported as being beneficial to everyone, they have concluded the following regarding the report:

  • The advisory reinforces that omega-3s are important for cardiovascular function and affirms that treatment with EPA and DHA supplements is appropriate for some specific populations.
  • The new update gets a little more specific about where omega-3 supplements may be valuable, but it does not really change the prior AHA recommendation significantly. Remember, the AHA never recommended supplementation for the general population, only for those with diagnosed CHD. For the general population, the AHA recommended consuming two servings of fatty fish. This current recommendation does not assess fish intake.
  • The panel made no recommendation on whether EPA and DHA supplements could prevent cardiovascular events in the general population because a large trial is currently underway to assess this. They did not say there was no effect; they essentially said let’s wait and see.
  • The lack of a recommendation for fish oil supplementation in the general population does not undermine the importance of getting enough EPA and DHA in the diet, even for heart health where RCTs have shown they help maintain healthy blood pressures, triglyceride levels and heart rates.
  • The advisory only assessed the RCT evidence for supplements in specific outcomes, not whether adequate intakes of EPA and DHA in the diet are associated with a healthy heart or cardiovascular outcomes, which has been observed consistently in long-term observational studies, including studies conducted by many of the advisory’s authors.
  • Penny Kris-Etherton, one of the authors of the advisory, noted that supplements can still play a role in getting enough EPA and DHA into the diet. “People are not getting enough omega-3 fatty acids,” Kris-Etherton said. “Of course, people should eat fish first, but if they can’t meet those recommendations with fish, fortified foods or supplements are OK.”
  • The findings from the report underscore that despite the fact that omega-3s are the most clinically researched nutrients in human nutrition, we are still at the beginning of understanding all the roles EPA and DHA play in the body. There were multiple areas of cardiovascular health where the panel noted that no research has yet been conducted.

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