Omega-3s have long been touted for their heart-healthy benefits, but new research shows that certain types of supplements may not do anything to stave off heart attack and death.
The two most common elements of popular omega-3 supplements — EPA and DHA — might actually work against each other in the body, the latest from the Intermountain Healthcare Heart Institute finds.
“You can’t buy any product off the shelf and assume that’s going to be good for you,” said Viet T. Le, researcher and principal investigator of the study, presented at the 2021 American College of Cardiology’s Scientific Session.
“We can still tell our patients to eat omega-3-rich foods, but we should not be recommending them in pill form as supplements or even as combined (EPA and DHA) products,” the physician assistant said.
The Utah-based study tracked blood samples taken from 987 patients from 1994 to 2012 to determine whether omega-3s helped to prevent stroke, heart attack, heart failure and other fatal heart events. It found that patients with the highest levels of eicosapentaenoic acid (EPA) did see a reduction in life-threatening events, but docosahexaenoic acid (DHA) did not have the same effect, even blunting the protective impact of EPA. The two long-chain fatty acids are commonly combined in supplemental omega-3 products.
Le said it is the EPA component “that really provides benefit.”
After consulting with a physician to decipher any risks or benefits, he said, patients should look for products with higher EPA levels.
“Our data adds further strength to the findings of the recent REDUCE-IT (2018) study that EPA-only prescription products reduce heart disease events,” Le said.
Patients with the highest levels of EPA had reduced risk of major heart events, but higher DHA levels worked against those patients, even producing higher risk for heart problems, including heart disease, which can lead to death.
Lifestyle changes and healthy behaviors, Le said, continue to be most beneficial for heart health.
“Don’t be afraid of fish. Other than worrying about lead in our fish, the behaviors that come with choosing diets that are enriched with fish are important,” he said. “In the end it comes down to lifestyle and if you practice good and healthy lifestyle habits, that will include thinking about fish and adding that to your diet.”
Doctors have recommended omega-3 fatty acids to help patients lower their cholesterol and improve heart health. The fatty acids have also been shown to help with the aging process and other conditions affecting the brain, nervous system and mental health.
And while omega-3s can come from fatty fish like salmon, tuna, trout and shellfish, such as crab, mussels and oysters, they are, however, more commonly ingested via fish oil supplements that contain both EPA and DHA, among other ingredients.
The National Institutes of Health estimates that more than 8 million people in America regularly take omega-3 supplements and Intermountain’s latest research shows that “science doesn’t really back this up for every single omega-3,” Le said.
EPA and DHA, he said, are similar and may void the heart health benefits patients and their doctors hope to achieve.