What a landmark weekend for omega-3s!
Two studies show that the long-chain polyunsaturated fatty acids EPA and DHA are indeed helpful in preventing cardiovascular disease.
But caveats abound.
The VITAL study, which stands for VITamin D and OmegA-3 TriaL, was presented at the 2018 American Heart Association Scientific Sessions on Saturday, Nov. 9, and simultaneously published in the New England Journal of Medicine.
While some media outlets focused on topline results that showed the fish oil did not reach statistical significance in reducing the risk of major cardiovascular disease events, other media outlets saw the truth of the matter in more than 25,000 subjects taking 2,000 IU vitamin D and 1,000 mg omega-3 fish oil concentrate containing 465 mg EPA and 375 mg DHA for more than five years.
- Almost a 30 percent reduction in heart attacks in the fish oil group compared with placebo (145 vs 200 in the placebo group).
- 50 percent fewer heart attack deaths in the fish oil group compared with placebo (13 vs 26 events).
- 40 percent reduction of heart attacks in fish oil groups who had less than 1.5 servings of fish per week, with even more dramatic effects among African-Americans.
- 17 percent fewer coronary heart disease events (308 vs. 370 in the placebo group).
- Reduction in the rate of cancer deaths two or more years later in people who took vitamin D.
“The study reaffirms the safety of both vitamin D and omega-3 fatty acids, and does not change decades of research showing how critical vitamin D and omega-3 supplementation are for overall health,” said Duffy MacKay, N.D., senior vice president of scientific and regulatory affairs at the Council for Responsible Nutrition. “Vitamin D plays an important role in bone health, immune function, and maintaining cardiovascular health in adults. Omega-3 is essential to cardiovascular health, prenatal health, and cognitive health.”
The major cardiovascular disease (CVD) events were specifically defined as the composite of myocardial infarction (aka, heart attacks), stroke and cardiovascular disease deaths. VITAL also looked at total invasive cancer reports in people who did not have a prior history of these illnesses. This is the first large-scale primary prevention trial—subjects included 25,871 men and women—looking at heart disease as an outcome.
2nd study results
In the other major study, called REDUCE-IT, researchers found a 25 percent cut in major adverse cardiovascular disease events after five years in those also taking statin drugs compared to the group that took just the statins.
The caveat in this study was it was a decidedly pharmaceutical-size dose—4,000 mg/day—and only using the omega-3 EPA.
The following results from REDUCE-IT were statistically significant when the treatment group was compared to placebo:
- Primary endpoint composite of the first occurrence of major adverse cardiovascular events, including cardiovascular death, nonfatal heart attack, nonfatal stroke, coronary revascularization, or unstable angina requiring hospitalization: 25% risk reduction.
- Key secondary composite of CV death, heart attack, or stroke: 26% risk reduction
- Cardiovascular death or nonfatal heart attack: 25% risk reduction
- Fatal or nonfatal heart attack: 31% risk reduction
- Urgent or emergent revascularization: 35% risk reduction
- Cardiovascular death: 20% risk reduction
- Hospitalization or unstable angina: 32% risk reduction
- Fatal or nonfatal stroke: 28% risk reduction
- Total mortality, nonfatal heart attack or nonfatal stroke: 23% risk reduction.
"I think the success of REDUCE-IT is a success in principle for the omega-3 field,” said William S. Harris, PhD; President of OmegaQuant, LLC and Research Professor, Department of Internal Medicine, University of South Dakota, Sioux Falls, SD. “But dose is a big deal – probably a bigger deal than EPA vs DHA.”