The science of EPA/DHA for heart health

In the last two years, conclusions among meta-analyses looking at omega-3s and coronary heart disease (CHD) outcomes have been inconsistent, but a closer look suggests much is left to the interpretation of the results.

Harry B. Rice

August 31, 2018

2 Min Read
The science of EPA/DHA for heart health

Research articles on the cardiovascular benefits associated with the long-chain omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are published almost daily. While most report positive results, the ones reporting neutral results (i.e., no benefit) seem to garner the most attention from the media. In the last two years, conclusions among meta-analyses looking at omega-3s and coronary heart disease (CHD) outcomes have been inconsistent, but a closer look suggests much is left to the interpretation of the results. For the last 10+ years, the benefit of omega-3s on CHD/cardiac death has been consistently reported.

In 2016, the U.S. Agency for Healthcare Research and Quality (AHRQ) published “Omega-3 Fatty Acids and Cardiovascular Disease: An Updated Systematic Review” with mixed findings (Balk et al. 2017). While most of the findings in the 1,000+ page report were not unexpected, it was a surprise that the authors concluded there was a low strength of evidence of no association of EPA/DHA and CHD death. Curiously, this was based on only five RCTs reporting on cardiac death (combined CHD and other cardiac death) and no statistics were provided. When the Global Organization for EPA and DHA Omega-3s (GOED) ran the statistics, it found a 17 percent risk reduction, but it just missed statistical significance, which was most likely due to a lack of power. While there was pre-specified inclusion and exclusion criteria applied, the criteria may have missed some studies given its “arbitrary” nature. More specifically, the authors stated, “Due to the very large number of potentially eligible studies (more than 400), we applied arbitrary thresholds based on sample size, follow-up duration, and whether subgroup or interaction analyses were reported.” Had a scientifically substantiated threshold been chosen, additional studies may have been included, resulting in increased power and statistically significant results.

This is an excerpt from the article, “EPA/DHA Cardiovascular Science Update.” To read the complete article, download INSIDER’s Heart Health digital magazine.

About the Author

Harry B. Rice

Harry B. Rice, Ph.D., is the vice president of regulatory and scientific affairs for the Global Organization for EPA and DHA Omega-3s (GOED), and the past vice president of the United Natural Products Alliance (UNPA). He has worked in the ingredient, dietary supplement, functional food and consumer packaged goods industries for more than a decade. Among Rice’s responsibilities for GOED are monitoring and reporting on regulatory issues, developing written comments and oral testimony to domestic and international government bodies to advance industry positions on critical health issues, and providing scientific analysis of the growing body of scientific literature. Previously, he spent over six years at Cargill Inc. involved in the development and execution of global regulatory and scientific strategies for a wide range of functional ingredients.

 

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