Omega-3 Fatty Acids: Fishy business?

What are Omega-3 fatty acids?

Omega-3 fatty acids are a type of polyunsaturated fats, and considered a healthy fat, that are critical for normal cell function, which are not made in sufficient quantities in the body.  Therefore, it is important to consume Omega-3 fatty acids in the diet.  Omega-3 fatty acids are grouped into two types: Alpha-linolenic acid (ALA) primarily from plants and Eicosapentaenoic acid (EPA) as well as Docosahexaenoic acid (DHA) primarily from seafood and fatty fish.

Why are Omega-3’s important?

The Omega-3 fatty acids are critical for good heart health, brain health, as well as anti-inflammatory benefits.

For heart health, Omega-3 fatty acids can lower triglycerides in the blood as well as potentially reduce the risk of heart disease and heart attack.  Additionally, Omega-3 fatty acids may lower the risk of blood clots.  There are some reports of increased risk of atrial fibrillation with Omega-3 fatty acid supplementation.

Dietary intake of Omega-3 fatty acids has been linked with lower risk of dementia.

The anti-inflammatory effects of Omega-3 fatty acids can help with conditions such as autoimmune disease such as rheumatoid arthritis, lupus and Crohn’s disease.

Other benefits of Omega-3 fatty acids include lowering risk of cancer including breast cancer, improving asthma, and lower risk of eye disease including macular degeneration.

Which Omega-3 has the most benefit?

The Omega-3 Eicosapentaenoic acid (EPA) has the strongest scientific evidence for benefit at lowering heart disease risk, specifically those individuals with high triglycerides, and preexisting heart disease with a normal cholesterol.  The EPA type of Omega-3 is found mostly in fatty fish, such as mackerel, salmon, and anchovies, which is an important part of a heart healthy diet.  Consuming fish with high levels of mercury such as shark, swordfish, tilefish, bluefin tuna and bigeye tuna can be dangerous and should be taken into consideration.

What studies show benefits of Omega 3?

The study (REDUCE-IT) published in the New England Journal of Medicine evaluated individuals with high triglyceride levels (125-499 mg/dL) and relatively normal LDL levels (41-100 mg/dL) and prior establish atherosclerotic cardiovascular disease or other high risk features including diabetes.  In those individuals taking 4 grams daily of EPA Omega-3, there were less major cardiac events including death from cardiac issues, heart attack, needing revascularization (stent procedure or heart bypass surgery), stroke that did not result in death or unstable angina (new or worsening chest pain or symptoms from plaque related blockage in the blood vessels of the heart) compared to those that were not taking EPA.

Of note, more individuals taking the EPA Omega-3 were hospitalized for abnormal heart rhythms including atrial fibrillation or atrial flutter.