Valentine’s Day is Coming: Are you Getting Enough EPA and DHA for your Heart? 11 Feb 2013
Ever wondered if you were consuming enough omega-3 fatty acids to be good for your heart? It is always interesting to ask researchers about nutrient recommendations. Some experts will give a personal endorsement. Others will say the evidence is insufficient and more research is needed. Others will declare their commitment to the concept ‘do no harm’ and preach against the dangers of excesses. Who to believe? What to do?
Two new studies help us reach a decision. They build upon the 2002 American Heart Association scientific statement:
Omega-3 fatty acids have been shown in epidemiological and clinical trials to reduce the incidence of CVD. Large-scale epidemiological studies suggest that individuals at risk for CHD benefit from the consumption of plant- and marine-derived omega-3 fatty acids, although the ideal intakes presently are unclear. Evidence from prospective secondary prevention studies suggests that EPA+DHA supplementation ranging from 0.5 to 1.8 g/d (either as fatty fish or supplements) significantly reduces subsequent cardiac and all-cause mortality.
But at that time, the AHA recognized that more research was needed:
RCTs have demonstrated that omega-3 fatty acid supplements can reduce cardiac events (eg, death, nonfatal MI, nonfatal stroke) and decrease progression of atherosclerosis in coronary patients. However, additional studies are needed to confirm and further define the health benefits of omega-3 fatty acid supplements for both primary and secondary prevention.
They also recognized that supplementation may be required to get sufficient intakes of EPA and DHA:
A dietary (ie, food-based) approach to increasing omega-3 fatty acid intake is preferable. Still, for patients with coronary artery disease, the dose of omega-3 (≈1 g/d) may be greater than what can readily be achieved through diet alone ( Table 5 ). These individuals, in consultation with their physician, could consider supplements for CHD risk reduction. Supplements also could be a component of the medical management of hypertriglyceridemia, a setting in which even larger doses (2 to 4 g/d) are required ( Table 5 ).
Two new research studies eludicate the importance of getting enough EPA and DHA for your heart. The first is a study in people with kidney disease undergoing hemodialysis. Hemodialysis using an artificial kidney to remove waste and fluid from the blood. People with kidney disease have a high risk of sudden cardiac death during the first year of hemodialysis. Friedman and colleagues report that omega-3 status at the onset of hemodialysis predicts risk of a cardiac event. This may occur because hemodialysis removes lipids, including EPA and DHA, from the circulation. Thus, EPA and DHA levels can fall unless they are eating lots of fatty fish, which is probably not the case.
And the risk of low EPA and DHA status is explained by the research of Phang and colleagues. They conducted a randomized placebo controlled trial (RCT) with 94 healthy men and women. For 4 weeks, these men and women received EPA-rich (1000 mg EPA & 200 mg DHA) or DHA-rich (200 mg EPA & 1000 mg DHA) daily. Increasing omega-3 fatty acid intakes significantly reduced platelet aggregation and markers of inflammation. In both men and women, EPA reduced platelet aggregation but there were sex differences with respect to the effect of DHA.
So the 2002 AHA recommendations still stand. Don’t let your heart be at risk from poor circulation associated with inadequate EPA and DHA intakes. -mm-
Friedman AN, Zhangsheng Y, Tabbey R, Denski C, Tamez H, Wenger J, Thadhani R, Li Y, Watkins BA. Inverse relationship between long-chain n-3 fatty acids and risk of sudden cardiac death in patients starting hemodialysis. 2013 Kidney Intern doi: 10.1038/ki.2013.
Phang M, Lincz LF, Garg ML. Eicosapentaenoic and docosahexaenoic acid supplementation reduces platelet aggregation and hemostatic markers differentially in men and women. 2013 J Nutr doi:10.3945/jn.112.171249