The omega effect

Recognize the picture? It’s actually a movie from the 50s about the last man on earth – and if that sounds familiar, then you might know it as the remake, I am Legend. Omega 3 fatty acids are advertised like they can turn you into The Omega Man, but how good are they really for your heart? 

The Lancet looked at marine omega-3 acids (or n-3 PUFA if you want to get technical), and generally the results were beneficial, but pretty minor. When looking at coronary artery disease, they noted that the JELIS study (from Japan in 2007) noted a lower risk of an acute coronary syndrome with an omega-3 on board, but the most benefit was for people who already had coronary artery disease, high triglycerides, low HDL or impaired glucose tolerance. There’s not a great deal of evidence for them for patients who are otherwise well. 

Omega-3 fatty acids also might have a beneficial effect on atrial fibrillation, depending on whether it’s secondary to heart failure or whether there has been electrical remodelling of the atrium. 

Generally though, omega-3’s do lower triglycerides, which can be a useful touch when starting people on a lifestyle regimen for hyperlipidaemia. According to the GISSI trial, they may even be useful in heart failure – would be an interesting trial to do. 

NEJM also comments on the omega-3 fatty acid saga, testing patients who had margarine supplemented with various omega-3 acids. Unfortunately, neither of the combinations they tested reduced the risk of a major cardiovascular event significantly – but this is in patients who are already optimally medically treated. 

It looks like omega-3 fatty acids can be beneficial in the right groups – people with coronary artery disease, heart failure, hyperlipidaemia, and possibly impaired glucose tolerance – but not if they are already on optimal medical management. Still, a useful adjunct in lifestyle management, and an area of ongoing research. 

Read more about it over at NEJM here and The Lancet here. Do you take omega-3?

IMAGE: Warner Bros


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