ABC World News (9/11, story 4, 2:35, Sawyer) reported, “The American Heart Association has long said that eating oily fish is good for your heart, so millions of people take fish oil supplements hoping for the benefit and, in fact, doctors often recommend the supplements for people who already have heart disease. But a big new study out tonight says those pills are not doing what they thought.”
On NBC Nightly News (9/11, story 7, 2:15, Williams), chief science correspondent Robert Bazell said, “The research out today combined 20 previous studies involving more than 68,000 patients since 1989.
USA Today (9/12, Weise) reports the researchers “found no statistically significant association between all deaths, cardiac-related deaths, sudden deaths, heart attacks and strokes among people taking the supplements.”
MedPage Today (9/12, Neale) reports that the study authors wrote that the results “do not justify the use of omega-3 as a structured intervention in everyday clinical practice or guidelines supporting dietary omega-3 polyunsaturated fatty acid administration.”
“There’s never been any compelling evidence of a clinical benefit,” said Dr. Steven Nissen, professor of medicine at the Cleveland Clinic Lerner School of Medicine.
“I still say it’s very important for my patients to have a plant-based diet with omega-3 rich fatty fish as part of a heart-healthy Mediterranean-like dietary strategy which holds benefits probably above and beyond individual omega-3 pill supplements.,” said Long Island Jewish Hospital’s David Friedman MD
Blogfinger Medical Commentary: By Paul Goldfinger, MD, FACC
A word on terminology: the substances in question are supplements containing omega-3 polyunsaturated fatty acids (PUFAs). This research did not look at dietary sources of PUFAs, which can be found especially in fatty fish (mackerel, sardines, lake trout, albacore tuna and salmon) as well as in walnuts, cashews, and flax seed.
What the summary above did not stress was that small benefits were found in this trial for the supplements, including 9% reduced cardiac death, 11% reduced heart attacks and 13% reduced sudden cardiac death. So, even though those authors did not find significant benefit in their end points, fish oil capsules are usually safe and can offer some potential small cardiovascular advantages as well as lowered triglycerides and perhaps some unproven benefits for other medical problems such as high blood pressure, blood clotting and arrhythmias. These real and potential benefits are no small achievement for a nutritional supplement as compared to actual pharmaceutical drugs
This is what we said about fish oil supplements in our 2011 book, “Prevention Does Work: A Guide to a Healthy Heart”:
“Fish oil supplements: Capsules containing fish oils may offer the benefits of omega-3 fatty acids, but most of the evidence of benefit was obtained from studying people who ate fish frequently. Taking fish oil capsules may reduce the risk of heart attacks and other complications, but the evidence is still incomplete. One cannot assume that fish oil capsules will confer the same protection as eating fish. On the other hand, the Italian GISSI Trial found a moderate reduction in cardiac risk with fish oil supplements.”
Note that $1.1 billion is spent each year in the US on fish oil capsules.
My advice is to try to get the benefits of fish oil by eating fish. The American Heart Association recommends eating fish at least twice per week. There have been two large diet trials with over 1,000 patients, and these trials showed a benefit from eating fish.