Meta-analysis of Long-Chain Omega-3 Fatty Acids and Coronary Heart Disease Risk Interview with:
Dominik D Alexander, PhD, MSPH

Principal Epidemiologist
EpidStat Institute
Ann Arbor, MI Seattle, WA What is the background for this study? What are the main findings?

Response: In recent years, the body of scientific literature on n-3 LCPUFA (EPA/DHA) intake and coronary heart disease (CHD) risk has exploded with mixed results. It was only logical to conduct a comprehensive meta-analysis of randomized controlled trials (RCTs) to estimate the effect of EPA+DHA on CHD, and to conduct a comprehensive meta-analysis of prospective cohort studies to estimate the association between EPA+DHA intake and CHD risk.

Among RCTs, there was a nonstatistically significant reduction in CHD risk with EPA+DHA
provision (SRRE=0.94; 95% CI, 0.85-1.05). Subgroup analyses of data from RCTs indicated a statistically significant CHD risk reduction with EPA+DHA provision among higher-risk populations, including participants with elevated triglyceride levels (SRRE=0.84; 95% CI, 0.72-0.98) and elevated low-density lipoprotein cholesterol (SRRE=0.86; 95% CI, 0.76-0.98). Meta-analysis of data from prospective cohort studies resulted in a statistically significant SRRE of 0.82 (95% CI, 0.74-0.92) for higher intakes of EPA+DHA and risk of any CHD event. What should readers take away from your report?

Response: Heart disease morbidity and mortality is a global public health burden, with poor diet (e.g. low EPA/DHA intake) being a leading cause of CHD burden. Authoritative bodies recommend intake of EPA+DHA for heart and overall health. This comprehensive meta-analysis of data from RCTs and prospective cohort studies supports such recommendations. Although not statistically significant, a 6% reduced risk of any CHD event was observed among RCTs. This finding was supported by a statistically significant 18% reduced risk of CHD among the prospective cohort studies.

From a clinical perspective, the results indicate that EPA+DHA may be associated with reducing CHD risk to a greater extent in populations with elevated triglyceride levels or elevated LDL cholesterol, which are risk factors that impact a significant portion of the general adult population in the United States. Our meta-analysis of randomized controlled trials and prospective cohort studies of EPA and DHA long-chain omega-3 fatty acids and coronary heart disease risk provides a significant step in the evolution of the state of the science on this topic area. What recommendations do you have for future research as a result of this study?

Response: Additional RCTs with more homogeneous exposure and outcome classifications with longer follow-up periods may continue to provide a better understanding of the promising beneficial relationship between EPA+DHA and CHD risk. Our comprehensive analysis serves as a foundation for future studies that examine the effects of EPA+DHA on coronary heart disease risk. It is expected that as new studies are conducted and published, data from these studies can be integrated into our analyses to garner an ongoing appraisal of the evidence in real-time. Is there anything else you would like to add?

Response: I am a Principal Epidemiologist with EpidStat Institute (Seattle, WA; Ann Arbor, MI). This study was supported by funding from the Global Organization for EPA and DHA Omega-3s (GOED). Thank you for your contribution to the community.


The article is open access. Here is the link Also, there is an accompanying editorial written by three well-respected medical doctors. Here is the link

A Meta-Analysis of Randomized Controlled Trials and Prospective Cohort Studies of Eicosapentaenoic and Docosahexaenoic Long-Chain Omega-3 Fatty Acids and Coronary Heart Disease Risk

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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