Omega 3 Fish Oil Supplements
EPA vs. DHA: Which is Best For Your Heart? There has been a lot of controversy around fish oils over the years—like whether or not they influence the risk of heart disease and whether they are better to get from food or supplements.
There’s also a lot of confusion about which type of omega-3 fats in fish oil supplements are most important—DHA or EPA?
First a quick background. In 2018, the REDUCE-IT trial was published in the New England Journal of Medicine. It showed that a prescription drug providing high-dose EPA reduced cardiovascular events. Because of that, the US FDA as well as Health Canada and European countries approved the drug to reduce cardiovascular risk in people with high triglycerides.
Above is a class I did on the background of Omega 3 fatty acid supplements and the FDA. You have not always been able to get fish oil supplements easily. Now that there is a FDA approved prescription for EPA, the price has gone up exponentially for that approach.
But since then, studies of fish oils have produced mixed results. The authors of this study screened 798 articles and pinpointed studies that met the investigator’s selection criteria. Namely, they looked at randomized placebo controlled trials with follow up of at least 12 months duration. The trials looking at EPA supplements alone had dosing up to 4 grams daily. The trials looking at EPA+DHA supplements had dosing up to 5.5 grams daily. There were no studies looking only at DHA supplements alone, a limitation of this study.
Now we have a newly published meta-analysis that looks at 38 randomized controlled trials of omega-3 fatty acids. Here’s what you need to know:
- The 38 studies included a total of more than 149,000 participants
- Some studies evaluated EPA alone and some combined EPA + DHA
- No trials studied the effects of DHA alone
- The studies looked at key cardiovascular outcomes, like cardiovascular deaths, bleeding, and atrial fibrillation
- Overall, omega-3s improved cardiovascular outcomes
- EPA alone showed better outcomes than combined EPA + DHA
Even though they are both omega-3 fatty acids, EPA and DHA have different chemical structures and different effects in the body. This latest research confirms that EPA is likely more specific to heart health than DHA.
Please remember that we provide these research updates to share information and knowledge but NOT to replace medical advice. Heart health is a serious topic that is best addressed with your healthcare practitioner. Whenever considering supplementation, we need to look at your health history, health conditions, medications, and more.
To get a personalized assessment and recommendations, please click through to our website www.healthwithoutrisk.com or send an email to email@example.com and ask for guidance. We’ll send you an intake history form as well as a metabolic assessment form that will help outline development of goals you would like to achieve in managing, taking control of and advocating for your own health as you age.
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Khan SU, Lone AN, Khan MS, et al. Effect of omega-3 fatty acids on cardiovascular outcomes: A systematic review and meta-analysis. E Clinical Medicine. 2021. [link]