Benefits of fish oil remain sound in preventing and treating heart disease

17 September 2012

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The Australian Self-Medication Industry (ASMI) said the overwhelming weight of evidence supports the use of omega-3 fatty acid supplements for patients with heart disease.

ASMI Regulatory and Scientific Affairs Director, Steven Scarff, said that the most recent study1, which questions the efficacy of omega-3 fatty acid supplements, was at odds with the large body of evidence which demonstrates the benefits of fish oil supplements in providing primary and secondary prevention in patients with cardiovascular disease.

The results from this later study, a systematic review and meta-analysis, do not change the balance of scientific evidence which demonstrates a cardiovascular benefit of omega-3 fatty acids in healthy populations, as well as in the majority of populations with pre-existing cardiovascular ailments.

Consumers should therefore continue to take omega-3 products for heart health.
Several aspects of the study warrant careful consideration. Most importantly, this study looked at people who have already suffered heart attacks or strokes rather than the general healthy population, and failed to take into account the effect of cardiovascular disease medications consumed by subjects in the studies.
It should be noted that while earlier studies were carried out in the pre-statin era, the authors of the study indicate that "half of the included trials had been conducted during the period where statins were routinely recommended for cardiovascular risk modification (1998 or later)".

Subjects in the more recent trials were also given multiple prescription medicines (e.g. cardiac glycosides, antiarrhythmics, antihypertensives, hypolipidemics, antianginals, anticoagulants, beta-blockers, calcium channel blockers, diuretics and/or vasodilators) as well as Omega- 3s. This makes it very difficult for researchers to work out what benefits any individual substance, whether fish oil or medication, may have had.
The study findings contrast with a strong body of evidence that supports fish oil supplements in both preventing heart disease, and in patients that have suffered heart disease.

The National Heart Foundation recommends that Australian adults consume about 500 mg of omega- 3 daily, through docosahexaenoic acid (DHA) or eicosapentaenoic acid (EPA), and that those with heart disease consume about 1,000 mg daily.

The World Health Organization recommends an intake of 1-2 servings of fish (where each serving is defined as providing 200-500 mg/week DHA and EPA) as protection against coronary heart disease and stroke.

The National Health and Medical Research Council's (NHMRC's) Nutrient Reference Values for Australia and New Zealand Including Recommended Dietary Intakes, recommends an intake of combined DHA, EPA and DPA of 610 mg/day for men and 430 mg/day for women to prevent chronic disease.

A recent study, undertaken by Deloitte Access Economics identified savings of approximately $4.2 billion through avoidance of disease burden if heart attack survivors began taking fish oils2.

"The accumulated evidence shows that fish oil has extremely strong backing for its effectiveness in addressing cardiovascular heart disease," Mr Scarff said.
"Indeed, the benefits associated with fish oil treatment warrant wider consideration into ways of better integrating it as part of the broader preventative health agenda."
He said there was a strong case for expanding the uptake and usage of therapies such as this, which have a positive impact on cardiovascular disease, which now affects almost one-in-five Australians.3,4
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About ASMI: The Australian Self-Medication Industry (ASMI) is the peak industry body for the Australian self care industry representing consumer healthcare products including over-the-counter medicines and complementary medicines. ASMI's mission is to promote better health through responsible self-care. This means ensuring that safe and effective self-care products are readily available to all Australians at a reasonable cost. ASMI works to encourage responsible use by consumers and an increasing role for cost-effective self-medication products as part of the broad national health strategy. www.asmi.com.au

Media contact: Bob Bowden, Foresight Communications (02) 9241 2811, 0412 753 298

References

1 Rizos EC, Ntzani EE, Bika E, Kostapanos MS, Elisaf MS. Association between omega-3 fatty acid supplementation and risk of major cardiovascular disease events: a systematic review and meta-analysis. JAMA. 2012 Sep 12;308(10):1024-33.

2 Lynne Pezzullo, Deloitte Touche Tohmatsu

3 GISSI-Prevenzione Investigators. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet. 1999; 354: 447-455.

4 Burr ML, Fehily AM, Gilbert JF, Rogers S, Holliday RM, Sweetnam PM, Elwood PC, Deadman NM. Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet. 1989 Sep 30;2(8666):757-61.