Omega-3 fatty acids, whether from eating fish or as dietary supplements, or produced in the body from alpha linolenic acid of vegetable origin, have always had a favourable reputation in the prevention of cardiovascular diseases. This was mainly based on the findings of epidemiological research. However, systematic analyses of the results of randomised controlled clinical studies have failed to demonstrate any cardiovascular protective effect. Guidelines recommending omega-3 fatty acids could be revised in this respect.
- Omega-3 fatty acids, whether from eating fish or from dietary supplements or alpha-linolenic acid (ALA, which is present in plants and is converted to omega-3 fatty acids in the human body) are currently recommended in guidelines, based on their favourable reputation concerning the possible prevention of cardiovascular diseases.
- Epidemiological research has found associations between a reduced incidence of cardiovascular morbidity and a high intake of omega-3 fatty acids, though the causal relation is unclear.
- A carefully designed and conducted systematic review with meta-analysis of the pooled findings of over 70 randomised controlled studies now shows that the intake of omega-3 fatty acids or alpha-linolenic acid (ALA) has no effect on cardiovascular morbidity and mortality.
- The favourable reputation of omega-3 fatty acids and/or ALA regarding the prevention of cardiovascular diseases must be qualified or rejected, as the gold standard of proof, based on randomised controlled studies, is lacking.
- Abdelhamid AS, Brown TJ, Brainard JS, Biswas P, Thorpe GC, Moore HJ, et al. Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2018;11:CD003177.
- Nederlands Huisartsen Genootschap. Cardiovasculair risicomanagement (Tweede herziening) 2012 [Available from: https://www.nhg.org/standaarden/volledig/cardiovasculair-risicomanagement#note-19.
- Voedingscentrum. Omega 3 2019 [Available from: https://www.voedingscentrum.nl/encyclopedie/omega-3.aspx#blok7.
- Catapano AL, Graham I, De Backer G, Wiklund O, Chapman MJ, Drexel H, et al. 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias. Eur Heart J. 2016;37(39):2999-3058.
- Health NIo. Omega-3 Fatty Acids. Fact Sheet for Health Professionals 2019 [Available from: https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/.
- Aung T, Halsey J, Kromhout D, Gerstein HC, Marchioli R, Tavazzi L, et al. Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks: Meta-analysis of 10 Trials Involving 77917 Individuals. JAMA Cardiol. 2018;3(3):225-34.
- Group ASC, Bowman L, Mafham M, Wallendszus K, Stevens W, Buck G, et al. Effects of n-3 Fatty Acid Supplements in Diabetes Mellitus. N Engl J Med. 2018;379(16):1540-50.
The literature refers to the Dutch text