Lately, I have had some patients be fearful of fish oil supplements. They have heard fish oil get confusing media coverage. Especially surrounding AFIB.
When I was recently one of the few non-cardiologist participants in Dr. Mark Houston’s 24-hr Functional Cardiology program (first weekend of three), he said fish oil is one of our heart’s best friends. Even for AFIB.
Dr. Mark said most fish-dinging research uses dosages that are too low, too poor quality, or not the right combination of the individual essential fatty acids.
Now Brigham and Women's Hospital researchers tackled a large body of literature looking at fish oil and heart health. Remember, Brigham and Women's Hospital is the second-largest teaching hospital of Harvard Medical School.
These investigators conducted a systematic review and meta-analysis of 38 randomized controlled trials of omega-3 fatty acids. In total, these trials included a bit over 149,000 participants.
They evaluated key cardiovascular outcomes, including cardiovascular mortality from heart attack and stroke, non-fatal cardiovascular outcomes, bleeding, and atrial fibrillation.
Overall, omega-3 fatty acids healthfully “reduced” cardiovascular mortality and improved cardiovascular outcomes.
Fascinatingly, EPA was more heart-protective than the combination of EPA+DHA supplements
For decades, there has been great interest in whether omega-3 fatty acids can lower rates of cardiovascular events, such as heart attack or stroke.
In 2018, results from the Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT) were published showing that a high dose of a purified ethyl ester of eicosapentaenoic acid (EPA) in patients at elevated cardiac risk significantly “reduced” cardiovascular events.
This is pharmaceutical fish oil.
Results from this trial led to the U.S. Food and Drug Administration, Health Canada, and European Medicines Agency’s approval of the prescription drug icosapent ethyl for reducing cardiovascular risk in patients with elevated triglycerides, as well as updates to worldwide guidelines. (PS Functional doctors have used high-dose EPA and full-flush niacin to lower triglycerides for many years, I remember recommending this back in the 1970s).
But previous and subsequent studies of omega-3 fatty acid supplements that combine both EPA and docosahexaenoic acid (DHA) have had mixed results.
But according to Deepak L. Bhatt, MD, MPH, the executive director of Interventional Cardiovascular Programs at the Brigham and lead investigator of the REDUCE-IT trial and part of the meta-analysis group said, “Now, we can see that the totality of evidence supports a robust and consistent benefit of EPA."
Fish oil has now gotten cardiovascular blessings.
Looking at these individual fish oils, both EPA and DHA are omega-3 fatty acids. But there are biological nuances between them. They have different chemical properties that influence their strength of the effect, stability, and how they act on cholesterol molecules and cell membranes.
When I reached out to Dr. Houston he responded, “Both essential fatty acids work. But the best ratio is 4 to 1, EPA to DHA.”
I am a personal big fan of Dr. Houston’s EFA Sirt Supreme by Biotics. It is the only one I know that combines EPA and DHA in that 4:1 ratio, along with GLA.
My link for Dr. Houston’s fish oil.
I often rotate this product with Xymogen’s Pure Omega as this product has been specifically processed to be able to take with or without food. You can even take it with water. Most fish oils need to be taken with a large meal containing fatty foods, but Xmogen’s can be taken with or without food
For my Xymogen store link at Whole Script do the following:
Provider’s Last Name: Berkson
Referral Code: BERKSONHEALTH
Visit WholeScripts.com
Click on Register
You will be asked to put in the Providers Last Name, Referral Code, and Your Email Address
Click on Verify Practitioner
The next page will ask for First and Last names and Phone Number
Patients can create their account by inputting their Phone Number and Password
Hope this was fish oil and heart helpful. Let me know.
Dr. B.
Reference:
Effect of omega-3 fatty acids on cardiovascular outcomes: A systematic review and meta-analysis. EClinicalMedicine, 2021; 100997
There have been a number of recommendations promoting DHA as being the critical component. Personally I believe it's best to take both DHA and EPA, but of course with a good quality product that doesn't contain a lot of "other fish oil".
I like having recommendations for specific products. But, both of those products seem to have an EPA to DHA ratio of 1.3 to 1 and you said the recommendation is 4 to 1. Have the formulas been changed or am I missing something?