Long chain omega-3 fatty acids and cardiovascular disease: a systematic review

Abstract

Introduction: Cardiovascular disease remains the commonest health problem in developed countries, and residual risk after implementing all current therapies is still high. The use of marine omega-3 fatty acids (DHA and EPA) has been recommended to reduce cardiovascular risk by multiple mechanisms. Objectives: To update the current evidence on the influence of omega-3 on the rate of cardiovascular events. Review Methods: We used the MEDLINE and EMBASE databases to identify clinical trials and randomized controlled trials of omega-3 fatty acids (with quantified quantities) either in capsules or in dietary intake, compared to placebo or usual diet, equal to or longer than 6 months, and written in English. The primary outcome was a cardiovascular event of any kind and secondary outcomes were all-cause mortality, cardiac death and coronary events. We used RevMan 5·1 (Mantel-Haenszel method). Heterogeneity was assessed by the I 2 and Chi 2 tests.

Omega-3 long-chain polyunsaturated fatty acids and aquaculture in perspective

“…Epidemiological studies, that are normally large and long, looking at n-3 LC-PUFA intake (fish/fish oil) and/or status (blood/tissue fatty acid compositions) almost uniformly show a protective effect, decreasing the risk of developing CVD (Delgado-Lista et al, 2012). When all confounders are controlled the data are robust albeit they show only an "association" and not "cause and effect".…”

“…However, randomised controlled trials, normally designed for patients with some disease already (i.e. in at-risk patients), have also been generally positive and show that patients benefit from dietary n-3 LC-PUFA therapy (Calder and Yaqoob, 2012;Delgado-Lista et al, 2012). Until recently, meta-analyses were also largely positive although there have been some recent studies showing less effect (Rizos et al, 2012;Chowdhury et al, 2014).…”

“…However, in addition to protein, fish are also important dietary sources of minerals including iodine and selenium, and vitamins such as A, D and E (Tacon and Metian, 2013). Arguably, of greatest importance for consumers in the developed world, fish and seafood are unique and rich sources of omega-3 (n-3) long-chain polyunsaturated fatty acids (LC-PUFA), particularly eicosapentaenoic (EPA; 20:5n-3) and docosahexaenoic (DHA; acids (Tur et al, 2012), that have well-known and generally accepted beneficial effects in a range of human pathologies including cardiovascular and inflammatory diseases, and an important role in neural development Delgado-Lista et al, 2012;Campoy et al, 2012;Calder, 2013).…”

The relation of red blood cell fatty acids with vascular stiffness, cardiac structure and left ventricular function: The Framingham Heart Study

“…However, the literature is inconclusive in this regard. Of four recently published meta-analyses, two concluded that omega-3 polyunsaturated fatty acids (PUFAs) were cardioprotective 6,7 whereas the other two did not. 8,9 Different biological mechanisms may underlie the potential cardioprotective effects of omega-3 fatty acids, in particular lower systemic inflammation, lower blood pressure and a healthier lipid profile.…”

Modulation of selenium tissue distribution and selenoprotein expression in Atlantic salmon (Salmo salarL.) fed diets with graded levels of plant ingredients

“…Among lipids, dietary n-3 long-chain PUFA (LC-PUFA) have a range of beneficial effects in several pathological conditions, including CVD and neurological diseases, and some cancers (1)(2)(3)(4)(5)(6)(7) . The beneficial effects of fish have been generally attributed largely to the presence of n-3 LC-PUFA; however, fish provide significant levels of a number of other potentially protective components such as Se, a trace element that is essential for human health.…”