At Water for Health, we have long touted the merits of fish oil. Although frequently discredited by mainstream voices, the evidence indicating a therapeutic benefit of omega-3 supplements – and a significant one – is compelling and dates back decades.
We have written at length on omega-3, investigating its potential to alleviate childhood allergies, reduce autism and ADHD symptoms and improve behaviour and school performance in youngsters. However, it’s fair to say that fish oil pills continue to be synonymous with heart health.
In this article, we will take a closer look at a recent study conducted by the Harvard T.H. Chan School of Public Health, the public health graduate school of Harvard University. Hardly a fringe institution – which makes the study all the more interesting.
Fish Oil for the Heart: What the Study Says
The study in question was published on September 30, 2019, in the Journal of the American Heart Association.
A meta-analysis, it encompassed a population of over 120,000 adults in 13 randomised trials worldwide – making it one of the most comprehensive studies of its kind published to date.
What the Harvard researchers found was that people who took omega-3 fish oil supplements in the clinical studies had “lower risks of heart attack and other cardiovascular disease events compared with those who were given a placebo.”
That’s right, it wasn’t just outright heart attack risk which fish oil helped with: it was an assortment of cardiovascular outcomes including death from CVD, death from coronary heart disease and myocardial infarction.
What’s more, there was a correlation between higher doses of fish oil and risk reduction.
To be clear, this is not the first time that an association between omega-3 consumption and heart disease risk has been explored. Both observational and clinical studies have shown that fish oils can reduce triglycerides and blood pressure, block clot-forming platelet activation, protect those at risk of arrhythmia and improve general vascular function.
However, the size of the Harvard study blows the others out of the water. A meta-analysis of this magnitude is as close to a gold standard as you’re likely to get.
As far as numbers are concerned, the new findings showed that individuals who supplemented with omega-3 fish oil enjoyed an 8% reduced risk of heart attack and death from coronary heart disease.
As noted in the paper, “this finding may suggest that marine omega-3 supplementation dosage above the 840 mg/day used in most randomized clinical trials may provide greater reductions in CVD risk.”
Given the results of the study, the the American Heart Association is unlikely to alter its guidance to patients with prevalent coronary heart disease – namely, to supplement with marine omega?3 capsules on a daily basis.
That said, Federal regulations prevent dietary supplements from being prescribed by doctors as a treatment for a disease. In the UK, too, the process is very much geared towards the pharmaceutical industry.
So don’t expect the hatchet jobs that are periodically carried out on fish oil to end any time soon!
The Importance of a Therapeutic Dosage
What is clear from the paper, and from previous research, is that to obtain statistically significant benefits on certain heart outcomes, an effective dose is required. If 840mg is the typical dosage used in studies, you may require 1g, 2g or even 4g per day depending on the extent of your needs.
One of the most widely-quoted studies to date on this topic was REDUCE-IT, which used a high-dose, pure EPA fish oil named Vascepa. Incidentally, REDUCE-IT was incorporated in the Harvard meta-analysis – although results held true even when it was discounted.
What the REDUCE-IT trial showed was that pure EPA fish oil, when supplemented at 4g per day for five years, reduced coronary event risk by 25% among participants with elevated levels of triglycerides at the outset and either cardiovascular disease or type 2 diabetes, plus at least one other cardiovascular risk factor.
What’s interesting is that Vascepa is actually classed as a pharmaceutical, not a dietary supplement. However, it is possible to obtain Vascepa’s “therapeutic” dosage by taking regular, off-the-shelf supplements.
Other Factors to Ponder When Choosing a Fish Oil
Of course, dosage is only one factor that should be considered. In truth, the same process must be followed when selecting any supplement.
When shopping for a protein powder, for instance, your primary consideration might be how much protein is supplied per serving. However, you’ll also want to know how many calories; how many grams of carbohydrates; how much sugar; whether the protein is whey or plant-based; which amino acids are included, and so on.
Aside from providing an effective omega-3 dosage, you should ensure that the fish oil comes from sustainable sources and small-species fish (which absorb less toxins); you should also opt for a fish oil in the more bioavailable r-Triglyceride form, which is preferable to the commonly available (synthetic) ethyl ester form.
It should go without saying that the fish oil should also be made by a reputable manufacturer who follows sound manufacturing practices (GMPs) and has won approval from the IFOSP (International Fish Oil Standards Program) as well as other independent aggregators such as Labdoor.
Should You Combine Fish Oil and Vitamin D?
A global overview of worldwide causes of death proves that cardiovascular disease remains the biggest killer, followed by cancer. These causes are way in front of the others: deaths from cardiovascular death are roughly double those from cancer, and deaths from cancer are more than double those from the third biggest killer: respiratory disease.
It may seem morbid to draw attention to these statistics, but what they expose is a grave public health crisis. The simple fact is that we are not looking after our hearts as we should, and we remain vulnerable to cancer in its many forms.
The evidence indicates that, where heart health is concerned, we should up our omega-3 intake. We should also strive to incorporate regular exercise into our routine, limit our consumption of trans fats, shun tobacco, manage stress levels and achieve a healthy weight.
It is also possible to manage cancer risk. According to Cancer Research UK, “our risk depends on a combination of our genes, our environment and things to do with our lifestyle, which we’re more able to control.”
Controllable factors listed by the charity include not smoking, maintaining a healthy body weight, eating a balanced diet, staying active, cutting back on alcohol and enjoying the sun safely. As such, they are broadly similar to the guidance for heart health.
As far as cancer is concerned, there is some research to suggest that vitamin D supplements could offer a protective effect.
In one study of nearly 26,000 participants aged 50 and older, published in the New England Journal of Medicine at the turn of this year, those who took 2,000 IU of vitamin D daily had a 25% reduced risk of death from cancer during the five-year study period.
Moreover, a Japanese study from 2018 showed that overall cancer risk was 22% lower among people with the highest vitamin D levels, versus those with the lowest levels. People with the highest vitamin D levels were also 55% less likely to be diagnosed with liver cancer than those with the lowest.
And there’s another reason why you might want to take fish oil and vitamin D together: the latter is best absorbed when taken with a meal containing fats or oils.
It is encouraging to note that more people are taking an interest in what may be broadly termed preventive nutrition – the understanding that diet can significantly reduce the risk, and impact, of disease and disease-related complications.
Omega-3 fish oil continues to prove itself as one of the key nutrients for heart health, and when you consider its uses beyond improving cardiac health, it’s easy to view it as one of the indispensable elements of our diet.
If you wish to combine omega-3 and vitamin D, there is no better supplement than UnoCardio 1000 – ranked by Labdoor as the world’s best quality fish oil since 2015. WHC’s formula combines 1.2g of exceptionally pure omega-3 fish oil per serving, plus 1,000 IU of vitamin D, and each pack provides 60 servings.
Water for Health Ltd began trading in 2007 with the goal of positively affecting the lives of many. We still retain that mission because we believe that proper hydration and nutrition can make a massive difference to people’s health and quality of life. Click here to find out more.
“Cancer risk depends on a combination of our genes, our environment and things to do with our lifestyle, which we’re more able to control.” – Cancer Research UK