• Omega 3

Omega 3 protect our heart!

Omega 3 in prevention of cardiovascular diseases

A public health problem in developed countries!

According to the World Health Organization, cardiovascular diseases are the first cause of mortality in the world(1). It is estimated that 17.7 million deaths are due to cardiovascular diseases, i.e. 31% of total world mortality. Of these deaths, an estimated 7.4 million are due to coronary heart disease and 6.7 million to stroke (2015 figures).

Cardiovascular disease can be prevented by reducing risk factors. These are mainly behavioral, such as smoking, excess alcohol, sedentary lifestyle, obesity and poor diet.

It cannot be repeated enough, adopting a healthy lifestyle, integrating physical activity and a healthy and varied diet, gives us the opportunity to directly influence our health and longevity.

See also → Omega 3: Dosage, Benefits and Contraindications

The benefits of omega 3 on our heart

Epidemiological studies have shown that populations with a high consumption of fish have the lowest mortality rates from cardiovascular diseases. The diet of these populations explains, at least in part, their protection against death from cardiac pathologies. Subsequently, numerous studies have confirmed that omega-3s (EPA and DHA), essentially present in seafood, are capable of reducing the risk of heart attack and coronary heart disease (2),(3).

The health authorities have validated the health claims for omega 3 !

The studies on omega-3 (EPA and DHA) are particularly numerous and their conclusions have allowed the French (ANSES) (4) and European(EFSA) health authorities to validate the role of omega-3 for health. They authorize the following health claim:“Omega-3 fatty acids help maintain heart function” (5) provided that the daily consumption is at least 250 mg of DHA.

Similarly, the American health authority(FDA) approves the health claim for Omega 3 food supplements. It is authorized to say that the consumption of omega 3 (EPA and DHA) would be able to reduce the risks of cardiovascular diseases (6)

Thus, on the basis of a daily consumption of omega 3 (EPA + DHA) (7), they contribute :

– To the good functioning of the heart / for a consumption of 250 mg,

– To the preservation of a good blood pressure (arterial pressure) / for a consumption of 3 g,

– To the maintenance of a good serum triglyceride level / for a consumption of 2 g

These claims have been approved by the World Health Organization(WHO) and the ISSFAL ” Heart Foundation and the International Society for the Study of Fatty Acids and Lipids which recommend a daily consumption of 250 to 500 mg of EPA and DHA (cumulated).

What are these molecules called Omega 3?

The omega 3 vegan constitute a family of polyunsaturated fatty acids “essential” because not produced by the organization and of the derivatives:

– ALA: alpha linolenic acid an “essential” fatty acid

– EPA: eicosapentaenoic acid, a fatty acid derived from ALA

– DHA docosahexaenoic acid fatty acid derived from ALA

ALA EPA DHA schema

The transformation rates are very low. They explain the very frequent deficiencies in EPA and DHA.

Part of ALA is transformed into EPA which in turn can be transformed into DHA. This transformation, which occurs in the liver, has only a low yield (about 15%) (8), which is why it is important to ensure a good dietary intake of DHA.

DHA constitutes about 97% of the fatty acids in the brain and as much in the retina. It is an essential component for the good health of our visual and cardiac functions.

Scientific evidence and study results

Omega-3s play an essential role in maintaining our health (9)

It has been proven that a sufficient and regular consumption of omega 3s is capable of significantly reducing mortality due to heart problems.

The benefit of omega 3 supplementation is all the more important for people with deficiencies, i.e. those who do not consume marine products or who have high triglyceride or LDL cholesterol levels.

Omega 3 protects our heart by:

– Reducing blood pressure and heart rate
– Lowering cholesterol / triglyceride, LDL levels
– Improving vascular function (10) (11)

A large number of randomized clinical studies have concluded that a sufficient level of omega 3 in the blood is beneficial in the fight against cardiac pathologies (12 to 23).

Clinical studies have shown that the consumption of EPA and DHA would reduce cardiovascular diseases, to fight against the risks of infarction and coronary diseases (24 – 25) but also inflammation. They contribute to reinforce the treatment of many diseases such as atherosclerosis, by fighting against cholesterol. They have shown an ability to control the level of sugar in the blood, for protection against diabetes. In clinical trials on diabetes, they have been shown to repair neurological damage.

A synthesis of randomized studies published in 2019 in the Mayo Clinic journal (26) focuses on the results of these studies, which concern the evaluation of the effects of omega 3 supplementation on the frequencies of cardiac events related to cardiovascular diseases. The conclusions of these 3 randomized trials are detailed below.

Preventive consumption of purified fish oil containing 840 mg/day of EPA and docosahexaenoic acid (DHA) significantly reduces the risk of death from coronary heart disease or heart attack, particularly in people who did not consume fish and seafood frequently.

For people with coronary heart disease, consumption of 4 grams/day of highly purified omega-3 containing eicosapentaenoic acid (EPA) reduced the risk of major cardiovascular events by 25% (P < 0. 001).

The American Heart Association (AHA) continues to emphasize the importance of marine omega-3 as a nutrient to potentially reduce the risk of congestive heart failure, ischemic heart disease, and heart attack. Consumption recommendations are 1g per day for those who do not consume marine products (fish, seafood, seaweed) at least twice a week (27) (28).

Omega-3s are clearly associated with the protection of our heart. The health benefits are observed from a daily consumption of 250 mg of EPA + DHA.

Sources

(1) Les maladies cardiovasculaires / état des lieux selon l’organisation mondiale de la santé (consultation le 18/12/19)

(2) Djousse L, Akinkuolie AO, Wu JH, Ding EL, Gaziano JM. Fish consumption, omega-3 fatty acids and risk of heart failure: a meta-analysis. Clin Nutr 2012;31:846-53. [PubMed abstract]

(3) Del Gobbo LC, Imamura F, Aslibekyan S, Marklund M, Virtanen JK, Wennberg M, et al. Omega-3 polyunsaturated fatty acid biomarkers and coronary heart disease: pooling project of 19 cohort studies. JAMA Intern Med 2016;176:1155-66. [PubMed abstract]

(4)  Acide gras de la famille Oméga 3 et système cardiovasculaire : intérêt nutritionnel et allégations. ANSES, juillet 2003, consulté en octobre 2019, disponible sur : https://www.anses.fr/fr/system/files/NUT-Ra-omega3.pdf

(5) EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA), ‘Scientific Opinion on the substantiation of a health claim related to DHA and contribution to normal brain development pursuant to Article 14 of Regulation (EC) No 1924/2006,’ EFSA Journal, vol. 12, no. 10, 2014, p. 3840.

(6) Office of Nutritional Products, Labeling, and Dietary Supplements, Center for Food Safety and Applied Nutrition, US Food and Drug Administration. Letter responding to a request to reconsider the qualified claim for a dietary supplement health claim for omega-3 fatty acids and coronary heart disease. Docket No. 91N-0103. February 8, 2002. Available at: http://www.cfsan.fda.gov/~dms/ds-ltr28.html. Accessed October 3, 2002.Google Scholar

(7) Allégations santé « fonctionnelles génériques » autorisées par UE Article 13.1 pour EPA/DHA

Journal officiel de l’UE 25.2.12, Commission regulation (EU) 432/2012 du 16 Mai 2013

Journal officiel de l’UE L160/4, Commission regulation (EU) 536/2013 du 12 juin 2013 

(8) Harris 2010 encyclopedia of dietary sup

(9) Agency for Healthcare Research and Quality. Omega-3 fatty acids and cardiovascular disease: an updated systematic review. 2016.

(10) Lavie CJ, Milani RV, Mehra MR, Ventura HO. Omega-3 Polyunsaturated Fatty Acids and Cardiovascular Diseases. J Am Coll Cardiol 2009;54:585-94.

(11) Deckelbaum RJ, Leaf A, Mozaffarian D, Jacobson TA, Harris WS, Akabas SR. Conclusions and recommendations from the symposium, Beyond Cholesterol: Prevention and Treatment of Coronary Heart Disease with n-3 Fatty Acids. Am J Clin Nutr 2008;87(6):2010S-2S.

(12) Walker, R.E., Jackson, K.H., Tintle, N.L. et al, Predicting the effects of supplemental EPA and DHA on the omega-3 index. Am J Clin Nutr. 2019;110:1034–1040 Google Scholar

(13) Zibaeenezhad, M.J., Ghavipisheh, M., Attar, A., Aslani, A. Comparison of the effect of omega-3 supplements and fresh fish on lipid profile: a randomized, open-labeled trial. Nutr Diabetes. 2017;7:1 Google Scholar

(14) Kris-Etherton, P.M., Harris, W.S., Appel, L.J. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation. 2002;106:2747–2757 Google Scholar

(15) Alexander, D.D., Miller, P.E., Van Elswyk, M.E., Kuratko, C.N., Bylsma, L.C. A meta-analysis of randomized controlled trials and prospective cohort studies of eicosapentaenoic and docosahexaenoic long-chain omega-3 fatty acids and coronary heart disease risk. Mayo Clin Proc. 2017;92:15–29 Google Scholar

(16) Siscovick, D.S., Barringer, T.A., Fretts, A.M. et al, Omega-3 polyunsaturated fatty acid (fish oil) supplementation and the prevention of clinical cardiovascular disease: a science advisory from the American Heart Association. Circulation. 2017Google Scholar

(17) Tavazzi, L., Maggioni, A.P., Marchioli, R. et al, Effect of n-3 polyunsaturated fatty acids in patients with chronic heart failure (the GISSI-HF trial): a randomised, double-blind, placebo-controlled trial. Lancet. 2008;372:1223–1230 Google Scholar

(18) Aung, T., Halsey, J., Kromhout, D. et al, Associations of omega-3 fatty acid supplement use with cardiovascular disease risks: meta-analysis of 10 trials involving 77,917 individuals. JAMA Cardiol. 2018;3:225–234  Google Scholar

(19) Del Gobbo, L.C., Imamura, F., Aslibekyan, S. et al, Omega-3 polyunsaturated fatty acid biomarkers and coronary heart disease: pooling project of 19 cohort studies. JAMA Intern Med. 2016;176:1155–1166 Google Scholar

(20) GISSI-Preventione-Investigators. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo studio della Sopravvivenza nell’infarto miocardico. Lancet. 1999;354:447–455 Google Scholar

(21) Yokoyama, M., Origasa, H., Matsuzaki, M. et al, Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet. 2007;369:1090–1098 Google Scholar

(22) Heydari, B., Abdullah, S., Pottala, J.V. et al, Effect of omega-3 acid ethyl esters on left ventricular remodeling after acute myocardial infarction: the OMEGA-REMODEL randomized clinical trial. Circulation. 2016;134:378–391 Google Scholar

(23) Zibaeenezhad, M.J., Ghavipisheh, M., Attar, A., Aslani, A. Comparison of the effect of omega-3 supplements and fresh fish on lipid profile: a randomized, open-labeled trial. Nutr Diabetes. 2017;7:1 Google Scholar

(24) Djousse L, Akinkuolie AO, Wu JH, Ding EL, Gaziano JM. Fish consumption, omega-3 fatty acids and risk of heart failure: a meta-analysis. Clin Nutr 2012;31:846-53. PubMed abstract

(25) Del Gobbo LC, Imamura F, Aslibekyan S, Marklund M, Virtanen JK, Wennberg M, et al. Omega-3 polyunsaturated fatty acid biomarkers and coronary heart disease: pooling project of 19 cohort studies. JAMA Intern Med 2016;176:1155-66. PubMed abstract

(26) Evan L. O’Keefe, Randomized Trials Show Fish Oil Reduces Cardiovascular Events Mayo Clinic article December 2019 Volume 94, Issue 12, Pages 2524–2533

(27) Rimm, E.B., Appel, L.J., Chiuve, S.E. et al, Seafood long-chain n-3 polyunsaturated fatty acids and cardiovascular disease: a science advisory from the American Heart Association. Circulation. 2018; Google Scholar

(28) Millen, B., Lichtenstein, A.H., Abrams, S. et al, 2015-2020 Dietary Guidelines for Americans. 8th Ed. US Department of Agriculture, Washington, DC; 2015  Google Scholar

Note from the eChlorial team
We would like to stress that the people interviewed or who testify on our blog do so in all sincerity without any conflict of interest.

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