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EPA, DHA, and Risk of Cardiovascular Disease: Summary of Scientific Evidence


The benefits of omega-3 fatty acids are well established. What is not as clear is how much fish or other sources of omega-3 fatty acids you need to eat or take each day to get these benefits. The American Heart Association (AHA) recommends eating at least two servings per week of fatty fish like salmon or sardines, which provide heart-healthy fats and are also high in protein and vitamins. If you do not eat two servings per week, the AHA recommends taking an omega-3 supplement that contains 250 milligrams (mg) DHA plus 500 mg EPA for every 1 gram (g) ALA consumed from plant sources such as flaxseed oil and walnuts.


image for the important component of fish oil EPA, DHA

There is conclusive evidence that DHA and EPA are beneficial for cardiovascular health.


There is conclusive evidence that DHA and EPA are beneficial for cardiovascular health.

DHA and EPA reduce the risk of coronary heart disease and lower triglycerides. They also reduce the risk of stroke, but the evidence on this point is not as strong.

EPA can help lower blood pressure, especially when it is high, to begin with.


DHA and EPA supplements have been shown to reduce the risk of coronary heart disease and lower triglycerides.


The supplements decreased the risk of coronary heart disease and lowered triglycerides. However, they do not affect blood pressure or blood sugar levels. EPA and DHA are omega-3 fatty acids in fish oil and plant oils like flaxseed, hempseed, pumpkin seed, soybean, and walnut.


DHA and EPA from diet or supplements reduce the risk of stroke.


Diet, not supplements

EPA and DHA are found in seafood, fish oil supplements, and seaweed. Individuals at risk of developing cardiovascular disease should talk to their doctors about what dietary sources or accessories may be best for them.

  • A diet rich in oily fish or omega-3 fatty acids reduces the risk of stroke by 14 percent.

  • In a study on over 21,000 people over age 30 from Iowa and North Karelia (Finland), researchers found that those who ate more fatty fish had lower risks of both ischemic stroke (where blood flow to part of the brain is cut off) and hemorrhagic stroke (when there is bleeding into part of the brain). It also reduced their overall risk for mortality from any cause. The participants with higher intakes of DHA had lower blood pressure levels than those with lower intakes during follow-up after ten years (but not after four years). Those who ate more EPA did not have a significantly different blood pressure than those who consumed less EPA.

DHA can help lower blood pressure, especially when it is high, to begin with.


In a meta-analysis of studies that measured the effect of omega-3 fatty acid supplements on blood pressure, intake of DHA was significantly associated with lower systolic and diastolic blood pressure. The result was more robust in people who were overweight or obese and those who had high triglycerides (a type of fat in the blood).

A study published in 2017 found that people who consumed more DHA than those who did not have lower blood pressure. However, this study also showed that other omega-3s had similar effects on lowering blood pressure as DHA.


Increasing intake of the omega-3 fatty acid ALA may also be beneficial, but the evidence is less conclusive than the evidence for the benefits of DHA and EPA.


  • ALA. While some studies have found that increasing intake of ALA may reduce the risk of cardiovascular disease, others have not. In addition, it's unclear whether eating foods rich in ALA can raise blood levels of EPA and DHA to the same extent as fish oil supplements.

  • Fish oil supplements containing both EPA and DHA are the preferred source for omega-3 fatty acid intake because they provide two fish oils that act together to prevent heart attacks and strokes by lowering triglycerides and raising HDL ("good") cholesterol while also reducing inflammation throughout your body.


Not all omega-3s are created equal—omega-3s in plants like flaxseed, walnuts, and chia seeds do not provide the same heart health benefits as omega-3s from fish or algae.


Omega-3s in plant foods, such as flaxseed, walnuts, and chia seeds, is not the same as the omega-3s found in fish or algae. These plant sources contain alpha-linolenic acid (ALA), which your body can convert to DHA and EPA at a low rate. DHA and EPA—the forms of omega-3 found in fish oil supplements—can't be converted from ALA by humans and must be consumed directly from marine sources. However, some studies suggest consuming ALA may still have health benefits for cardiovascular health even if you don't get enough DHA or EPA.


The amount of omega-3 fatty acids needed to see significant health benefits varies between individuals, but research shows that most Americans have low levels. The American Heart Association advises adults to eat no more than two 3.5-ounce servings a week of fatty fish like salmon and sardines, which provide heart-healthy fats and are also high in protein and vitamins.


The amount of omega-3 fatty acids (EPA and DHA) needed to see significant health benefits varies between individuals, but research shows that most Americans have low levels. The American Heart Association advises adults to eat no more than two 3.5-ounce servings a week of fatty fish like salmon and sardines, which provide heart-healthy fats and are also high in protein and vitamins.


Takeaway: Omega-3s from plants like flaxseed do not provide the same heart health benefits as omega-3s from fish or algae because they are a different type of omega-3 fatty acid than those found in these marine sources.


Our take: Omega-3s from plants like flaxseed do not provide the same heart health benefits as omega-3s from fish or algae because they are a different type of omega-3 fatty acid than those found in these marine sources.


Conclusion


Although there is strong evidence that omega-3 fatty acids can help prevent cardiovascular disease, the best way to get these benefits remains debatable. While some believe that following a heart-healthy diet rich in fruits and vegetables, whole grains, nuts, and seeds will provide enough omega-3s, others argue that supplementation may be necessary. Weighing the risks and benefits of any treatment should be done with your doctor's guidance before starting any new regimen!

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