As of Thursday, August 1, 2013
DEAR DOCTOR K: I have risk factors for heart disease. I’ve been dutifully taking fish oil supplements for years to reduce my risk of a heart attack. Now I read that they don’t help. Should I stop taking them?
DEAR READER: Fish oil, loaded with omega-3 fatty acids, has garnered a reputation as an easy way to protect the heart. But a recent study published in the New England Journal of Medicine found that fish oil pills don’t reduce the risk of heart attack and stroke in people at increased risk.
The new study focused on about 12,500 people who never had a heart attack or stroke. But they had high blood pressure, a family history of heart disease or other factors that increased their risk. Study participants were randomly divided into two groups. One group took a daily capsule containing omega-3 fatty acids found in fish. The other group took “dummy” pills that contained olive oil.
During the next five years, about 12 percent of people in each group died or suffered a heart attack, stroke or other heart-related problem. People who took fish oil did not fare any better than those who didn’t.
One study rarely settles a controversial question. There are hundreds of studies of fish oil supplements, and they don’t all point in the same direction. This new study was a very strong one, but it can be criticized.
For example, there is evidence that olive oil also is heart-healthy. If the truth is that both fish oil capsules and olive oil capsules can protect the heart, then perhaps the study would have been more convincing if fish oil were compared to a capsule with a substance not thought to be heart-healthy. Nevertheless, based on this study, I wouldn’t rely on fish oil pills to lower your risk of heart attack and stroke.
However, taking fish oil capsules is not the same thing as eating fish. There is very strong evidence that people who regularly eat fish have lower rates of heart disease. Multiple well-done studies have shown that a diet including fish leads to lower rates of heart disease and stroke. So I advise my patients to keep eating fish, especially fatty fish that are rich in omega-3 fatty acids. Examples of fatty fish include salmon, sardines, mackerel, char and halibut.
In the meantime, stick to proven ways to lower your chance of heart attack and stroke:
— Quit smoking.
— Exercise more.
— Eat smaller portions.
— Decrease saturated fats and trans fats.
— Keep your blood pressure in the normal range.
— Lower your LDL cholesterol.
— Ask your doctor if you should take a baby aspirin.
Send questions to Anthony L. Komaroff, M.D. through his website: www.AskDoctorK.com.