A spotlight on the growing interest in the benefits of DHA and EPA for Heart Health
Talking Nutrition Editors
A focus on heart health at EuroPrevent
- DSM’s Symposium at EuroPrevent 2019 investigated the latest evidence on the role of omega-3s in reducing the risk of cardiovascular disease (CVD).
- Despite the overwhelming population-based evidence that marine omega-3 intake improves heart health, the benefits have not been significantly demonstrated in recent randomized controlled trials (RCTs) and meta-analyses incorporating data. The focus of the symposium was to focus on the many factors as to why this has occurred and examine the important positive intervention trials of 2018/2019.
- DSM offers a range of nutritional products including omega-3s, vitamin D, E and K that are designed to maintain heart health and protect against CVD.
DSM at EuroPrevent
Bringing together health professionals specializing in the prevention of heart disease, this year’s EuroPrevent conference recently took place at the Centro de Congressos in Lisbon, Portugal. Organized by the European Association of Preventative Cardiology (EAPC), EuroPrevent 2019 focused on the influence factors such as fitness and nutrition have on the biomarkers of heart disease.
DSM held a satellite symposium at the event to highlight the latest epidemiological and intervention trial evidence for the use of omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) in reducing the risk of cardiovascular disease.
The symposium featured several presentations that examined the importance of omega-3 for improving cardiovascular health and explored why the benefits have not been significantly demonstrated in recent randomized controlled trials (RCTs) and meta-analyses.
Omega-3 and cardiovascular disease
The omega-3 acids DHA and EPA are associated with several heart health benefits such as reduced blood pressure, arrythmias, inflammation and lower triglyceride levels. In the presentation given by the Global Organization for EPA and DHA (GOED) as part of the symposium, it was highlighted that higher levels of EPA and DHA in erythrocyte membranes are associated with a lower risk of cardiovascular disease.
Professor Bruce Griffin from the University of Surrey discussed the cardio-protective role of long chain omega-3 PUFA’s. He explained that long chain omega-3 deficiency contributes to metabolic dysfunction in key metabolic tissues, for example the liver, which can ultimately result in the development of cardiovascular disease. The Professor also highlighted that long chain omega-3s are effective in reducing cardio-metabolic risk factors, including dyslipidaemia and ectopic fat accumulation in the liver.
He also stressed that demonstrating the efficacy of long chain omega-3s in RCTs is challenging due to the complexity involved in reproducing the long-term effects of nutrition on tissue status. This has a significant impact on how the pathophysiological role of these essential fatty acids is reported. To be able to demonstrate the benefits of omega-3s in reducing the risk of CVDs, Professor Griffin highlighted the importance of considering adequate dose duration and sample size in clinical trials.
Showcasing the benefits of omega-3 in clinical trials
Numerous RCTs and meta-analyses have been conducted around the benefits of omega-3s, but many have failed to record the associated specific cardiovascular advantages.
Robert Winwood, Manager of Nutrition Science and Advocacy at DSM Nutritional Products and Chairman of the DSM Symposium at EuroPrevent said, “Some four thousand RCTs have been conducted on interventions with marine omega 3s regarding their effect on cardiovascular disease, with the overwhelming majority showing positive benefits. However, in recent years a few large-scale, influential studies and meta-analyses conducted on trials have failed to demonstrate clear significant benefits on the role of omega-3s in reducing the risk of CVDs. I believe there are multiple reasons for this, including inappropriate experimental design and statistical analysis, ineffective intervention doses, the use of inappropriate biomakers and failure to properly take into account the participants baseline tissue omega 3 fatty acid levels.”
Meta-analyses can be treated as benchmarks for evidence, but inevitably the quality of the study depends on the rigor applied when they are conducted. Professor Michelle Wiest from the University of Idaho delivered an in-depth presentation on interpreting a meta-analysis. The Professor concluded that although in principle meta-analyses offer an attractive way to maximize the usefulness of prior research, in practice, different methods can result in different conclusions and ultimately, the results are only as good as the studies included.
The VITAL study1 demonstrated for the first time the significant levels of benefit provided by omega-3s in risk reduction of cardiovascular disease. The European Food Safety Authority (EFSA) has advised that a minimum dose of 3 g per day EPA and DHA is required to maintain normal blood pressure and triglyceride levels which are key heart health biomarkers2. Despite this guidance, the majority of recent intervention trials used less than 1g per day. Often in human clinical trials the baseline levels of EPA and DHA present in the cohorts receiving interventions is not considered which can limit the effectiveness of the additional dose if their omega-3 status is already deficient.
Rob Winwood adds, “The interest in conducting clinical trials into the benefits of EPA and DHA for heart health continues to grow exponentially. The impact of human clinical trials is likely to improve as more people become aware of the factors that need to be considered for nutritional intervention tests.”
Solutions for heart health
DSM offers a range of nutritional solutions support heart health and the reduction of the risk factors related to cardiovascular disease including life’s™OMEGA, a vegetarian source of EPA and DHA derived from algae, and MEG-3®, a fish oil that is sustainably sourced from omega-3 rich ocean fish. DSM also supplies vitamin rich products like Quali®-K, which helps the body to coagulate blood and Fruitflow®, an innovative, new ingredient that contains the anti-platelet compounds of tomato fruit, designed to a healthy blood flow.
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- Manson et al, The VITamin D and OmegA-3 TriaL (VITAL): Rationale and Design of a Large Randomized Controlled Trial of Vitamin D and Marine Omega-3 Fatty Acid Supplements for the Primary Prevention of Cancer and Cardiovascular Disease, Contemp Clin Trials. 2012 January ; 33(1): 159–171.
- EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA); Scientific Opinion on the substantiation of health claims related to EPA, DHA, DPA and maintenance of normal blood pressure (ID 502), maintenance of normal HDL-cholesterol concentrations (ID 515), maintenance of normal (fasting) blood concentrations of triglycerides (ID 517), maintenance of normal LDL-cholesterol concentrations (ID 528, 698) and maintenance of joints (ID 503, 505, 507, 511, 518, 524, 526, 535, 537) pursuant to Article 13(1) of Regulation (EC) No 1924/2006 on request from the European Commission. EFSA Journal 2009; 7(9):1263. [26 pp.]. doi:10.2903/j.efsa.2009.1263
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