Omega 3 protect heart without raising prostate cancer risk, find studies

Intermountain Healthcare Heart Institute researchers in recent studies have found that Omega-3 supplements protect the heart without raising prostate cancer risk.

Use of Omega supplements is continuously on the rise amid controversies regarding their efficacy and safety. The common questions raised are- are Omega 3 supplements totally safe? Should one keep taking omega 3 pills? Or try to have two servings of omega-3 rich fish a week, as the American Heart Association recommends? Does Omega 3 increases risk of prostate cancer?

The researchers at the Intermountain Healthcare Heart Institute conducted research regarding potential benefits and risks of this popular supplements, especially when it comes to prostate cancer risk and heart health. Earlier studies suggested a possible link between higher omega 3 plasma levels and the development of prostate cancer.

The Intermountain research team presented 2 new studies about omega 3s at the 2019 American Heart Association Scientific Sessions recently.

Omega 3 is a type of fat. Small amounts of omega 3 fats are essential for good health, and they can be found in the food that we eat. The main types of omega 3 fatty acids are, alphalinolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). ALA is normally found in fats from plant foods, such as nuts and seeds ( walnut and rapeseed are rich sources). EPA and DHA 

collectively called long-chain omega 3 fats are naturally found in fatty fish, such as salmon and fish oils, including cod liver oil.

In one study, the research team identified 87 patients who were part of the study, had developed prostate cancer. These patients were also tested for plasma levels of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), which are 2 common omega 3 fatty acids.

When compared to a matched control group of 149 men, the researchers found that higher omega 3 levels were not linked with elevated prostate cancer risk.

A researcher said, they undertook this study in light of findings from a 2013 paper that suggested a possible link between higher omega 3 plasma levels and the development of prostate cancer, one that has been debated since publication.

If I’m recommending omega 3 for my patients to save their hearts, I want to make sure I’m not putting them at risk for prostate cancer, said the researcher. Our study found no evidence of a link between the two.

In the 2^nd study presented at the 2019 American Heart Association Scientific Sessions, the researchers looked at 894 patients undergoing coronary angiography.

These patients had no prior history of heart attack or coronary artery disease, however upon their 1^st angiogram, about 40 % of those patients had sever disease and about 10 % had the 3 vessel disease, the researcher said.

Researchers also measured patients’ plasma levels of omega 1 metabolites, including DHA and EPA.

Those patients were then followed to see who had a subsequent heart attack, stroke, heart failure, or who died.

Researchers found that patients who had higher rates of omega 3 metabolites had a lower risk of those follow up adverse effects regardless of whether they had severe disease or not on their initial angiogram.

This study is important because we looked at how omega 3 helps patients who have already developed the disease, and its effects on survival—both in getting to the first angiography to be diagnosed ( vs having a heart attack or worse before even knowing they have heart disease) and thereafter, said the researcher.

While a seeming association between higher plasma omega 3 levels and the findings of severe heart disease upon initial angiogram might raise alarms that omega 3 isn’t beneficial, they did live to see a doctor and get diagnosed, he added. And we saw a link between higher levels of omega 3 and their survival rate thereafter.

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Omega-3 fatty acid effectively lowers high triglycerides

Omega-3 fatty acid medication reduces triglyceride levels by 20-30% among the majority of people who require treatment for high triglyceride levels, suggests a study.

From our review of the evidence from 17 randomised, controlled clinical trials on high triglyceride levels, we concluded that treatment with 4 gm daily of any of the available prescription choices is effective and can be used safely in conjunction with statin medicines that lower cholesterol, said an author of the study.

There are 2 prescription omega-3 fatty acid medications available. One combines 2 types of fatty acids, EPA ( eicosapentaenoic acid) and DHA ( docosahexaenoic acid). The other medication provides EPA only. Since there have been no head-to-head comparisons of the 2 formulations at prescription dosing, the advisory does not recommend one over the other.

Triglycerides are fats that circulate in the blood. Some studies have shown that elevated levels of triglycerides ( above 200mg/dL) can lead to atherosclerosis ( narrowing of the arteries), which increases the risk of heart attack and stroke. In addition to cardiovascular risk,  very high levels of triglycerides ( above 500mg.dL) can also cause pancreatitis, an inflammation of the pancreas.

A researcher pointed out that people with high triglyceride levels should not try to treat the condition themselves with non-prescription, omega-3 fatty acid fish oil supplements.

Dietary supplements containing omega-3 fatty acids are not regulated by the FDA, They should not be used in place of prescription medication for the long-term management of high triglycerides, he said.

The effective dose for prescription omega-3 fatty acids is 4 gm per day taken with food. Currently, the FDA has approved prescription omega-3 fatty acid medications only for treating very high triglyceride levels above 500 mg/dL.

Fish is a good source of omega-3 fatty acids and the American Heart Association recommends eating  fatty fish-such as salmon, mackerel, herring and albacore tuna- at least twice per week.

In the analysis of the current scientific data, the advisory panel found that most people with high triglycerides ( 200-490 mg/dL), prescription doses of omega-3 fatty acids using drugs with either EPA+DHA or EPA alone can reduce triglyceride by 20-30%.

Contrary to common perception, the formula that contains both EPA and DHA does not increase the " bad" form of cholesterol (LDL-C) among most people with high triglyceride levels (200-499 mg/dL). However, when the drug is given to people with very high triglyceride levels at 500 mg/dL or greater, LDL-C may increase.

The panel's review found that prescription omega-3 drugs are effective in reducing triglyceride levels regardless of whether people are on statin therapy.

In a recent large, randomized placebo-controlled study called REDUCE-IT, researchers found that the EPA-only medication combined with statin medication resulted in a 25 % reduction in major cardiovascular events ( heart attack, stroke and cardiovascular death) among people with high triglycerides.

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Omega-3 levels may better predict mortality risk than cholesterol

Measuring the levels of Omega-3 fatty acids present in the blood may indicate the risk of developing cardiovascular diseases and mortality more profoundly than serum cholesterol, researchers have claimed. The serum cholesterol level is the total amount of cholesterol present in the blood. A higher “Omega-3 Index” a combination of the EPA and DHA (two important types of Omega-3) content of red blood cell membranes is associated with a 33 per cent reduced risk of death due to total cardiovascular disease (CVD) events, total coronary heart disease events, and total strokes, the study showed.

“We all know that the serum cholesterol level is a major risk factor for coronary heart disease (CHD), and since the latter is a major cause of death, it would be reasonable to expect that a high cholesterol level would portend higher risk for premature death,” said the lead author.  For the study,  the team compared the total serum cholesterol and Omega-3 fatty acids, two “risk factors” for heart disease, in 2,500 individuals aged 60 years, who were free of known cardiovascular disease (CVD) at baseline.

Researchers primarily focussed on total mortality (death from any cause) as an end-point, but also tracked death from CVD, cancer and other causes. In addition, they reported the associations between Omega-3 Index levels and a risk for any CVD event fatal or not whether a heart attack or stroke.The results showed that the category most strongly associated with the Omega-3 Index was non-cardiovascular disease, non-cancer deaths from all other causes.

“When baseline serum cholesterol levels were substituted for the Omega-3 Index in the same multi-variable models, the former was not significantly associated with any of the tracked outcomes whereas the latter was related to four of the five outcomes assessed,” the author said.

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