Current Atherosclerosis Reports

, Volume 10, Issue 6, pp 503–509 | Cite as

Intakes of long-chain omega-3 fatty acid associated with reduced risk for death from coronary heart disease in healthy adults

  • William S. HarrisEmail author
  • Penny M. Kris-Etherton
  • Kristina A. Harris


Numerous organizations and national health agencies have begun to recommend consumption of the long-chain omega-3 fatty acids (FAs) eicosapentaenoic acid and docosahexaenoic acid (EPA and DHA), respectively, in pill or fish form for general cardiovascular health. The purpose of this article is to present a rationale for an official target intake of 400 to 500 mg/d of EPA + DHA in the United States. Six epidemiologic studies reporting EPA + DHA intake and risk of coronary heart disease (CHD) death have been conducted in the United States, and five studies reported statistically significant inverse trends. Meta-analysis of these data showed a significant dose-response relationship between risk for CHD death and intake (P = 0.03), with relative risk reductions of 37% at an average EPA + DHA intake of 566 mg/d. Coincidentally, two servings per week of oily fish (the current American Heart Association recommendation) would provide 400 to 500 mg/d. We conclude, therefore, that an intake of 400 to 500 mg/d of EPA + DHA is achievable by diet alone and would be expected to significantly reduce risk for death from CHD in healthy adults.


Food Frequency Questionnaire Coronary Heart Disease Death Multiple Risk Factor Intervention Trial Primary Cardiac Arrest Target Intake 
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References and Recommended Reading

  1. 1.
    Kris-Etherton PM, Harris WS, Appel LJ: Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation 2002, 106:2747–2757.PubMedCrossRefGoogle Scholar
  2. 2.
    Wang C, Harris WS, Chung M, et al.: n-3 Fatty acids from fish or fish-oil supplements, but not {alpha}-linolenic acid, benefit cardiovascular disease outcomes in primary-and secondary-prevention studies: a systematic review. Am J Clin Nutr 2006, 84:5–17.PubMedGoogle Scholar
  3. 3.
    Robinson JG, Stone NJ: Antiatherosclerotic and antithrombotic effects of omega-3 fatty acids. Am J Cardiol 2006, 98:39i–49i.PubMedCrossRefGoogle Scholar
  4. 4.
    Psota TL, Gebauer SK, Kris-Etherton P: Dietary omega-3 fatty acid intake and cardiovascular risk. Am J Cardiol 2006, 98:3i–18i.PubMedCrossRefGoogle Scholar
  5. 5.
    Lichtenstein AH, Appel LJ, Brands M, et al.: Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation 2006, 114:82–96.PubMedCrossRefGoogle Scholar
  6. 6.
    Morris MC, Manson JE, Rosner B, et al.: Fish consumption and cardiovascular disease in the Physicians’ Health Study: A prospective study. Am J Epidemiol 1995, 142:166–175.PubMedGoogle Scholar
  7. 7.
    Hu FB, Cho E, Rexrode KM, et al.: Fish and long-chain omega-3 fatty acid intake and risk of coronary heart disease and total mortality in diabetic women. Circulation 2003, 107:1852–1857.PubMedCrossRefGoogle Scholar
  8. 8.
    Hu FB, Bronner L, Willett WC, et al.: Fish and omega-3 fatty acid intake and risk of coronary heart disease in women. JAMA 2002, 287:1815–1821.PubMedCrossRefGoogle Scholar
  9. 9.
    Albert CM, Hennekens CH, O’Donnell CJ, et al.: Fish consumption and risk of sudden cardiac death. JAMA 1998, 279:23–28.PubMedCrossRefGoogle Scholar
  10. 10.
    Siscovick DS, Raghunathan TE, King I, et al.: Dietary intake and cell membrane levels of long-chain n-3 polyunsaturated fatty acids and the risk of primary cardiac arrest. JAMA 1995, 274:1363–1367.PubMedCrossRefGoogle Scholar
  11. 11.
    Dolecek TA: Epidemiological evidence of relationships between dietary polyunsaturated fatty acids and mortality in the Multiple Risk Factor Intervention Trial. Proc Soc Exper Bio Med 1992, 200:177–182.Google Scholar
  12. 12.
    Mozaffarian D, Lemaitre RN, Kuller LH, et al.: Cardiac benefits of fish consumption may depend on the type of fish meal consumed: the Cardiovascular Health Study. Circulation 2003, 107:1372–1377.PubMedCrossRefGoogle Scholar
  13. 13.
    Albert CM, Campos H, Stampfer MJ, et al.: Blood levels of long-chain n-3 fatty acids and the risk of sudden death. N Engl J Med 2002, 346:1113–1118.PubMedCrossRefGoogle Scholar
  14. 14.
    Haddock CK, Rindskopf D, Shadish W: Using odds ratios as effect sizes for meta-analysis of dichotomous data: a primer on methods and issues. Psych Meth 1998, 13:339–353.CrossRefGoogle Scholar
  15. 15.
    Brown BG, Cheung MC, Lee AC, et al.: Antioxidant vitamins and lipid therapy: end of a long romance? Arterioscler Thromb Vasc Biol 2002, 22:1535–1546.PubMedCrossRefGoogle Scholar
  16. 16.
    Rosano GM, Vitale C, Silvestri A, et al.: Hormone replacement therapy and cardioprotection: the end of the tale? Ann N Y Acad Sci 2003, 997:351–357.PubMedCrossRefGoogle Scholar
  17. 17.
    Yokoyama M, Origasa H, Matsuzaki M, et al.: Effects of eicosapentaenoic acid on major coronary events in hyper-cholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet 2007, 369:1090–1098.PubMedCrossRefGoogle Scholar
  18. 18.
    GISSI-Prevenzione Investigators: Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E in 11,324 patients with myocardial infarction: results of the GISSI-Prevenzione trial. Lancet 1999, 354:447–455.CrossRefGoogle Scholar
  19. 19.
    von Schacky C, Angerer P, Kothny W, et al.: The effect of dietary w-3 fatty acids on coronary atherosclerosis. a randomized, double-blind, placebo-controlled trial. Ann Intern Med 1999, 130:554–562.Google Scholar
  20. 20.
    Kromhout D, Bosschieter EB, de LezenneCoulander C: The inverse relation between fish consumption and 20-year mortality from coronary heart disease. N Engl J Med 1985, 312:1205–1209.PubMedGoogle Scholar
  21. 21.
    Rodriguez BL, Sharp DS, Abbott RD, et al.: Fish intake may limit the increase in risk of coronary heart disease morbidity and mortality among heavy smokers. The Honolulu Heart Program. Circulation 1996, 94:952–956.PubMedGoogle Scholar
  22. 22.
    Tavani A, Pelucchi C, Negri E, et al.: n-3 Polyunsaturated fatty acids, fish, and nonfatal acute myocardial infarction. Circulation 2001, 104:2269–2272.PubMedCrossRefGoogle Scholar
  23. 23.
    Daviglus ML, Stamler J, Orencia AJ, et al.: Fish consumption and the 30-year risk of fatal myocardial infarction. N Engl J Med 1997, 336:1046–1053.PubMedCrossRefGoogle Scholar
  24. 24.
    Burchfiel CM, Reed DM, Strong JP, et al.: Predictors of myocardial lesions in men with minimal coronary atherosclerosis at autopsy. The Honolulu Heart Program. Ann Epidemiol 1996, 6:137–146.PubMedCrossRefGoogle Scholar
  25. 25.
    Burr ML, Fehily AM, Gilbert JF, et al.: Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet 1989, 2:757–761.PubMedCrossRefGoogle Scholar
  26. 26.
    Marchioli R, Barzi F, Bomba E, et al.: Early protection against sudden death by n-3 polyunsaturated fatty acids after myocardial infarction: time-course analysis of the results of the Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico (GISSI)-Prevenzione. Circulation 2002, 105:1897–1903.PubMedCrossRefGoogle Scholar
  27. 27.
    United States Department of Agriculture: Foods commonly eaten in the United States. Available at: Accessed on May 27, 2008.
  28. 28.
    Food Standards Agency: Advice on fish consumption: benefits and risks. Available at: Accessed on May 27, 2008.
  29. 29.
    Health Council of the Netherlands: Guidelines for a healthy diet 2006. Available at Accessed on May 27, 2008.
  30. 30.
    Mozaffarian D, Rimm EB: Fish intake, contaminants, and human health: evaluating the risks and the benefits. JAMA 2006, 296:1885–1899.PubMedCrossRefGoogle Scholar
  31. 31.
    Iso H, Kobayashi M, Ishihara J, et al.: Intake of fish and n3 fatty acids and risk of coronary heart disease among Japanese: the Japan Public Health Center-Based (JPHC) Study Cohort I. Circulation 2006, 113:195–202.PubMedCrossRefGoogle Scholar
  32. 32.
    Kuriki K, Nagaya T, Tokudome Y, et al.: Plasma concentrations of (n-3) highly unsaturated fatty acids are good biomarkers of relative dietary fatty acid intakes: a cross-sectional study. J Nutr 2003, 133:3643–3650.PubMedGoogle Scholar
  33. 33.
    Andersen LF, Solvoll K, Drevon CA: Very-long-chain n-3 fatty acids as biomarkers for intake of fish and n-3 fatty acid concentrates. Am J Clin Nutr 1996, 64:305–311.PubMedGoogle Scholar
  34. 34.
    Nobmann ED, Ebbesson SO, White RG, et al.: Associations between dietary factors and plasma lipids related to cardiovascular disease among Siberian Yupiks of Alaska. Int J Circumpolar Health 1999, 58:254–271.PubMedGoogle Scholar
  35. 35.
    Food and Drug Administration: Substances affirmed as generally recognized as safe: Menhaden Oil. Fed Regist 1997, 30751–30757.Google Scholar
  36. 36.
    Castoldi AF, Coccini T, Manzo L: Neurotoxic and molecular effects of methylmercury in humans. Rev Environ Health 2003, 18:19–31.PubMedGoogle Scholar
  37. 37.
    Food and Drug Administration: Guidance on mercury. Available at Accessed on May 27, 2008.
  38. 38.
    Ascherio A, Rimm EB, Stampfer MJ, et al.: Dietary intake of marine n-3 fatty acids, fish intake, and the risk of coronary disease among men. N Engl J Med 1995, 332:977–982.PubMedCrossRefGoogle Scholar
  39. 39.
    Eurodiet Core Report 2000. Available at Accessed on May 27, 2008.
  40. 40.
    AFFSA: Apports Nutritionnels Conseilles (ANC). In Apports Nutritionnels Conseilles pour la Population Franąise, edn 3. Edited by Martin A. Lavoisier, France: Tech. & Doc; 2001.Google Scholar
  41. 41.
    International Society for the Study of Fatty Acids and Lipids, 2004: Statement on essential fatty acid intakes. Available at Accessed on May 27, 2008.
  42. 42.
    National Health and Medical Research Council: Nutrient reference values for Australia and New Zealand, 2005. Available at Accessed on May 27, 2008.
  43. 43.
  44. 44.
    Kris-Etherton PM, Innis S: Position of the American Dietetic Association and Dietitians of Canada: dietary fatty acids. J Am Diet Assoc 2007, 107:1599–1611.PubMedGoogle Scholar
  45. 45.
    Howe P, Buckley J, Meyer B: Long-chain omega-3 fatty acids in red meat. Nutr Dietetics 2007, 64:S135–S139.CrossRefGoogle Scholar

Copyright information

© Current Medicine Group LLC 2008

Authors and Affiliations

  • William S. Harris
    • 1
    Email author
  • Penny M. Kris-Etherton
  • Kristina A. Harris
  1. 1.Metabolism and Nutrition Research CenterSanford Research/University of South DakotaSioux FallsUSA

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