Fish Oil in Health and Disease

Taking Fish Oils Lowered Heart Attack Survivors’ Risk of Having Subsequent Heart Attacks

SANTA MARIA IMBARO, ITALY. There is clear evidence that a diet rich in oily fish confers considerable protection against heart disease. What is less clear is whether concentrated fish tissue oils in capsule form confer similar benefits. A very large group of Italian researchers (Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico) has completed a major study which shows the benefits of fish oil supplementation in patients who have survived a first heart attack.

Their study involved over 11,000 heart attack survivors who were randomly assigned to one of four groups. Group one received a one- gram gelatin capsule containing about 580 mg of eicosapentaenoic acid (EPA) and 290 mg of docosahexaenoic acid (DHA) as ethyl esters every day. Group two received 300 mg of synthetic vitamin E daily; group three both fish oil and vitamin E; and group four served as the control group. All participants ate a largely Mediterranean diet and continued to take their prescribed medications (beta- blockers, aspirin, and ACE-inhibitors). After 3.5 years of follow-up it was clear that the participants who had received fish oil or fish oil plus vitamin E had lowered their risk of dying or having another heart attack or a stroke by 10 to 15 per cent. The group who had taken vitamin E alone derived no statistically significant benefit from doing so.

Editor's note: The 300 mg of synthetic vitamin E used in the study corresponds to about 150 IU of natural vitamin E. This would be much less effective than the 200-400 IU/day of natural vitamin E used in studies which have shown a benefit of vitamin E in regard to heart disease and stroke.

The researchers conclude that daily supplementation with fish oils (equivalent of consuming 100 grams of fish per day) is beneficial for patients who have survived a first heart attack. They suggest that the role of vitamin E needs further exploration.

Editor's note: Other studies have shown that vitamin E protects fish oils from going rancid so it is a good idea to take a combination of fish oil and vitamin E together.
Note: This study was funded in part by Bristol-Myers Squibb, Pharmacia-Upjohn, Societa Prodotti Antibiotici, and Pfizer.

Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. The Lancet, Vol. 354, August 7, 1999, pp. 447-55
Brown, Morris. Do vitamin E and fish oil protect against ischaemic heart disease? The Lancet, Vol. 354, August 7, 1999, pp. 441-42 (commentary)

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