Study puts people-beloved omega-3 fatty acids in grey area

The $4.1 billion global markets of omega-3 fatty acids are expected to double by 2025 which highlights the popularity of this product across the world. However, based on the VITAL Rhythm Study, published in this issue of JAMA, scientists have tried to make consumers aware of the potential risks associated.

4 randomized clinical trials in the past 2 years namely the STRENGTH trial, REDUCE-IT trial, OMEMI, and VITAL Rhythm Study, published in this issue of JAMA conducted on 13078, 8179, 1027 & 12542 participants respectively have provided data on Atrial fibrillation with the intake of omega-3 fatty acids.

In the STRENGTH trial, patients suffering from cardiovascular disease were randomized to receive a high dose, 4 g/d, of a carboxylic acid formulation of omega-3 fatty acids (a combination of eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) or corn oil. After a median of 42 months, there was no significant difference between the 2 randomized groups in the primary composite cardiovascular endpoint, but there was an increase in the risk of developing AF in the omega-3 fatty acids group compared with the corn oil group (2.2% vs 1.3%; hazard ratio, 1.69; 95% CI, 1.29-2.21; P < .001).

In the REDUCE-IT trial, participants were randomized to a high dose (4 g/d, as in STRENGTH) of an omega-3 fatty acid preparation which consisted of purified EPA (icosapent ethyl) or mineral oil. After 4.9 years of median follow-up, icosapent ethyl resulted in a relative reduction of 25% in the primary composite cardiovascular endpoint when compared to mineral oil. As in STRENGTH, there was a significant increase in the risk of AF with omega-3 fatty acids compared with mineral oil (5.3% vs 3.9%; P = .003).

In the OMEMI trial, participants were randomized to be given an intermediate dose of 1.8 g/d, of omega-3 fatty acids or corn oil. 2 years later there was no significant difference between the 2 groups in the primary composite cardiovascular endpoint, However, 7.2% of the omega-3 fatty acids group vs 4.0% of the corn oil group developed AF (hazard ratio, 1.84; 95% CI, 0.98-3.45; P = .06).

In the VITAL Rhythm, Study participants were randomized to get a standard dose of omega-3 fatty acids, 840 mg/d, and 12557 to receive a placebo. After a median of 5.3 years, the incidence of Atrial fibrillation was 7.2 per 1000 person-years in those taking omega-3 fatty acids vs 6.6 per 1000 person-years in those taking placebo (hazard ratio, 1.09; 95% CI, 0.96-1.24; P = .19).

The data from the 4 trials when considered together suggests, that there may be a dose-related AF risk with the intake of omega-3 fatty acids. People taking high doses of omega-3 fatty acids should be aware of the potential risk of AF and must be regularly checked up for the same on a regular basis as it may be hazardous.

For the full article click here: https://jamanetwork.com/journals/jama/fullarticle/2777450