- Polyunsaturated fatty acids (PUFAs), such as those in fish oils, do little for cardiovascular disease (CVD) prevention and nothing for all-cause or CVD mortality, according to this Cochrane review.
- Unusually rapid update of 2018 meta-analysis of randomized controlled trials (RCTs).
Why this matters
- The PUFA/fish oil evidence base has been tilting in different directions recently.
- This Cochrane review finds little effect, in keeping with recent findings from the VITAL trial of omega-3s and CVD risk and another recent study of fish oil supplements for CVD protection.
- However, findings from a trial of a proprietary formulation of omega-3s found reduced CVD risk.
- Risk ratios (95% CIs) with PUFA supplement/foods vs control (all moderate-quality evidence):
- All-cause mortality: 0.98 (0.89-1.07); 19,290 participants, 24 trials.
- Coronary heart disease: 0.87 (0.72-1.06); 10,076 participants, 15 trials.
- CVD events: 0.89 (0.79-1.01); 17,799 participants, 21 trials.
- Risk ratios and 95% CIs with PUFA supplement/foods vs control (all low-quality evidence):
- Coronary heart disease death: 0.91 (0.78-1.06); 8810 participants, 9 trials.
- Stroke: 0.91 (0.58-1.44); 14,742 participants; 11 trials.
- CVD mortality: 1.02 (0.82-1.26); 15,107 participants, 16 trials.
- Slightly decreased triglycerides but no/little cholesterol, BMI effects.
- 49 RCTs, 24,272 participants, 1-8-year durations.
- Funding: WHO.
- Those of included studies.