Omega-3 fats are found in some fatty fish and in some plant sources, such as walnuts, canola and soybean oils, and flaxseed. They do not affect LDL levels but may help protect the heart in other ways. In some studies, people who ate fish had a reduced death rate from heart disease. It is possible that this is related to the effects of omega-3 fats, which may help prevent blood clots from forming and inflammation from affecting artery walls. Omega-3 fats also may reduce the risk for heart rhythm problems and, at high doses, reduce triglyceride levels. Studies have suggested that omega-3 fats reduce the risk for heart attack and death from heart disease for those who already have heart disease (National Cholesterol Education Program, 2001 [R]). The recommended daily amount of omega-3 fatty acids in patients with dyslipidemia is 1 gram of EPA/DHA by capsule supplement, or by eating at least two servings per week of fatty fish. Studies show that 1.5 grams of ALA or more per day from plant sources is associated with a 40%-65% reduced risk of death from cardiac events. The amounts of omega-3 fatty acids in various foods are found in the table in Appendix A, "Omega-3 Fatty Acids." Plant-based sources of omega-3 fatty acids would be ground flax seed, flax seed oil, walnut oil, canola oil and soybean oil. Fish meals can be difficult for patients to maintain, and there are issues of potential environmental contaminants including mercury, PCBs, dioxin and others. Because of this, capsule supplements may be preferred, although there is no uniformity of EPA/DHA content or purity. Patients should consult their health providers or nutritionists regarding this issue (Kris-Etherton, 2002 [R]). Dietary and non-dietary intake of n-3 polyunsaturated fatty acids may reduce overall mortality and sudden death in patients with stable CAD (Bucher, 2002 [M]). See the ICSI Stable Coronary Artery Disease guideline for more information. |