04.25.12
The Agency for Healthcare Research and Quality (AHRQ) in the U.S. released a meta-analysis supporting the association of EPA and DHA on reducing cardiovascular and all-cause mortality at 200 mg of intake per day. Although the report found no further mortality benefit above 200 mg of daily intake, the Global Organization for EPA and DHA Omega-3s (GOED) views this as a positive development because FDA relies on AHRQ for scientific advice.
The systematic review included randomized controlled trials (RCTs) of EPA and DHA supplementation (>4 weeks of intervention, <6 grams per day) and large prospective cohorts (>1000 people, >3 years of follow-up) quantifying EPA or DHA intake. The review included RCTs of population groups with history of coronary artery disease or myocardial infarction; patients with intermittent claudication or hypercholesterolemia; and patients with implantable cardioverter defibrillators, as well as prospective cohorts of healthy populations.
According to the analysis, mean EPA and DHA intake up to 0.20 grams daily was associated with decreased risk of cardiac mortality, with no significant change in risk at higher mean intakes.
These findings are in line with a GOED-funded meta-analysis in individuals with no reported coronary heart disease, published last year in the British Journal of Nutrition, following a similar approach and reaching similar conclusions. The main difference is that the current analysis excludes some papers that the GOED analysis did not and includes others not included in our analysis, but interestingly, the different inclusion criteria does not significantly affect the conclusions. The GOED analysis did show additional benefit at higher dosages for reducing the risk of non-fatal cardiac events.
While the present report indicates, “The levels of EPA and DHA associated with lowest mortality risk, either cardiovascular or all-cause, are consistent with the current dietary guidance of the 2010 Dietary Guidelines…to consume at least two fish meals per week,” the 2010 Dietary Guidelines failed to recognize that low intakes of EPA and DHA posed a public health concern. Perhaps the 2015 revision will now include such acknowledgement, GOED said.
As mentioned previously, GOED believes industry should view this as a positive analysis from a government body on which FDA relies for information. Given that the data from “healthy” people is prospective, it’s unclear how close the AHRQ review gets to the “significant scientific agreement” standard needed for FDA to authorize a health claim. Also, the question remains whether the industry believes the 0.20 gram recommendation is an adequate intake.