Do Fish Oil Supplements Really Support Heart Health?
For years, the headlines have swung between excitement and skepticism over whether fish oil supplements truly benefit the heart. At OmegaQuant, we remain confident in their value—especially when it comes to raising the Omega-3 Index and delivering protective levels of EPA and DHA.
A recent study published in the British Medical Journal (BMJ) revisited this question by analyzing whether fish oil use lowers the risk of cardiovascular events like heart attack and stroke, as well as overall mortality.
What Experts Are Saying
Alice Lichtenstein, director of the Cardiovascular Nutrition Laboratory at Tufts University, noted that “with regard to fish oil and CVD the data for the most part have been positive, albeit with some wobbling among studies. The latest study adds to the database suggesting effectiveness.”
Others, like Brian Power, a dietitian at University College London Hospital, still recommend food-first approaches—encouraging people to get omega-3s from fish twice a week or plant-based foods like walnuts, tofu, or leafy greens.
However, there’s an important caveat: plant-based omega-3s (ALA) convert into EPA and DHA at a rate of only about 1%. That means sources like chia, flax, and soy, while healthy, cannot provide the same cardiovascular benefits as direct sources of EPA and DHA from fish or high-quality supplements.
The BMJ Study: Key Findings
The BMJ study examined data from nearly half a million adults over nine years. After excluding participants with baseline heart disease or cancer, researchers followed 427,678 individuals to evaluate the long-term effects of habitual fish oil use.
Results showed that fish oil users experienced:
-
13% lower risk of all-cause mortality
-
16% lower risk of death from cardiovascular disease
-
7% lower risk of cardiovascular events
Interestingly, about a third of the participants reported using fish oil supplements. These users tended to be older, more often female, non-smokers, and more physically active than non-users. They also ate oily fish more frequently and were more likely to use other supplements or medications like antihypertensives and aspirin.
Why Dose Matters in Fish Oil Research
One reason past studies have produced mixed results is dosage. Many trials tested very low doses of omega-3s, which likely diluted their benefits.
For example:
-
The VITAL trial used 840 mg/day of omega-3s.
-
The REDUCE-IT trial used 3992 mg/day of purified EPA.
Not surprisingly, REDUCE-IT produced dramatic results, while lower-dose studies often found little effect. A recent meta-analysis pooling 13 randomized controlled trials confirmed that higher doses yield greater cardiovascular protection.
This is why the International Society for the Study of Fatty Acids and Lipids (ISSFAL) now encourages studies to include omega-3 blood testing in their designs—helping ensure that participants actually reach therapeutic Omega-3 Index levels.
Omega-3s and Coronary Artery Health
Adding to the evidence, a study in the European Journal of Clinical Nutrition looked at coronary artery calcification (CAC)—a key predictor of heart disease. Researchers found that patients in the early stages of atherosclerosis had low Omega-3 Index levels, suggesting a connection between inadequate omega-3 intake and early arterial damage.
Previous lab research supports this link, showing that EPA and DHA can help prevent calcification of blood vessels at the cellular level. While larger human studies are needed, these findings point to a protective role for omega-3s in slowing cardiovascular disease progression.
The Takeaway: Fish Oil Still Matters
Despite ongoing debates, the weight of evidence shows that higher omega-3 intake—particularly EPA and DHA—supports cardiovascular health and longevity.
Key points to remember:
-
Plant-based ALA is not enough — prioritize direct sources of EPA and DHA.
-
Dose matters — higher daily intake is linked with stronger cardiovascular benefits.
-
Testing matters — aim for an Omega-3 Index of 8–12% to achieve protective blood levels.
With their low cost, safety, and convenience, fish oil supplements remain one of the simplest tools for supporting heart health—especially for those who do not eat oily fish regularly.