Evidence-Based Nutrient Recommendations

Systematic Review on Omega-3s and Heart Disease


We updated our omega-3s and heart disease information to include a 2020 Cochrane Review, which is a gold-standard, highly systematic evaluation of research on a particular topic. The authors call this Cochrane Review “the most extensive systematic assessment of effects of omega‐3 fats on cardiovascular health to date.”

The review analyzed 86 randomized controlled trials of 12 to 88 months duration testing omega-3 capsules, omega-3-enriched food, or dietary advice to eat more omega-3s. The researchers found little to no effect of increasing omega-3s on all-cause or cardiovascular mortality, cardiovascular events, stroke, or arrhythmias. Increasing omega-3s slightly reduced coronary heart disease mortality and events. Increasing long-chain omega-3s reduced triglycerides by ~15% in a dose‐dependent way.

Increasing ALA was found to have little to no effect on all-cause or cardiovascular mortality, or coronary heart disease mortality or events. Increasing ALA slightly reduced the risk of cardiovascular disease events and arrhythmias.

Overall, the authors stated that 334 people would need to increase their long-chain omega-3 intake to prevent one person from having a coronary heart disease event and they believed this wasn’t enough of an impact to recommend supplementation.

There wasn’t enough evidence to assess the impact of fish on cardiovascular health.

This review does not change our omega-3 recommendations.


Abdelhamid AS, Brown TJ, Brainard JS, Biswas P, Thorpe GC, Moore HJ, Deane KHO, Summerbell CD, Worthington HV, Song F, Hooper L. Omega‐3 fatty acids for the primary and secondary prevention of cardiovascular disease. Cochrane Database of Systematic Reviews 2020, Issue 3.

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