DiNicolantonio, James J.; Niazi, Asfandyar K.; McCarty, Mark F.; O'Keefe, James H.; Meier, Pascal; Lavie, Carl J.
Background: Omega-3 (n-3) fatty acids have previously been shown to reduce the risk of cardiac events, cardiac death, and all-cause mortality in randomized controlled trials. However, recent data have challenged the benefits of n-3 fatty acids in the current era of optimal medical therapy.; Methods: We performed a literature review indicating important limitations that must be considered when interpreting the recent negative n-3 fatty acids trials.; Results: Our review found relative strengths and weaknesses of both the older and more recent studies, along with many possible explanations for the disparate results. The principal difference between the older and the more recent n-3 studies was a greater use of background optimal medical therapy that may have reduced the benefit from n-3s. Additionally, some of the more recent n-3 trials used relatively low doses or tested n-3 supplementation on top of a relatively high baseline intake of n-3s.; Conclusion: Despite the recent negative data about n-3 fatty acids, the overall evidence still supports the American Heart Association recommendation of 1 gram of eicosapentaenoic acid/docosahexaenoic acid per day for patients with coronary heart disease.