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Omega-3: what the largest trial did and did not show

Omega-3s are essential nutrients with well-established roles. Outcome trials in the general population are mixed, so we grade B, not A.

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Editorial section. Research summaries are not product claims and contain no product links or offers. A summary is never proof that any product works.

The question
What does high-quality evidence say about marine omega-3 supplements in healthy adults?
Study design
VITAL: randomized, placebo-controlled trial of 25,871 US adults, median follow-up 5.3 years, 1 g/day marine omega-3. [1][2]
What they found
The trial did not find a reduction in its primary composite endpoints versus placebo. We publish this null result because honest evidence matters more than a tidy story. Omega-3 intake from food is low for many adults, and EPA and DHA are structural parts of cell membranes in the heart, brain and eyes. [1][2]
Limitations
One dose (1 g/day) was tested. Results may differ at higher EPA doses or in people with low fish intake.
What this does not mean
This does not mean omega-3s are useless, and it does not mean a supplement prevents any disease.
Sources
  1. Manson JE et al. N Engl J Med. 2019;380:23-32. doi.org/10.1056/NEJMoa1811403
  2. NIH Office of Dietary Supplements: Omega-3 Fatty Acids fact sheet. ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/

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