(P01-13-26) Defining EPA+DHA Intakes Associated With Reduced Risk for Cardiovascular Disease: A Systematic Review and Meta-Analysis of Observational Cohort Studies

Objectives: Evidence available in 2006 suggested that an intake of eicosapentaenoic acid and docosahexaenoic acid (EPA+DHA) of 250 mg/day was sufficient to reduce risk for death from coronary heart disease. In the ensuing years, additional evidence has accumulated to enable an updated estimate of cardioprotective intakes of EPA+DHA.

Methods: A systematic search was conducted in PubMed to identify prospective observational studies that examined the relationships between EPA+DHA intake and major adverse cardiovascular and cerebrovascular events (MACCE) and cardiac death, as well as 5 other secondary outcomes (atrial fibrillation; heart failure; ischemic stroke; hemorrhagic stroke; total mortality). Twenty-four datasets were identified for MACCE and seventeen datasets were identified for cardiac death; only 3 to 6 studies were identified for each secondary outcome. Data were meta-analyzed across intake quintiles, comparing risk in the highest quintile (Q5) vs the lowest (Q1).

Results: The risk for MACCE was lower in Q5 as compared to Q1 [hazard ratio, HR, (95% confidence interval, CI) = 0.84 (0.73,0.97)]. Similarly, for cardiac death, risk was lower in Q5 as compared to Q1 [HR (95% CI) = 0.84 (0.70,0.99)]. Median intakes in Q5 were similar across both primary outcomes and were 571 mg/day for MACCE and 565 mg/day for cardiac death. The meta-analysis showed no evidence of study-to-study heterogeneity in either case (I2=0%). Although most Q5 point estimates of HRs for secondary outcomes were < 1.0, none of the relationships were statistically significant.

Conclusions: Intakes of EPA+DHA associated with the lowest risk for MACCE and cardiac death were between 500 and 600 mg/day. Based on these findings, an EPA+DHA intake of at least 500 mg/day should be considered as a dietary target to reduce cardiovascular risk.

Funding Sources: The Global Organization for EPA and DHA Omega-3s (GOED)