Life Extension Magazine®
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Fish Oil Drug Advertised on TV

An FDA panel endorsed a fish-oil-derived drug that contains the omega-3 fatty acid EPA. TV commercials tout this new drug as reducing cardiovascular risk by 25%. Yet there are advantages to fish oil providing EPA and DHA.

Scientifically reviewed by: Dr. Gary Gonzalez, MD, on December 2020. Written By Stephanie Stephens.

At the end of 2019, a Food and Drug Administration (FDA) advisory panel endorsed wider use of an EPA-only (fish oil) prescription drug.1

The physicians on this panel recommended this EPA-only drug to be used in conjunction with cholesterol-lowering statins to reduce triglycerides and other cardiovascular risks.

The panel based its recommendation on a clinical trial using this fish-oil-derived drug that demonstrated improved outcomes in patients at high risk for cardiovascular disease.2

Television ads now tout this fish oil drug as reducing cardiovascular risks by 25%.3

The importance of omega-3 fatty acids in preventing degenerative illnesses has long been recognized.

Fish oil contains both EPA and DHA omega-3s. These fatty acids fight cardiovascular disease by reducing triglycerides and inflammation, along with improving insulin sensitivity.4-6

Studies have consistently shown that taking both EPA and DHA provides robust systemic health benefits.

A recent meta-analysis found that EPA+DHA supplementation is associated with a 35% reduced risk of fatal heart attack.7

The DHA part of fish oil provides unique benefits, particularly in promoting brain and eye health and helping to protect against certain cancers.

Life Extension® recommends daily intake of fish oil containing at least 2,000 milligrams of combined EPA and DHA to maximize benefits.

Some people require higher fish oil doses to obtain protective effects.

What are EPA and DHA?

Man reviewing brain scan images with a doctor

EPA and DHA are omega-3 fatty acids found in fish, and both are vital for optimal health.

They are known to be protective against diverse types of chronic disease.8-13

Some DHA can be converted to EPA in the body, but this conversion is limited.14-16

For years, consumers have been educated on the health benefits of following a Mediterranean diet, rich in fish and extra virgin olive oil, paired with a high-concentration EPA/DHA fish oil supplement.

DHA’s Unique Health Benefits

DHA provides numerous health benefits that do not overlap with those of EPA.

Here are some key ways that DHA differs from EPA:

  • Levels of DHA in the brain are 250 to 300 times higher than EPA, making DHA even more critically important to brain health.16
  • While both DHA and EPA aid the growth and development of brain cells in young animals, DHA has a rejuvenating effect in the brain of older animals.17
  • In response to oxidative stress, DHA is converted in the body to neuroprotectin D-1, which protects against brain aging, neurodegenerative diseases such as Alzheimer’s, Parkinson’s, and brain injury due to stroke.18
  • EPA and DHA work in different ways to limit and resolve inflammation, providing greater benefits together than either one alone.19

Considering these factors, ensuring adequate intake of both EPA and DHA is vital.

Brain Health

Reproduction of a human heart

DHA is instrumental for the proper early development of the brain, and has been the subject of great scientific interest for protecting against cognitive decline in older age.9,12,16,20

In early life, inadequate intake of omega-3 fatty acids has been linked to developmental defects, including autism and attention deficit hyperactivity disorder (ADHD).21,22

In later life, fish oil helps maintain cognitive function.9,12

One reason is that omega-3s boost levels of brain-derived neurotrophic factor.23,24 Lower amounts of this protein have been associated with cognitive decline, Alzheimer’s disease, and other age-related brain conditions.25,26

Clinical trials in patients with cognitive impairment that have focused on DHA have shown that people have significant improvements.

For example, one study randomized older individuals with mild cognitive impairment to receive either fish oil that was mostly DHA (1.3 grams DHA) or a placebo.12 After 12 months, the DHA group had significant improvements in memory.

In another study, patients with mild cognitive impairment received either mostly DHA or mostly EPA.27 Both groups had improvements in depression, but only those receiving the DHA had improved memory and verbal fluency.

In addition, people who died suffering from Alzheimer’s disease had significantly lower levels of DHA in their brains.28

What you need to know

EPA and DHA: A Vital Combination

  • An FDA panel recently endorsed wider use of a drug for heart problems that is derived from the omega-3 fatty acid EPA.
  • EPA provides numerous health benefits. But fish oil containing a balanced combination of EPA and DHA has shown comparable results at a fraction of the cost.
  • DHA has also shown unique abilities to protect the brain, fight forms of cancer, and promote healthy vision.
  • Taking daily fish oil with at least two grams of combined EPA and DHA is ideal for optimal health benefits.

Cardiovascular Disease

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Protection against cardiovascular disease is a well-documented benefit of omega-3 supplementation.

A recent meta-analysis of 40 clinical trials showed that omega-3 supplementation is associated with significant reductions in the risk for cardiovascular disease death.7

The study, published in the Mayo Clinic Proceedings, concluded that supplementation with EPA and DHA reduced the risk of coronary heart disease, including heart attack.7

Fish oil containing both EPA and DHA fatty acids has been shown to reduce the risk of cardiovascular disease by lowering triglyceride levels and improving insulin sensitivity.4-6

Specifically, a recent study found that EPA+DHA supplementation is associated with a reduced risk of:

  • Fatal myocardial infarction (35%)
  • Myocardial infarction (13%)
  • Coronary heart disease events (10%)
  • Coronary heart disease mortality (9%)

The cardiovascular protection was greater with increases in omega-3 dosage. Increasing intake of EPA and DHA by 1,000 mg per day was associated with a reduction of 5.8% in the risk of cardiovascular disease events.7

Life Extension® readers have been advised for decades to supplement with at least 2,000 mg and higher of combined EPA and DHA to maximize health benefits.

Fighting Cancer

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Several studies in humans and animals have shown that omega-3 intake is protective against cancer and even improves response to cancer treatment.29-33

One review study found evidence that DHA in particular helps prevent the development and progression of breast cancer.32

It works by reducing breast cancer cell growth and reducing contributors to breast cancer risk like obesity, inflammation, and metabolic derangements.32

Another review found that high consumption of fish oil reduces the risk for developing pancreatic cancer.33

Again, DHA in particular was found to directly attack pancreatic cancer cells, inducing cell death, inhibiting abnormal signaling associated with cancer progression, and reducing new tumor blood vessel growth.33

Supporting Eye Health

DHA is a structural component of the retina and is vital for the proper development of the eyes in infants and babies.34

In adults, it also appears to support strong vision.

After only 90 days of taking a supplement containing mostly DHA plus a small amount of EPA, individuals with corrected vision saw improvement in visual acuity (sharpness of vision) compared to a placebo group.35

Summary

The two major omega-3 fatty acids in fish oil, EPA and DHA, support healthy biology in different ways.

In published studies, fish oil containing a balanced combination of EPA and DHA has been shown to improve cardiovascular health, brain function, and more.

A study reviewed by an FDA panel of experts found remarkable cardiovascular benefits when using 4,000 mg of EPA by itself (along with a statin when needed). Other studies report similar findings when both EPA and DHA are used.

DHA also provides unique benefits in brain and eye health, and in fighting multiple forms of cancer.

It is important to note that anyone prescribed an EPA-derived drug should not stop taking it without consulting a physician.

Life Extension® recommends daily intake of fish oil containing at least 2,000 mg of EPA + DHA to maximize health benefits.

Those with stubbornly high triglyceride blood levels or other cardiovascular risk factors may consider higher supplemental EPA/DHA doses or increase their dietary intake of cold-water fish like salmon.

If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.

References

  1. Available at: https://www.washingtonpost.com/health/fda-panel-endorses-wider-use-of-fish-oil-drug-to-protect-against-heart-problems/2019/11/14/635e73f0-070f-11ea-8292-c46ee8cb3dce_story.html. Accessed November 29, 2019,
  2. Bhatt DL, Steg PG, Miller M, et al. Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia. N Engl J Med. 2019 Jan 3;380(1):11-22.
  3. Available at: https://www.ispot.tv/ad/nQ21/vascepa-we-got-the-beat. Accessed November 2, 2020.
  4. Gao H, Geng T, Huang T, et al. Fish oil supplementation and insulin sensitivity: a systematic review and meta-analysis. Lipids Health Dis. 2017 Jul 3;16(1):131.
  5. Thota RN, Acharya SH, Garg ML. Curcumin and/or omega-3 polyunsaturated fatty acids supplementation reduces insulin resistance and blood lipids in individuals with high risk of type 2 diabetes: a randomised controlled trial. Lipids Health Dis. 2019 Jan 26;18(1):31.
  6. Le Couteur D, Lanza IR, Macura SI, et al. Distinct Influence of Omega-3 Fatty Acids on the Plasma Metabolome of Healthy Older Adults. The Journals of Gerontology: Series A. 2020 Apr 17;75(5):875-84.
  7. Bernasconi AA, Wiest MM, Lavie CJ, et al. Effect of Omega-3 Dosage on Cardiovascular Outcomes: An Updated Meta-Analysis and Meta-Regression of Interventional Trials. Mayo Clin Proc. 2020 Sep 17.
  8. Kris-Etherton PM, Richter CK, Bowen KJ, et al. Recent Clinical Trials Shed New Light on the Cardiovascular Benefits of Omega-3 Fatty Acids. Methodist Debakey Cardiovasc J. 2019 Jul-Sep;15(3):171-8.
  9. Thomas J, Thomas CJ, Radcliffe J, et al. Omega-3 Fatty Acids in Early Prevention of Inflammatory Neurodegenerative Disease: A Focus on Alzheimer’s Disease. Biomed Res Int. 2015;2015:172801.
  10. Alfaddagh A, Elajami TK, Ashfaque H, et al. Effect of Eicosapentaenoic and Docosahexaenoic Acids Added to Statin Therapy on Coronary Artery Plaque in Patients With Coronary Artery Disease: A Randomized Clinical Trial. J Am Heart Assoc. 2017 Dec 15;6(12):e006981.
  11. Ladesich JB, Pottala JV, Romaker A, et al. Membrane level of omega-3 docosahexaenoic acid is associated with severity of obstructive sleep apnea. J Clin Sleep Med. 2011 Aug 15;7(4):391-6.
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  13. Sakamoto A, Saotome M, Iguchi K, et al. Marine-Derived Omega-3 Polyunsaturated Fatty Acids and Heart Failure: Current Understanding for Basic to Clinical Relevance. Int J Mol Sci. 2019 Aug 18;20(16):4025.
  14. Arterburn LM, Hall EB, Oken H. Distribution, interconversion, and dose response of n−3 fatty acids in humans. The American Journal of Clinical Nutrition. 2006 Jun;83(6):1467S-76S.
  15. Brenna JT, Salem N, Jr., Sinclair AJ, et al. alpha-Linolenic acid supplementation and conversion to n-3 long-chain polyunsaturated fatty acids in humans. Prostaglandins Leukot Essent Fatty Acids. 2009 Feb-Mar;80(2-3):85-91.
  16. Dyall SC. Long-chain omega-3 fatty acids and the brain: a review of the independent and shared effects of EPA, DPA and DHA. Front Aging Neurosci. 2015;7:52.
  17. Robson LG, Dyall S, Sidloff D, et al. Omega-3 polyunsaturated fatty acids increase the neurite outgrowth of rat sensory neurones throughout development and in aged animals. Neurobiol Aging. 2010 Apr;31(4):678-87.
  18. Echeverría F, Valenzuela R, Catalina Hernandez-Rodas M, et al. Docosahexaenoic acid (DHA), a fundamental fatty acid for the brain: New dietary sources.Prostaglandins, Leukotrienes and Essential Fatty Acids. 2017 Sep;124:1-10.
  19. Serini S, Bizzarro A, Piccioni E, et al. EPA and DHA differentially affect in vitro inflammatory cytokine release by peripheral blood mononuclear cells from Alzheimer’s patients. Curr Alzheimer Res. 2012 Oct;9(8):913-23.
  20. Lauritzen L, Brambilla P, Mazzocchi A, et al. DHA Effects in Brain Development and Function. Nutrients. 2016 Jan 4;8(1).
  21. Fuentes-Albero M, Martinez-Martinez MI, Cauli O. Omega-3 Long-Chain Polyunsaturated Fatty Acids Intake in Children with Attention Deficit and Hyperactivity Disorder. Brain Sci. 2019 May 23;9(5).
  22. Martins BP, Bandarra NM, Figueiredo-Braga M. The role of marine omega-3 in human neurodevelopment, including Autism Spectrum Disorders and Attention-Deficit/Hyperactivity Disorder – a review. Critical Reviews in Food Science and Nutrition. 2019 Mar 18;60(9):1431-46.
  23. Knochel C, Voss M, Gruter F, et al. Omega 3 Fatty Acids: Novel Neurotherapeutic Targets for Cognitive Dysfunction in Mood Disorders and Schizophrenia? Curr Neuropharmacol. 2015;13(5):663-80.
  24. Wu A, Ying Z, Gomez-Pinilla F. Dietary omega-3 fatty acids normalize BDNF levels, reduce oxidative damage, and counteract learning disability after traumatic brain injury in rats. J Neurotrauma. 2004 Oct;21(10):1457-67.
  25. Bathina S, Das UN. Brain-derived neurotrophic factor and its clinical implications. Arch Med Sci. 2015 Dec 10;11(6):1164-78.
  26. Erickson KI, Prakash RS, Voss MW, et al. Brain-derived neurotrophic factor is associated with age-related decline in hippocampal volume. J Neurosci. 2010 Apr 14;30(15):5368-75.
  27. Sinn N, Milte CM, Street SJ, et al. Effects of n-3 fatty acids, EPA v. DHA, on depressive symptoms, quality of life, memory and executive function in older adults with mild cognitive impairment: a 6-month randomised controlled trial. Br J Nutr. 2012 Jun;107(11):1682-93.
  28. De Mel D, Suphioglu C. Fishy business: effect of omega-3 fatty acids on zinc transporters and free zinc availability in human neuronal cells. Nutrients. 2014 Aug 15;6(8):3245-58.
  29. Aronson WJ, Kobayashi N, Barnard RJ, et al. Phase II prospective randomized trial of a low-fat diet with fish oil supplementation in men undergoing radical prostatectomy. Cancer Prev Res (Phila). 2011 Dec;4(12):2062-71.
  30. Chagas TR, Borges DS, de Oliveira PF, et al. Oral fish oil positively influences nutritional-inflammatory risk in patients with haematological malignancies during chemotherapy with an impact on long-term survival: a randomised clinical trial. J Hum Nutr Diet. 2017 Dec;30(6):681-92.
  31. Djuric Z, Aslam MN, Simon BR, et al. Effects of fish oil supplementation on prostaglandins in normal and tumor colon tissue: modulation by the lipogenic phenotype of colon tumors. J Nutr Biochem. 2017 Aug;46:90-9.
  32. Molfino A, Amabile MI, Monti M, et al. The Role of Docosahexaenoic Acid (DHA) in the Control of Obesity and Metabolic Derangements in Breast Cancer. Int J Mol Sci. 2016 Apr 5;17(4):505.
  33. Park M, Kim H. Anti-cancer Mechanism of Docosahexaenoic Acid in Pancreatic Carcinogenesis: A Mini-review. Journal of Cancer Prevention. 2017 Mar;22(1):1-5.
  34. Calder PC. Docosahexaenoic Acid. Ann Nutr Metab. 2016;69 Suppl 1:7-21.
  35. Stough C, Downey L, Silber B, et al. The effects of 90-day supplementation with the omega-3 essential fatty acid docosahexaenoic acid (DHA) on cognitive function and visual acuity in a healthy aging population. Neurobiol Aging. 2012 Apr;33(4):824 e1-3.