By: Thomas Pickering, MD, DPhil, FRCP, Director of Integrative and Behavioral Cardiology Program
of the Cardiovascular Institute at Mount Sinai School of Medicine, New York.

There is a lot of circumstantial evidence that high intakes of both vitamin E and fish oils may be associated with less heart disease, but randomized trials in which the effects of these two dietary constituents are systematically studied are few and far between. A large Italian study, known as the GISSI-Prevenzione trial, has now provided more information.

It was conducted in 11,324 men who had recovered from a first heart attack. For the next 3 years they took either one fish oil capsule a day, one vitamin E capsule (300 IU), both , or neither. At the end of this period there were 10 per cent fewer cardiovascular events (heart attacks, strokes, or deaths) in the men taking the fish oils than in the other groups. Vitamin E conferred no benefit, but also appeared to cause no harm.

Doctor’s Comments

The benefits of fish oils were first suspected when it was noticed that Eskimos ate a very high fat diet but got little heart disease. One previous study (called DART, for Diet And Reinfarction Trial) found that eating fish prevented a second heart attack. The technical term for the ingredients of fish oils is n-3 or omega-3 PUFA (for Poly-Unsaturated Fatty Acids). The amount chosen was equivalent to 100 grams of fatty fish per day, or one serving. There is also one other study which did show a benefit from vitamin E, but others have not.

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