Today’s question is how much omega-3 fat is safe and effective to take via supplementation.  The large UK Biobank study and some other studies have shown that high dose omega-3 fat supplementation (above 1800 mg per day) may increase risk of atrial fibrillation, which is a major risk factor for stroke and heart failure. On the other hand, a number of well controlled human intervention studies have shown that lower dose supplementation with omega-3 fats, in the range of 800-1200 mg per day, can help to lower risk of heart attack (myocardial infarction) by about 30%, as well as reducing cardiovascular deaths from other causes. Doses below 800 mg per day have not shown any cardiovascular benefit. So, my suggestion is that you consider using an omega-3 supplement, using a daily dosage of no more than 1200 mg and no less than 800 mg per day.

I personally take an essential fatty acid supplement each day that contains 400 mg each of fish, flaxseed and borage seed oil. The fish and flaxseed oil provide the omega-3 fat content. One capsule yields 448 mg of omega-3 fat. I generally take and recommend two capsules per day, which yields 856 mg of omega-3 fat – exactly in the safe and effective range. The borage seed oil is 22% gamma-linolenic acid, which the body uses to produce anti-inflammatory prostaglandin-series 1, which is particularly important to improving skin texture and suppressing joint inflammation.

Regarding other ways to prevent atrial fibrillation, a number of studies have shown that CoQ10 supplementation, especially after age 45 or 50, may reduce risk of atrial fibrillation and heart failure ( https://pubmed.ncbi.nlm.nih.gov/25919281/) . The herb hawthorn also shows anti-arrhythmic effects and has been used to improve cases of heart failure (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4321072/). There is also evidence that L-taurine (an amino acid supplement) can help prevent heart arrhythmias via its effects on the heart muscle. What is noteworthy is that our body produces less CoQ10 and L-Taurine as we age, which are likely factors that lead to the age-related increased risk of atrial fibrillation and other dangerous arrhythmias. After age 45, I think that taking a supplement containing CoQ10, Hawthorn and L-Taurine makes sense as one more way to preserve heart health and help guard against atrial fibrillation and arrythmia problems.

Of course, remaining fit, not smoking, remaining at your ideal body weight, keeping your blood pressure and cholesterol levels in the healthy range, are foundational strategies in preventing atrial fibrillation and heart disease in general (https://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/symptoms-causes/syc-20350624).

But when it comes to omega-3 fat supplementation, the sweet spot for safety and efficacy appears to be 800-1200 mg per day. I have included the references for omega-3 fat and atrial fibrillation in the text below.

References:
Medscape: Who Benefits From Omega-3/Fish Oil Supplements. J. E Manson. June 2, 2024. Who Benefits From Omega-3/Fish Oil Supplements? (medscape.com)

Shen S et al. Omega-3 fatty acid supplementation and coronary heart disease risks: A meta-analysis of randomized controlled clinical trials. Frontiers of Nutrition. 2022, 9: 809311. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8850984/#:~:text=Both%20the%20results%20of%20VITAL,by%2028%25%20(13).

Eat Smart, Live Well, Look Great,
Dr. Meschino