LIPID METABOLISM AND THERAPY: Edited by Philip C. Calder and Richard J. DeckelbaumAre n-3 fatty acids still cardioprotective?Harris, William S.a,b,cAuthor Information aSanford School of Medicine, University of South Dakota, Sioux Falls, South Dakota bHealth Diagnostic Laboratory, Inc., Richmond, Virginia cOmegaQuant Analytics, LLC, Sioux Falls, South Dakota, USA Correspondence to William S. Harris, 737 N. 5th St, Ste 103, Richmond, VA 23291, USA. Tel: +1 877 443 5227/713; e-mail: [email protected] Current Opinion in Clinical Nutrition and Metabolic Care: March 2013 - Volume 16 - Issue 2 - p 141-149 doi: 10.1097/MCO.0b013e32835bf380 Buy Metrics Abstract Purpose of review Several recent randomized trials and subsequent meta-analyses have questioned the value of n-3 fatty acid supplementation in cardiovascular disease risk reduction. Recent findings This report focuses on four clinical trials published between 2010 and 2012 that have failed to show benefits of n-3 fatty acids, and on one meta-analysis from 2012 that used a controversial statistical approach in reaching a conclusion of no effect. Summary The question of the extent to which n-3 fatty acid supplementation reduces risk for cardiovascular disease remains open. Future studies must be properly powered, use doses of n-3 fatty acids significantly higher than those provided in background diets, focus on patient populations with low n-3 fatty acid tissue levels, treat for longer periods of time, and consider the effects of these agents in the great majority of patients who are not on guideline-directed therapeutic regimens. The strong evidence-base from prospective cohort studies and the ever-deepening understanding of the cellular effects of long-chain n-3 fatty acids together support the need for these nutrients in reducing cardiovascular risk. Short-term findings from randomized controlled trials need to be interpreted in the light of all the evidence. © 2013 Lippincott Williams & Wilkins, Inc.