Meta-analysisindependent cross-checkabstract checked I-SUP-113 standard review

Omega-3 dose and heart outcomes (industry-linked review)

Effect of Omega-3 Dosage on Cardiovascular Outcomes: An Updated Meta-Analysis and Meta-Regression of Interventional Trials.

Overview

Bernasconi AA et al.. Mayo Clin Proc 2021 · PMID 32951855 · DOI 10.1016/j.mayocp.2020.08.034

Pooling 40 trials, omega-3 lowered heart attacks by about 13%; one heart attack was prevented per 272 people treated.

Does the study support the specific claim? No · Methodological quality: moderate

Study explained simply

What did the researchers want to find out?: To estimate omega-3 effects and dose-response.
How was the study done?: Meta-analysis of 40 trials.
How many people, animals or samples were studied?: 135,267 people.
What was actually found?: Fewer heart attacks and coronary events; overall CVD events not significantly reduced.
How large was the observed effect?: MI RR 0.87, NNT 272.
What do the results mean in everyday life?: Any benefit is small for an individual.
What are the study's limitations?: Industry affiliation; mixed formulations.
What does it say about Elawady's specific claim?: Contradicts 'no benefit' in C-SUP-05, but modestly.
Do the results apply to Germany and Europe?: Applicable.
What can explicitly not be concluded from this study?: Cannot show benefit of ordinary low-dose capsules alone.

Authors: Bernasconi AA et al.
Journal: Mayo Clin Proc
Year: 2021
Identifier: PMID 32951855 DOI 10.1016/j.mayocp.2020.08.034
Verification: verified – PubMed efetch 2026-10-26; Crossref works API 2026-10-26
Retracted: no
Corrections: none
Extent checked: abstract only
Conflicts of interest and funding: First author's affiliation listed in the record: Global Organization for EPA and DHA Omega-3s (GOED), an omega-3 industry association; no COI statement in PubMed record.

Effect and dose-response of EPA/DHA on CVD outcomes.

Study design: Meta-analysis – Meta-analysis and meta-regression of RCTs of EPA/DHA supplementation
Population: Participants in EPA/DHA intervention trials
Country: Multinational
Period: Trials published before August 2019
Sample size: 40 studies; 135,267 participants
Inclusion and exclusion criteria: RCTs with EPA/DHA and cardiovascular outcomes

Results: MI RR 0.87 (0.80-0.96), NNT 272 (high certainty per authors); CHD events RR 0.90 (0.84-0.97), NNT 192; fatal MI RR 0.65 (0.46-0.91), NNT 128; CHD mortality RR 0.91 (0.85-0.98), NNT 431; CVD events RR 0.95 (0.90-1.00, n.s.); dose-dependent for CVD events and MI.
Absolute risks: NNT 272 for MI (implied control risk about 2.8%; stats/C-SUP-05_omega3.py)
Authors' conclusion: EPA and DHA supplementation is an effective lifestyle strategy for CVD prevention, probably increasing with dose.

Orienting tool: AMSTAR 2
Type of assessment: simplified assessment (abstract only)
Full formal assessment: no
Overall risk of bias: high
Rationale: Industry affiliation of the first author (GOED); pooling of heterogeneous formulations.

Small absolute benefits (NNT 128-431); overall CVD events not significantly reduced.

Strongest pro-supplement meta-analysis; contradicts 'no benefit at all' but its benefit is small and driven partly by high-dose EPA.

Cochrane (A-SUP-12) and I-SUP-114 find no effect at <=1 g/day.

Applicable.

Contradicting but of limited weight because of COI and heterogeneity.

Multidimensional assessment
Multidimensional assessment
Authenticity of the source	verified
Methodological quality	moderate
Risk of bias	high
Precision of results	moderate
Directness	direct
Reproducibility	partly replicated
Consistency with the overall evidence	mixed
Regional transferability	high
Adequacy of the interpretation (by the archive)	not applicable

Role of mineral-oil placebo in REDUCE-IT.