This has not stopped some heart doctors from using omega-3 supplements in their patients, however. Dr. Melvyn Rubenfire, director of preventive cardiology at the University of Michigan in Ann Arbor, says he is currently using EPA + DHA supplements in patients with coronary artery disease because "available evidence supports it."
But Rubenfire added that he would like to see a "trial in the modern era in patients on other evidence-based treatments such as aspirin, [blood pressure] control, statin and non smoking" to confirm an omega-3 benefit on top of standard care.
And then there is the question of whether people who take commercially available supplements will be getting enough of the nutrient to make a difference. Rubenfire warned that the lack of regulation in the supplement industry means "that 1,000 mg of fish oil caplets may contain as little as 300 mg of EPA+DHA."
The American Heart Association (AHA) appears to already be on board with omega-3 guidelines. The organization's current recommendation is that people with confirmed coronary heart disease should consume 1,000 mg daily of combined DHA + EPA. For healthy adults, the AHA recommends consuming 500 mg per day, which works out to consuming at least two servings of fatty fish a week.
But while it does promote heart healthy diets for all, the AHA remains wary about mercury contamination in fish and cautions that fish with the highest potential for contamination -- namely shark, swordfish, king mackerel or tilefish -- should be avoided.