Aug. 30, 2010 -- They taste like butter and offer a boost of heart healthy omega-3 fatty acids, but these omega-enhanced margarines may not actually help your heart, according to new research from the Netherlands.
In a study of almost 5,000 patients who had previously had a heart attack, eating a daily serving of omega-3 charged margarine had no effect on the likelihood of a second heart attack.
Margarines containing different types of omega-3 fatty acids were tested, one with EPA-DHA, one with ALA and another with both, were tested against a placebo, omega-free margarine.
Patients ranged from age 60 to 80 and were already on medicine to control their blood pressure and cholesterol. After more than three years on this margarine meal-plan, researchers saw no association between eating omega-supplemented margarine and a reduced risk of second cardiovascular event such as heart attack or stroke.
Previous research shows that giving an EPA-DHA supplement to patients with cardiovascular disease reduces their chance of dying from the disease by as much as 20 percent, authors note in the study, but supplementing with margarine didn't seem to cut it.
This doesn't mean that those at cardiovascular risk should give up on getting extra Omega-3 fatty acids or pass on margarine, experts say. It's just about getting the right amount of good fats from the right places.
Omega Enhancement -- Myths Busted
Peanut butter, margarine, cheese, baby food, even eggs -- you name it and manufacturers are pumping omega-3 supplements into it. But is eating these omega enhanced items actually healthy for your heart?
This study would suggest no, but experts say that it's not where you get your EPA-DHA omega 3's, it's how much you get and how it fits into your diet.
One of the reasons that the Netherlands study may not have seen a benefit was that the dose of omega-3 fatty acid was too low. Researchers were shooting for a daily intake of 400 mg of EPA-DHA and 2 g of ALA, but past research suggests that a therapeutic dose is closer to 850 mg of combined EPA-DHA per day.
Don't Pass on Omega-3s
"I recommend that all of my cardiac patients [with] significant coronary artery disease…take EPA/DHA at a dose of 800-1000 per day. To get this dose, most require a supplement, either one, two or three capsules of an over the counter supplement depending on the concentration," says Dr. Carl Lavie, medical director of Cardiac Rehabilitation and Prevention at John Ochsner Heart and Vascular Institute.
Similarly, Dr. Dean Ornish, founder and president of the Preventive Medicine Research Institute at University of California, San Francisco, recommends a fish oil supplement that contains one gram of combined EPA-DHA per day.
On the other hand, the dose given by the study's EPA-DHA margarine was roughly similar to that provided by two servings of fish a week, the current recommended amount for heart health, so the dose received by subjects was not insignificant, says Alice Lichtenstein, director of the Cardiovascular Nutrition Laboratory at Tufts University.
Another potential reason that the margarine seemed to have no effect is that the patients had been heart attack-free for a couple to several years, which means they were already at relatively low risk of another heart attack, says Lavie. Given the lower risk, it might be hard to gauge the effects.
What's more, these results can only speak to the effects of a modest supplementation of omega-3s for patients who, like the subjects, have had a previous heart attack and are now being rigorously treated for heart disease, experts point out.
"These results don't say anything about what omega-3 fatty acids could do for prevention [of a heart attack] or for someone whose heart disease is not as well managed," says Lichtenstein.
Fish Still Best Bet and Margarine Over Butter
Research on the heart-protective benefits of omega-3 supplements remains inconsistent, though some studies show benefit and these supplements are often suggested to patients with heart disease.
Research on the consumption of fish on the other hand, has shown a strong connection between a diet rich in fish and a decreased risk of heart disease and cardiovascular complications such as heart attack or stroke, experts say.
"Every time we try to isolate a nutrient and supplement it we get disappointed," says Lichtenstein, "but we consistently see results with those who eat fish on a regular basis."
One shouldn't "make a conclusion that fish aren't important. In general, those who consume fish versus [those who don't] seem to have less coronary heart disease," agrees Dr. Robert Eckel, professor of medicine at the University of Colorado School of Medicine.
That said, if eating fish a few times a week is hard for you to do, supplements are still advised, Lavie adds, because "very few people eat enough fish."
Similarly, when choosing something to spread on your bread, margarine is still a better choice than butter, doctors say, as long as it is low in saturated fat and trans fatty acids. Though Ornish says if you can trade the margarine for olive or canola oil, even better.
Soybean and canola oil contain ALA and have lower saturated fats than other oils, even olive oil, notes Lichtenstein, so these are a good fat to have in moderation.