Aug 30, 2010 (Stockholm, Sweden) – Margarine fortified with omega-3 fatty acids does not appear to protect elderly men and women who have survived a heart attack from another heart attack or other cardiac event.

That is the conclusion of the ALPHA-OMEGA study with 4,837 heart attack survivors aged 60 to 80 who spread the fortified margarine on their bread for more than 40 months.

The participants were divided into four groups. They got margarine supplemented with low doses of the fatty acids DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid), which are contained in fish oil.

In another, the spread was enriched with alpha-linolenic acid (ALA), which is obtained from soybean oil and walnuts. A third group received margarine fortified with all three fatty acids; the rest got a placebo margarine.

At the end of the study, 14% of myocardial infarction survivors had experienced another cardiac event, including fatal or non-fatal myocardial infarction, or a cardiac intervention such as angioplasty, regardless of which splay they used.

Possible benefits for women

There was a hint of benefit in women who ate the ALA fortified margarine. The likelihood of having a major cardiac event was about 25% lower than that of other participants, but the finding could be a coincidence.

Margarines fortified with omega-3 fatty acids “had no effect on the frequency of major cardiovascular events,” says researcher Daan Kromhout, PhD, MPH, of Wageningen University in the Netherlands.

About three quarters of the participants were men and 24% were obese.

Kromhout says one possible explanation for the results is that “the patients in this study were treated very well,” with the vast majority taking medication to control blood pressure and cholesterol levels.

Their excellent cardiovascular care makes it difficult to prove the beneficial effects of lower doses of EPA-DHA, he tells WebMD.

Participants were given a daily dose of 2 grams of ALA, or 400 milligrams of EPA and DHA – the latter is half the dose recommended by the American Heart Association, Kromhout says.

He reported on the results at the congress of the European Society of Cardiology. They were simultaneously published online in the New England Journal of Medicine.

Fish is best for omega fatty acids

American Heart Association spokeswoman Mariell Jessup, MD, medical director of the Penn Heart and Vascular Center at the University of Pennsylvania, tells WebMD that the best way to get your omega fatty acids is by getting two to three servings of fish to eat a week.

Spreading the margarine on bread was a poor choice, she adds, as it can lead to weight gain, a risk factor for heart disease.

In the study, the participants distributed 20 grams of the test margarine daily on three to four slices of bread.

The margarines used in the experiment were supplied by Unilever. In a press release, the company said that “the study result for EPA and DHA is surprising given the evidence published to date. This could be due to methodological issues such as the relatively low daily dose compared to previous studies or the fact that serious cardiovascular events were much lower in this study than in studies conducted in the past.

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