Cardiovascular disease is the leading cause of death worldwide, and preventive approaches, particularly achievable dietary changes, have major public health implications. An increase dietary intake of nā€”3 (polyunsaturated) fatty acids is one such dietary approach. This review discusses advances since the topic was last reviewed in the journal and highlights current gaps in knowledge.

On the basis of currently available evidence, the American Heart Association (AHA) has recommended that all adults eat fish (particularly fatty fish) at least twice a week, as well as vegetables containing plant-derived n-3 fatty acids (ALA). The AHA also suggests that patients with documented coronary heart disease consume approximately 1 g of EPA and DHA (combined) per day, from oily fish or fish-oil capsules (after consultation with a physician). The AHA recommendations also state that EPA-DHA supplements may be useful in patients with severe hypertriglyceridemia (>500 mg of triglycerides per deciliter [5.6 mmol per liter]), for whom effective doses are higher: 2 to 4 g of EPA-DHA per day to lower triglyceride levels by 20% to 40%. The AHA advises caution with respect to contaminants and notes that many species of fish are low in methylmercury and that fish-oil supplements are free of methylmercury.