St. Louis Park Chiropractor Best Practices

Research Commentary;

Omega 3’s and Stroke Risk

A review of

O’Keefe, James H., et al. “Omega-3 Blood Levels and Stroke Risk: A Pooled and Harmonized Analysis of 183 291 Participants From 29 Prospective Studies.” Stroke 55.1 (2024): 50-58.

Reviewed by Dr. Bryan Stephens

Omega 3's and Stroke Risk

Summarized Review Conclusions

Marine omega-3 fatty acids once again are shown to have a significant impact on our health.  This study showed their relationship to risk of stroke.  The authors noted an inverse relationship, meaning that the higher the omega 3s, the lower the incidence of stroke.  When EPA and DPA are combined, the risk of stroke drops by 18%.  Even when on their own, EPA had a reduction of risk by 18% and DPA had a reduction of 16%.  They also took cardiovascular disease in consideration and excluded those individuals to avoid reverse causation.  They did mention that they help with prevention of cardiovascular disease as well.

“…1 in 4 adults will suffer a stroke in their lifetime, and it is the second-leading cause of death and the third-leading cause of death and disability combined”

O’Keefe, James H., et al. “Omega-3 Blood Levels and Stroke Risk: A Pooled and Harmonized Analysis of 183 291 Participants From 29 Prospective Studies.” Stroke 55.1 (2024): 50-58

“…risk of ischemic stroke was 18% lower for EPA+DHA, 18% lower for EPA, and 16% lower for DHA”

O’Keefe, James H., et al. “Omega-3 Blood Levels and Stroke Risk: A Pooled and Harmonized Analysis of 183 291 Participants From 29 Prospective Studies.” Stroke 55.1 (2024): 50-58

“long-chain omega-3 PUFA levels were inversely associated with risk of total and ischemic stroke”

O’Keefe, James H., et al. “Omega-3 Blood Levels and Stroke Risk: A Pooled and Harmonized Analysis of 183 291 Participants From 29 Prospective Studies.” Stroke 55.1 (2024): 50-58.

DHA and EPA have anti-inflammatory, antiplatelet, and hypotriglyceridemic effects, reduce arterial stiffness, improve endothelial function, and provide dose-dependent reductions in blood pressure and resting heart rate via heightened vagal tone.”

O’Keefe, James H., et al. “Omega-3 Blood Levels and Stroke Risk: A Pooled and Harmonized Analysis of 183 291 Participants From 29 Prospective Studies.” Stroke 55.1 (2024): 50-58.

Introduction to the Research

With stroke being one of the leading causes of death and disability, the authors looked at studies from around the world to see the change that can happen from higher omega 3 fatty acids in the blood and tissues.  This continues to support the ongoing evidence on the importance of proper nutrition and essential nutrients such as marine omega 3s in our diet to avoid chronic lifestyle diseases.  They do mention some pathways and benefits of EPA and DHA as well by explaining the anti-inflammatory effects they have along with their effect on the cardiovascular system.

Research Methodology

“Authors will make data, analytic methods, and study materials available to other researchers upon request. This study was conducted within the Fatty Acid and Outcome Research Consortium—an international collaboration of observational studies with baseline PUFA biomarker data and ascertainment of chronic disease events during follow-up. For the current project, all 60 prospective studies in the consortium as of November 2021 were invited to participate. Of these, 18 did not have the required PUFA and stroke data, 11 indicated a lack of funding/analyst time and 2 had too few incident stroke outcomes for adjusted statistical models to fit robustly. Thus, the current investigation comprised data from 29 studies across 15 countries. The details of each individual study are presented in Table S1, including individual cohort IRB approvals. All participating studies followed a prespecified standardized analysis protocol with harmonized inclusion and exclusion criteria, exposures, outcomes, covariates, and analytical methods inclusive of statistical models and assessment of missing covariate data. In each study, new analyses of individual data were performed according to the protocol, and study-specific results were collected using a standardized electronic form. Information regarding registration required by any of the cohorts included herein is shown in Table S1. Individual cohorts conducted their studies in accordance with the criteria set by the Declaration of Helsinki, and informed consent was obtained from all participants after IRB approval.”

O’Keefe, James H., et al. “Omega-3 Blood Levels and Stroke Risk: A Pooled and Harmonized Analysis of 183 291 Participants From 29 Prospective Studies.” Stroke 55.1 (2024): 50-58.

Research Findings

“The pooled analyses of 29 cohorts included marine omega-3 PUFA biomarker levels from 183 291 individuals (Table S2), 67 165 excluding the the United Kingdom Biobank (UKBB). The median follow-up time was 14 years (range, 5–30 years). In total, 10 561 participants were recorded as incident stroke cases: 78% ischemic, 11% hemorrhagic, and 11% unspecified. At baseline, the mean age was 65 years, 53% were women; White adults comprised 82% of the study population. Total stroke in relation to each PUFA exposure was analyzed in 2 models—those with and without preexisting CVD (Table S3). The distribution (10th, 50th, and 90th percentiles) of PUFA levels by lipid compartment and by cohort are shown in Table S4. In the pooled data, the estimated 10th, 50th, and 90th percentiles for RBC EPA+DHA content were 3.4%, 5.2%, and 7.9%, respectively as shown in Table S5.

When analyzing by quintile, for DHA (including the UKBB cohort), a significant inverse association was observed for total stroke, with the risk in Q4 and Q5 being 12% to 13% lower than the reference group, Q1 (Figure 1). Similar patterns were seen for EPA and EPA+DHA in analyses without the UKBB with the risk in Q5 17% lower than that in Q1 (Table). The quintile analysis of associations between docosapentaenoic acid (DPA) and total stroke (again, excluding the UKBB) suggested a threshold effect, with no associations in Q2 to Q4 but an 11% lower risk in Q5 versus Q1 (Table). These analyses showed low levels of heterogeneity (I2<50%) in all cases. When analyzing the relations between DHA, EPA, and their sum on a per IQ5R basis, each was associated with an 8% to 9% lower risk of total stroke (Table S6). DHA results were similar with or without inclusion of the UKBB cohort (Table S6). DPA was not significantly associated with risk of stroke in this analysis.

Patterns for ischemic stroke followed those of total stroke, with risk in Q5 versus Q1 being 14% to 18% lower (Table). In contrast to ischemic stroke, results for hemorrhagic stroke showed little to no evidence of differential risk for any omega-3 PUFA tested. In IQ5R analyses, risk for ischemic stroke was reduced by 11% to 13% for DHA and EPA+DHA (Table S6). No significant associations with DPA were observed for either stroke subtype.”

O’Keefe, James H., et al. “Omega-3 Blood Levels and Stroke Risk: A Pooled and Harmonized Analysis of 183 291 Participants From 29 Prospective Studies.” Stroke 55.1 (2024): 50-58.

Research References

As always with these reviews, these are my takeaways from the article and I encourage you to read the article in its entirety.  The references used in this article by the authors of this article are listed here.

Our Message

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