Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.
S Afr Med J. 2020 Nov 27;110(12):1158-1159. doi: 10.7196/SAMJ.2020.v110i12.14730.
Cardiovascular diseases (CVDs) are defined as conditions involving decreased blood flow to the heart that can lead to heart attacks, stroke or other disorders. CVDs are a common cause of death in low- and middle-income countries. In South Africa (SA) in particular, CVD is the leading cause of death after HIV/AIDS, responsible for 1 in 6 deaths. CVD risk factors include unhealthy diets, hypertension, obesity, high cholesterol levels and diabetes. Omega-3 fatty acids may have a protective role in the risk of developing heart disease.
To evaluate the consequences of an increased intake of fish and plant-based omega-3 fatty acids on the risk of CVD mortality and events.
The inclusion criteria for this review were randomised controlled trials (RCTs) lasting at least 12 months, which investigated men and women aged ≥18 years. These participants had to be at any risk of CVD while receiving dietary supplements and an advised diet to promote the intake of omega-3. This diet included oily fish, fish oils and seeds rich in omega-3. Comparisons with the interventions included the participants' usual diet, no advice, no supplements, placebo or lower-dose omega-3. The review evaluated the effectiveness of these interventions on primary (e.g. CVD deaths and events), secondary (e.g. major adverse cerebrovascular or CVD events, body weight and other adiposity measures, and lipids) and tertiary (e.g. blood pressure and side-effects) outcomes.
Evidence from this review indicates that increasing the intake of long-chain omega-3 fatty acids (LCn3) or alpha-linolenic acid (ALA) probably has little or no effect on all-cause CVD or coronary heart disease mortality. Evidence was of moderate certainty, except for all-cause mortality, where there was a high certainty.
According to moderate- to high-certainty evidence, short-chain fatty acids and LCn3 have little or no effect on mortality or cardiovascular health. However, omega-3 ALA slightly reduces the risk of CVD events and arrhythmias.
心血管疾病（CVDs）是指流向心脏的血液减少的病症，可导致心脏病发作、中风或其他疾病。CVDs 是低收入和中等收入国家的常见死因。特别是在南非，CVD 是继艾滋病病毒/艾滋病之后的主要死因，占死亡人数的 1/6。CVD 的风险因素包括不健康的饮食、高血压、肥胖、高胆固醇水平和糖尿病。ω-3 脂肪酸可能在心脏病发病风险中具有保护作用。
评估增加鱼类和植物性 ω-3 脂肪酸的摄入量对 CVD 死亡率和事件风险的影响。
本综述的纳入标准是持续至少 12 个月的随机对照试验（RCTs），调查年龄≥18 岁的男性和女性。这些参与者在接受饮食补充剂和建议的饮食以促进 ω-3 摄入时，必须处于任何 CVD 风险中。这种饮食包括油性鱼类、鱼油和富含 ω-3 的种子。与干预措施相比，包括参与者的常规饮食、无建议、无补充剂、安慰剂或低剂量 ω-3。该综述评估了这些干预措施对主要（如 CVD 死亡和事件）、次要（如主要不良脑血管或 CVD 事件、体重和其他肥胖指标以及脂质）和三级（如血压和副作用）结局的有效性。
本综述的证据表明，增加长链 ω-3 脂肪酸（LCn3）或α-亚麻酸（ALA）的摄入量可能对全因 CVD 或冠心病死亡率几乎没有或没有影响。证据的确定性为中等至高度，除全因死亡率外，其确定性为高度。
根据中等至高度确定性证据，短链脂肪酸和 LCn3 对死亡率或心血管健康几乎没有影响。然而，ω-3 ALA 略微降低了 CVD 事件和心律失常的风险。
