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(Stroke. 2009;40:3485.)
© 2009 American Heart Association, Inc.

Original Contributions

Effects of Moderate-Dose Omega-3 Fish Oil on Cardiovascular Risk Factors and Mood After Ischemic Stroke

A Randomized, Controlled Trial

Sally D. Poppitt, PhD; Colin A. Howe, PhD; Fiona E. Lithander, PhD; Karen M. Silvers, PhD; Ruey-Bin Lin, MSc; John Croft; Yogini Ratnasabapathy, MBBS, FRACP; Robert A. Gibson, PhD Craig S. Anderson, MBBS, FRACP, PhD

From the Human Nutrition Unit (S.D.P., F.E.L.), School of Biological Sciences (S.D.P.) and Clinical Trials Research Unit (C.A.H., R.-B.L., C.S.A.), University of Auckland, Auckland, New Zealand; Trinity College (F.E.L.), Dublin, UK; University of Otago (K.M.S.), Christchurch, New Zealand; Scientific Marine (J.C.), Auckland, New Zealand; Waitemata District Health Board (Y.R.), Auckland, New Zealand; Nutrition and Functional Food Science (R.A.G.), University of Adelaide, Adelaide, Australia; and The George Institute for International Health and University of Sydney (C.S.A.), Sydney, Australia.

Correspondence to Sally D. Poppitt, PhD, Human Nutrition Unit, 18 Carrick Place, Mt Eden, Auckland, New Zealand. E-mail s.poppitt{at}auckland.ac.nz

Background and Purpose— Fish-derived omega-3 fatty acids have long been associated with cardiovascular protection. In this trial, we assessed whether treatment with a guideline-recommended moderate-dose fish oil supplement could improve cardiovascular biomarkers, mood- and health-related quality of life in patients with ischemic stroke.

Methods— Patients with CT-confirmed stroke were randomized to 3 g/day encapsulated fish oil containing approximately 1.2 g total omega-3 (0.7 g docosahexaenoic acid; 0.3 g eicosapentaenoic acid) or placebo oil (combination palm and soy) taken daily over 12 weeks. Serum triglycerides, total cholesterol and associated lipoproteins, selected inflammatory and hemostatic markers, mood, and health-related quality of life were assessed at baseline and follow-up. The primary outcome was change in triglycerides. Compliance was assessed by capsule count and serum phospholipid omega-3 levels (Australian Clinical Trials Registration: ACTRN12605000207617).

Results— One hundred two patients were randomized to fish oil or placebo. Intention-to-treat and per-protocol (>85% compliance) analyses showed no significant effect of fish oil treatment on any lipid, inflammatory, hemostatic, or composite mood parameters measured. Adherence to treatment based on pill count was good (89%) reflected by increased serum docosahexanoic acid (P<0.001) and eicosapentaenoic acid (P=0.0006) in the fish oil group. Analysis of oil composition, however, showed some degradation and potentially adverse oxidation products at the end of the study.

Conclusions— There was no effect of 12 weeks of treatment with moderate-dose fish oil supplements on cardiovascular biomarkers or mood in patients with ischemic stroke. It is possible that insufficient dose, short duration of treatment, and/or oxidation of the fish oils may have influenced these outcomes.

Key Words: DHA • EPA • fish oils • ischemia • omega-3 • stroke