The role of plant-based omega-3s in cardiac outcomes

Aleix Sala-Vila, PhD, is an associate scientist at the Fatty Acid Research Institute (FARI) and research fellow at Hospital del Mar Research Institute–cardiovascular risk and nutrition group, Barcelona, Spain.

In this interview, Sala-Vila shares his research on the effects of ALA from foods such as walnuts compared to marine-derived EPA and DHA. He explains the cardiovascular support ALA provides and potential future research.

For an in-depth examination of more of Sala-Vila’s research, read more on a longitudinal study linking omega-3 levels and risk of early-onset dementia.

Transcript

Erin McEvoy: Some of your research from your group suggests plant-based omega-3s may play roles in cardiac outcomes. Could you share a little bit more about the plant-based omega-3s?

Aleix Sala-Vila: Most of my research focused on ALA, thanks for, instance, support from the California Walnut Commission, but also, well, I also did some research on my own without external support. I think this is a matter of interest, because research on omega-3 is heavily biased towards EPA and DHA. But times are changing, and some people are not consuming fish for several reasons, maybe concerns for contamination, pollutants, or for ethical issues, or maybe they don't like fish. So I think that it's worthy to try to adapt to these new times and. And go for research on ALA. The interesting thing is that at the very beginning, I thought, okay, may maybe ALA can be protective only if you don't eat fish, only if your intake of EPA and DHA is quite low, because if you really eat fish, EPA and DHA is going to overrun any protective effect that you can see for ALA.

But interesting part – and I'm quite lucky, because Spain is a country with people still consuming quite amount of fatty fish – Well, we're not at levels of Japan or Norway, but, well, we're not that bad. So we see we have consistently observed that including both types of omega-3 in your diet can be helpful in the sense that maybe they help each other, they are synergistic, we don't know, but for sure, they are not antagonist. So you can see benefits associated to ALA, and you can see benefits associated to EPA or DHA. So I think that it’s something that is interesting. And I said, I have been doing some research, and maybe the main results would be that, first, ALA relates to a lower burden of atherosclerotic plaque. Second, having high levels of ALA once you have the heart attack relates to a lower risk of mortality in the next three years, and higher levels of ALA relates to a better prognosis once you have a diagnosis of heart failure.

The issue is whether these associations are all explained by ALA per se, or maybe ALA is just a surrogate marker of intake of healthy foods containing other stuff which is also helpful and healthy. For instance, in Spain, ALA is mostly supplied by walnuts. So, we cannot ascribe just one effect, just to ALA. It could be if ALA comes from walnuts, they can supply other kind of good stuff besides ALA. But, I think that the message that ALA and EPA plus DHA could be partners in crime, I think it's an appealing it's an appealing one.