Omega-3 consumption is not related to a greater risk of bleeding
Due to the potential health benefits, several expert committees and institutions have recommended consumption of omega-3 long-chain polyunsaturated fatty acids (ω-3 LC-PUFA) in healthy populations to prevent cardiovascular diseases and (in larger amounts) in people with cardiovascular disease. However, since a prolonged bleeding time associated with consuming very high levels of ω-3 LC-PUFA was observed among the Inuit population in Greenland, there has been some debate on the possible adverse effects of ω-3 LC-PUFA on the risk of bleeding. This is particularly relevant among people with a history of cardiovascular events or on antithrombotic medication (anticoagulants or antiplatelet drugs), bearing in mind that the recommended doses for people with a history of cardiovascular disease are higher.
With the aim of assessing the safety of ω-3 LC-PUFA, an analysis was conducted on eight clinical intervention studies involving enteral nutrition with fish oil in their composition as a source of ω-3 LC-PUFA, to study the occurrence of bleeding-related adverse events and key coagulation parameters (prothrombin time and activated partial thromboplastin time). The 600 individuals eventually included in the analysis met the following inclusion criteria: moderate to severe illness (various diseases) with or without concomitant use of antithrombotic agents who were at home or in intensive care units and who had received enteral nutrition with a minimum of 1.5 g of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)/day.
No evidence of an increased risk of bleeding with the use of ω-3 LC-PUFA was observed, even at high doses (up to 10 /day of EPA + DHA) in the short term or with consumption of over 1.5 g/day for up to 52 weeks in vulnerable or sensitive populations (subjects with gastrointestinal cancer, admissions to intensive care units or consumers of aspirin, vitamin-K antagonists or clopidogrel). No evidence was found to support the concern regarding the possible increase in the risk of bleeding associated with ω-3 LC-PUFA; the coagulation parameters did not vary significantly compared to base-line figures.
The results of this review support the view that ω-3 LC-PUFA is safe, even at high doses and in vulnerable populations.