Omega-3 reduced Heart Attacks by 28% (analysis of VITAL study)

Omega-3 Fatty Acid Supplementation Has Coronary and Other Selective Health Benefits: Comprehensive Results from the VITamin D and OmegA-3 TriaL (VITAL)

The Journal of Nutrition, November 2026 10.1016/j.tjnut.2026.101941 PDF behind paywall

JoAnn E. Manson MD, DrPH 1 2 , Shari S. Bassuk ScD 1 , Nancy R. Cook ScD 1 2 , I-Min Lee MBBS, ScD 1 2 , Samia Mora MD, MHS 1 , Heike Luttmann-Gibson PhD 1 3 , Christine M. Albert MD, MPH 1 4 , Farhad Mehrtash MPH 5 , Denise D’Agostino BS 1 , Claire Ridge MPH 1 , Vadim Bubes PhD 1 , Joseph A. Walter BA, BS 1 , Jacqueline Suk Danik MD, DrPH 6 , Julie E. Buring ScD 1 2 ,

Background

The VITamin D and OmegA-3 TriaL (VITAL) is the only large-scale randomized trial of marine omega-3 fatty acid (n-3 FA) supplementation for the primary prevention of cardiovascular disease (CVD) and cancer in a general population unselected for elevated risk. This article provides an integrated overview of the results of the n-3 FA component and its ancillary studies.

Methods

VITAL is a completed nationwide, randomized, placebo-controlled, 2x2 factorial trial of n-3 FAs (1 g/day) and vitamin D3 (2000 IU/day) for a median of 5.3 years for primary prevention of CVD and cancer among 25,871 U.S. men aged ≥50 and women aged ≥55 years. Ancillary studies investigated effects on heart failure, atrial fibrillation (AF), autoimmune disease, and other endpoints.

Results

Compared with placebo, the n-3 FA supplement did not significantly reduce the primary endpoint of major CVD events (hazard ratio [HR]=0.92 [95% confidence interval 0.80-1.06]) but did significantly reduce total myocardial infarction (MI; HR=0.72 [0.59-0.90]), fatal MI (HR=0.50 [0.26-0.97]), percutaneous coronary intervention (HR=0.78 [0.63-0.95]), and recurrent hospitalization for heart failure (HR=0.86 [0.74-0.998]). The intervention was not associated with AF risk. Supplemental n-3 FAs did not reduce total cancer incidence, other cancer endpoints, or all-cause mortality but was associated with significantly decreased risk of autoimmune disease (confirmed plus probable cases; HR=0.82 [0.68-0.99]). Effect modification by demographic, dietary, and clinical factors was observed for several endpoints, with greater benefits in Black participants and those with lower fish intake or cardiovascular risk factors, but with variable effects in women vs. men.

Conclusion

Supplemental n-3 FAs did not significantly reduce major CVD events or cancer but decreased multiple cardiac endpoints and autoimmune disease. Several factors modified treatment effects. Although the findings do not support routine n-3 FA supplementation among healthy adults for prevention of chronic disease, targeted supplementation of those with low fish intake and other select groups warrants consideration.

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