How good is the evidence for a favourable effect of very long chain n‐3 polyunsaturated fatty acids on cardiovascular disease?

Abstract The evidence for beneficial effects of very long chain (VLC) n‐3 polyunsaturated fatty acids (PUFA) on cardiovascular disease (CVD) is strong because it is based on the results of adequately powered intervention trials with disease endpoints. This contrasts with the evidence for a detrimental effect of saturated fat on CVD which is weak because such studies have not been carried out. Accordingly, any set of dietary recommendations which attaches more importance to saturated fat intakes than VLC n‐3 PUFA intakes can be questioned. Despite the strength of the evidence there are practical difficulties associated with implementing the recommendation to increase intake of VLC n‐3 PUFA to 1g per day which need to be overcome. These include the acceptability of fatty fish consumption, the presence of methyl mercury in fish at the top of the food chain and declining global fish stocks.