“Fish on Friday keeps the heart in good spirits” – this traditional saying has been upheld in many coastal cultures for generations. Today, science provides a modern interpretation: certain marine fats may reduce the risk of “silent” heart attacks – often occurring without warning signs. The crucial question is: How much omega-3 do you really need for your heart to function calmly, rhythmically, and resiliently in today's fast-paced world?

Omega-3 fatty acids are polyunsaturated fats that the body cannot produce on its own. Particularly relevant are EPA Eicosapentaenoic acidmarine omega-3 component with inflammation-modulating effects and DHA Docosahexaenoic acidmarine omega-3 component, important for cell membranes and mitochondrial energy metabolism. The Omega-3 Indexpercentage of EPA+DHA in red blood cells serves as a biomarker for tissue saturation with omega-3 and is linked to cardiovascular risk. ALA Alpha-linolenic acidplant-based omega-3 precursor from flaxseeds, chia, walnuts can only be converted to EPA/DHA to a limited extent by the body. Practically, this means that those who want to optimize heart health and performance should focus primarily on EPA/DHA from fish, algae, or high-quality oils.

EPA and DHA influence heart health in several ways: they stabilize cell membranes, improve endothelial functionability of the vascular endothelium to regulate blood flow, dampen inflammatory activity, and lower triglycerides – all factors that can pave the way for silent infarctions when they get out of control ^[1]. In people with low fish intake, two fish meals per week or moderate EPA+DHA supplementation significantly increase the omega-3 index – a marker associated with lower cardiovascular risk ^[2]. Additionally, exercise acts as a protective measure: regular training lowers blood pressure, improves blood lipids, and reduces stroke and heart attack events compared to inactive controls, further protecting the "heart environment" ^[3]. Moreover, quitting smoking not only lowers risk but also postpones the timing of potential first events – a gain in time for heart and life ^[4].

A randomized, controlled dietary study in young adults with low fish intake showed that two portions of fish per week or about 700 mg of EPA+DHA daily in capsules significantly increased the omega-3 index within eight weeks. The overall proportion of n-3 fatty acids in erythrocytes also rose, while n-6 proportions dropped – a favorable shift indicating a less inflammatory environment ^[2]. Although these interventions did not change classical blood fats or hs-CRP during the short study duration, they provide a clear lever: the measurable tissue build-up of EPA/DHA, which is relevant as a risk marker.

A recent review summarizes that marine omega-3 from fish oil, krill, or algal oil is superior in bioavailability and clinical efficacy to the plant precursor ALA. Particularly robust is the reduction of triglycerides by about 15–30% at dosages of 2–4 g/d, along with indications of anti-inflammatory effects. For specific indications, a higher EPA content may be beneficial; for vegetarians and vegans, algal oil offers a practical alternative ^[5]. Mechanistically, a scientific analysis describes the broad pathways of action: EPA modulates oxidative stress axes and vascular function, while DHA supports mitochondrial biogenesis and fatty acid oxidation – together forming a plausible protective barrier against metabolic and cardiovascular risks ^[1].

In parallel, a systematic review and meta-analysis on physical activity show that aerobic, strength, or combined training lowers systolic and diastolic blood pressure, improves blood lipids and BMI, and is associated with fewer stroke and heart attack events – despite heterogeneity, exercise remains one of the strongest preventive factors ^[3]. Finally, a projection from France indicates that ambitious tobacco reduction up to smoking cessation will significantly prevent myocardial infarctions by 2035 and increase the age of first disease occurrence – a population effect with immediate relevance for individuals ^[4].

- Eat fatty fish such as salmon, mackerel, or sardines twice a week. This directly delivers EPA and DHA – the forms that most effectively support the heart and blood vessels ^[1].
- If you rarely eat fish: supplement with 500–1000 mg EPA+DHA daily from high-quality fish oil. For vegans/vegetarians, algal oil is suitable; higher EPA contents are often meaningful for heart goals ^{[2] [5] [1]}.
- Engage in 150–300 minutes of moderate-intensity exercise per week (e.g., brisk walking, cycling, swimming) and include 2 strength training sessions. This lowers blood pressure, improves blood lipids, and reduces cardiovascular events ^[3].
- Quit smoking and limit alcohol. Both significantly lower your risk of a heart attack and add healthy years to your life ^[4].

The risk of silent heart attacks decreases not with mere hope but with proactive routines: omega-3 (EPA/DHA), regular exercise, and quitting smoking create a protective shield around your heart. Start this week – with two fish meals, smart supplementation, and 30 minutes of movement per day – and let your omega-3 index become your silent insurance policy.