Fish oil supplements plus a heart-healthy diet lowered a key heart risk score

If you have wondered whether omega-3 supplements do anything for your heart, here is good news. In a randomized trial of adults with high LDL cholesterol, adding fish oil supplements to a heart-healthy menu lowered a blood marker of heart risk more than the menu alone.

The marker is called CERT2. It picks up heart risk that your LDL cholesterol number does not show. The omega-3 fats behind the drop, EPA and DHA, are the same ones you find in oily fish like salmon, sardines and mackerel.

How the study worked

The MoKaRi trial assigned adults aged 20 to 80 by chance to one of two plans for 20 weeks, then followed them for another 20 weeks. All of them had high LDL cholesterol and were not taking cholesterol medicine. One group got personalized heart-healthy menu plans. The other group got the same menus plus 3 grams a day of EPA and DHA from fish oil. The results appeared on September 9, 2026 in the Journal of Clinical Lipidology. The trial measured a blood marker rather than heart attacks, and the fish oil dose was high.

What they found

Both groups ate a heart-healthy menu, so the difference came from the fish oil. The group that added it saw a bigger drop in the CERT2 score at every check:

• At 10 weeks, the score was about 2 and a half points lower than in the diet-only group (2.44 points).
• At 20 weeks, the end of the diet period, it was about 2 points lower (2.18 points).
• At 40 weeks, 20 weeks after the program ended, the gap was smaller but still clear (1.63 points).

There was a second win. The ratios between two kinds of blood fats, ceramides and phosphatidylcholines, moved in a healthy direction only in the fish oil group. The diet-only group did not show that change.

That matters because it shows your CERT2 score is not fixed. What you eat and take can move it.

What is CERT2, and why does it matter?

Ceramides are fat molecules that circulate in your blood. Together with fats called phosphatidylcholines, they make up the CERT2 score. Researchers have found that this score predicts heart attacks and strokes beyond what LDL cholesterol alone tells you.

Think of LDL as one gauge on the dashboard and CERT2 as another. This trial shows the second gauge responds to nutrition. That gives doctors and researchers a new way to track whether prevention efforts are working, especially for people whose LDL looks only part of the story.

What you can do today

The trial used 3 grams a day, which is a high dose. If you are thinking about supplements at that level, check with your doctor first. The easy step is food. Salmon, sardines and mackerel carry the same EPA and DHA fats, and a heart-healthy plate is what the trial built on. Canned sardines and canned salmon from any grocery store are quick and affordable. Pick one night this week, add the fish to your shopping list, and plan a side of vegetables or whole grains to go with it.