The new guidelines, produced by the National Collaborating Centre for Primary Care (NCC-PC) for the National Institute for Health and Clinical Excellence (NICE), could be seen as a validation of omega-3 supplements for heart health. While no individual brand of omega-3 was named in the guidelines, reports in the UK's Daily Express indicate that NICE are considering prescribing the Omacor brand of omega-3 acid ethyl-esters, currently available on prescription in the US and billed as the only FDA-approved omega-3. Such reports could have positive or negative implications, with, on the hand, the recognition of Omacor undermining the efficacy of all other omega-3 supplements, or, on the other hand, the guidelines seen as official recognition of omega-3 supplements in general. The guidelines, containing several lifestyle recommendations, are designed to have a significant impact in reducing premature deaths for the hundreds of thousands of British adults who survive a heart attack (myocardial infarction or MI). "Patients should be advised to eat a Mediterranean-style diet (more bread, fruit, vegetables and fish; less meat; and replace butter and cheese with products based on vegetable and plant oils)," state the new guidelines. "Patients should be advised to consume at least 7 g of omega 3 fatty acids per week from two to four portions of oily fish." "For patients who have had an MI within 3 months and who are not achieving 7 g of omega 3 fatty acids per week, consider providing at least 1 g daily of omega-3-acid ethyl esters treatment licensed for secondary prevention post MI for up to 4 years," state the guidelines. The advice could also negatively affect other supplements with NICE stating that patients should avoid supplements containing beta-carotene, as well as antioxidant supplements containing vitamins C and E. They also should be advised against taking folic acid supplements. "This new guideline compiles evidence-based recommendations on best practice in the management of people who have suffered a heart attack. Its overall aim is to provide the growing number of people who now survive a heart attack with the good quality systematic care that is essential to improving long term outcomes and quality of life," said Dr Gill Leng, NICE implementation systems director and executive lead for the guideline. "'We are what we eat' is literally true and this guideline recognises the importance of eating more of what is good for us, especially maintaining a Mediterranean-style diet, in order to reduce the risk of further MIs," said John Walsh, patient representative on the GDG. Commenting independently on the guidelines, Ellen Mason, cardiac nurse at UK charity British Heart Foundation (BHF) said: "The BHF recommends heart attack patients should try to eat two to four portions of oily fish a week including salmon, mackerel, and sardines. There are other benefits to be gained from getting omega 3 this way as the fish is full of nutrients and low in saturated fat so overall it is more nutritious to eat fish than swallowing a capsule. "People need to be aware that this is purely for a select group of people and for most people with or without heart disease omega 3 supplements are not being suggested as a daily requirement."