NIH - On Fish Oil

imoldernu

imoldernu

Gone but not forgotten
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Fish oil is now the third most widely used dietary supplement in the United States, after vitamins and minerals, according to a recent report from the National Institutes of Health. At least 10 percent of Americans take fish oil regularly, most believing that the omega-3 fatty acids in the supplements will protect their cardiovascular health.

But there is one big problem: The vast majority of clinical trials involving fish oil have found no evidence that it lowers the risk of heart attack and stroke.
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... more
http://well.blogs.nytimes.com/2015/03/30/fish-oil-claims-not-supported-by-research//

Note that this is a blog... not a regular article.
If the NYT paywall blocks the link, try the article title for alternate access.
"Fish Oil Claims Not Supported by Research"

I often wonder how many other "accepted" health supplements will see questions on their real value. Currently taking B12 and D. Not convinced, but inexpensive, and no info on bad side effects.

Will use the remaining fish oil gels for bicycle lubrication.:(

This all brings up the greater question of how well supplements are absorbed by the body.

:hide:
 
Thanks for sharing the article.

One thing to note that is mentioned in the article is that the recent studies that do not show a significant benefit may be composed of those taking statins in both the target group and the control group of the study. Statins are designed to have a significant effect on cholesterol levels that is more powerful than fish oil

I am currently voluntarily taking fish oil in the hope of avoiding the need for a lifetime statin prescription in the future and the possible negative side effects that would go along with that. I also enjoy being able to say that I am healthy and take no prescription medicine.

As such, the results from the early positive studies that supported the fish oil may still be relevant for those who would prefer not to adopt the modern treatments of Big Pharma if avoidable. These early studies were likely not confounded with the high level of statin use seen in today's population.

I guess I would be interested in seeing a study on the effectiveness of fish oil where statin use is a controlled variable in the study.

-gauss
 
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A gastroenterologist I saw for a colitis flare-up some years back recommended two supplements to me: flaxseed oil and folic acid.
 
For me, the point is that those studies were conducted with people already at high risk. So the preventive effect in the rest of the population is still unclear.

That omission may be clarified next year. From the linked article:
Dr. Manson is leading a five-year clinical trial, called the Vital study, of 26,000 people who are more representative of the general population. Set to be completed next year, it will determine whether fish oil and vitamin D, separately or combined, have any effect on the long-term prevention of heart disease, Type 2 diabetes, and other diseases in people who do not have many strong risk factors.
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I take EPA capsules, a brand manufactured by a company called Nordic Naturals.

EPA is one of three components in fish oil (along with DHA and ALA). It's my understanding that EPA is the one most deficient in the American diet. There should be a breakdown of each shown on your supplement label.

I have no background in medicine or pharmacology.
 
I also take the Nordic Naturals at the recommendation of my naturopath doctor. For me, I can feel the difference with inflammation/arthritis if I don't take them for a few days.
 
braumeister said:
For me, the point is that those studies were conducted with people already at high risk. So the preventive effect in the rest of the population is still unclear.
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If you are already in trouble, you need a bigger hammer...that makes sense.

Dash man said:
Then there is this article to consider from the NIH that led me to stop taking fish oil supplements:
Fish Oil Linked to Prostate Cancer Risk

However, I do still take red yeast rice to lower my cholesterol.
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While the study’s methods suggest there is a statistical association between an increased risk of developing prostate cancer and fish oil consumption, the authors note these findings do not demonstrate fish oil consumption causes prostate cancer.
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They picked-out men who were already in trouble, prostate-wise, and then compared them to a random group. I wonder if the first group of guys who were not feeling so great felt more inclined to "do what everyone is doing", and started on the fish oil.
 
Dash man said:
Then there is this article to consider from the NIH that led me to stop taking fish oil supplements:
Fish Oil Linked to Prostate Cancer Risk

However, I do still take red yeast rice to lower my cholesterol.
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Is the red yeast still working to lower your cholesterol and are you buying it as an OTC supplement?

My research 2 years ago, after first getting a bad cholesterol number, was that the red yeast products were "re-regulated" so that you could no longer buy the natural stuff with the effective active ingredient.

-gauss
 
I take Fish Oil and D from Nordic Naturals most mornings (not every, especially if I have fish). I do so to help with inflammation, including potential cardiovascular inflammation. Do I expect that it will prevent a heart attack alone? I do not.

There are mounds of studies out there about the positive effects on inflammation that Omega-3s have. Inflammation can be an ancillary cause of cardiovascular issues, so I do think it helps. Generally speaking, I don't think that an obese smoker eating a diet of refined carbs will be any less likely to have a heart attack from taking fish oil because that person is likely to have a great deal of inflammation going on anyway.

The fish oil-prostate cancer tie was debunked a while ago, if I'm remembering my reading correctly. The study was predisposed to people at high risk of prostate cancer in the first place.
 
gauss said:
Is the red yeast still working to lower your cholesterol and are you buying it as an OTC supplement?

My research 2 years ago, after first getting a bad cholesterol number, was that the red yeast products were "re-regulated" so that you could no longer buy the natural stuff with the effective active ingredient.

-gauss
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I buy it at Costco and it keeps my LDL cholesterol at a good level. I take one tablet twice a day and my LDL drops about 30-40 points.
 
gauss said:
Is the red yeast still working to lower your cholesterol and are you buying it as an OTC supplement?
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I hope everyone realizes that the main ingredient in the red yeast rice is actually a statin.
 
Ed_The_Gypsy said:
Well, it IS the basis for WD-40.
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When I use to Gran Prix motorcycles, the first oil we changed was the front forks. In the 70's Japan was using fish oil for fork oil, wow the smell stayed with you for awhile.
 
braumeister said:
I hope everyone realizes that the main ingredient in the red yeast rice is actually a statin.
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That's where pharma got the idea. They find something in naturs that they can manufacture, then look for a disease that they can claim the substance mitigates. Just because it comes from a plant doesn't mean it can't cause the same problems (muscle wasting, etc).
 
braumeister said:
For me, the point is that those studies were conducted with people already at high risk. So the preventive effect in the rest of the population is still unclear..
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Excellent point regarding prevention strategy for any disorder. Risk/Benefit ratios may be favorable or UNfavorable depending on the particular group studied.
 
The lack of positive results from most omega-3 supplementation studies most likely results from a failure to consider the ratio of omega-6 to omega-3 fatty acids.

Here is a review from the scientific literature which addresses this issue: The importance of the ratio of omega-6/omega-3 essential fatty acids. A.P. Simopoulos. Biomed Pharmacother. Volume 56, pages365-379, 2002.

From the abstract: “Several sources of information suggest that human beings evolved on a diet with a ratio of omega-6 to omega-3 essential fatty acids (EFA) of approximately 1 whereas in Western diets the ratio is 15/1-16.7/1.”

“Excessive amounts of omega-6 polyunsaturated fatty acids (PUFA) and a very high omega-6/omega-3 ratio, as is found in today's Western diets, promote the pathogenesis of many diseases, including cardiovascular disease, cancer, and inflammatory and autoimmune diseases, whereas increased levels of omega-3 PUFA (a low omega-6/omega-3 ratio) exert suppressive effects.”

“A lower ratio of omega-6/omega-3 fatty acids is more desirable in reducing the risk of many of the chronic diseases of high prevalence in Western societies, as well as in the developing countries, that are being exported to the rest of the world.”

These observations are consistent with the idea that omega-3 supplements will have little or no benefit if someone is consuming a diet that has high levels of omega-6 fatty acids. Vegetable oils and nuts are the major sources of omega-6 FA in western diets.
 
Faster said:
The lack of positive results from most omega-3 supplementation studies most likely results from a failure to consider the ratio of omega-6 to omega-3 fatty acids.

Here is a review from the scientific literature which addresses this issue: The importance of the ratio of omega-6/omega-3 essential fatty acids. A.P. Simopoulos. Biomed Pharmacother. Volume 56, pages365-379, 2002.

From the abstract: “Several sources of information suggest that human beings evolved on a diet with a ratio of omega-6 to omega-3 essential fatty acids (EFA) of approximately 1 whereas in Western diets the ratio is 15/1-16.7/1.”

“Excessive amounts of omega-6 polyunsaturated fatty acids (PUFA) and a very high omega-6/omega-3 ratio, as is found in today's Western diets, promote the pathogenesis of many diseases, including cardiovascular disease, cancer, and inflammatory and autoimmune diseases, whereas increased levels of omega-3 PUFA (a low omega-6/omega-3 ratio) exert suppressive effects.”

“A lower ratio of omega-6/omega-3 fatty acids is more desirable in reducing the risk of many of the chronic diseases of high prevalence in Western societies, as well as in the developing countries, that are being exported to the rest of the world.”

These observations are consistent with the idea that omega-3 supplements will have little or no benefit if someone is consuming a diet that has high levels of omega-6 fatty acids. Vegetable oils and nuts are the major sources of omega-6 FA in western diets.
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I've seen criticisms of many studies showing the "ill" effects of high-fat diets, in that the lab studies used "factory fats", i.e. vegetable oils as the fat source.

I'm no nutritionist, or any other type of medical professional, but it's my understanding that O-6 and O-3 fats are processed using the same chemical pathway, and that too much of one prevents proper processing and absorption of the other.
 
HFWR said:
I'm no nutritionist, or any other type of medical professional, but it's my understanding that O-6 and O-3 fats are processed using the same chemical pathway, and that too much of one prevents proper processing and absorption of the other.
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Exactly. The same biochemical pathway converts both O-3 and O-6 FAs into signaling molecules called eicosanoids. In general, the O-6 derived molecules promote high levels of inflammation while the O-3 derived molecules are significantly less inflammatory (and in some cases anti-inflammatory). The inflammatory signal from high levels of the O-6 molecules can overwhelm any positive effect from the O-3 molecules.
 
Live Free said:
I thought that extra virgin olive oil was the new Fish Oil. Consuming several tablespoons a day decreases the risk of heart disease, stroke, etc.
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This is the conventional wisdom. Unfortunately it is wrong. Since olive oil has an omega-6 to omega-3 ratio of 13.4 to 1, it would only be reasonable to expect that it would promote inflammation.

Here is an article on olive oil that cites the scientific literature: olive oil nutrition

From the article: “Foods rich in monounsaturated fats like olive oil may be better than foods full of saturated and trans fats, but just because something is “better” does not mean it is good for you.”
 
Amarin Pharmaceuticals is making news in this space with their Vascepa concentrated EPA fish oil based 'drug' that is showing promise with patients in a certain high risk category.


A drug derived from fish oil cut the rate of cardiovascular problems, including heart attacks and strokes, by 25%, a result that will likely transform the fortunes of its maker, Amarin Pharmaceuticals, and upend decades of thinking about cardiovascular disease.
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Amarin's drug, Vascepa, is already approved by the Food and Drug Administration to cut triglycerides in patients in whom levels have risen above 500 milligrams per deciliter, triple normal. But there had been skepticism regarding whether it would provide a benefit in heart disease, because other fish oil pills had used much lower doses and because it has proved difficult for any drug significantly to reduce the risk of heart attacks and strokes when given on top of cholesterol-lowering medicines, which are already very effective.
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https://www.forbes.com/sites/matthe...ically-cuts-heart-risk-in-study/#7d6c9f114f27
 
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Faster said:
From the article: “Foods rich in monounsaturated fats like olive oil may be better than foods full of saturated and trans fats, but just because something is “better” does not mean it is good for you.”
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In my cardio rehab class after my heart attack in 2004, the mantra was not to worry about the perfect 'good for you' food. Such as if you have several choices of food before you, choose the one that is less bad. Through this process I ended up with quite a better diet than before the heart attack.

This approach is actually another implementation of the 'the perfect is the enemy of the good' philosophy.
 
As a former forum member once said in a previous supplement thread - JERF! (just eat real food).

It's a multi-billion dollar ($220 billion this year apparently) industry and virtually none of it has been shown to be of value unless you have specific deficiencies which are relatively rare and some have been clearly shown to be harmful. Follow the money!
 
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