The debate on fish oil supplements rages on.
A new study by Dutch scientists found that low doses of omega-3 fatty acids provided little to no help preventing future heart attacks in patients with a history of heart disease. As published in the New England Journal of Medicine, researchers followed 4837 patients for 40 months and gave each supplements containing docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), as found in fish oil, and/or alpha-linolenic acid (ALA), as found in certain nuts and vegetables. All patients had previously had a myocardial infarction (heart attack). By examining which patients had (another) MI during the 40 months of observation, the researchers determined that these fatty acids weren’t helping. Does this spell the end for fish oil supplements? Hardly. The Dutch work is important, but still leaves many questions unanswered.
This research comes in contrast with previous experiments which showed that fatty acids could significantly reduce the risks of heart attacks when taken regularly as a supplement. The nearly 5000 patients in the Dutch study received the Omega-3s in amounts comparable to previous tests (400mg for DHA/EHA or 2g for ALA per day – disguised in identical tasting sticks of margarine). But when comparing the recipients of supplements to those of placebo, the fatty acids didn’t seem to provide protection against MI. Of the 4800+ patients, 671 had a heart attack during the trial. The Dutch scientists, led by Daan Kromhout of Wageningen University, gave several reasons in their paper for why the discrepancy may have arisen.
The first idea is that the Dutch patients were mostly old men. Average age was 69 (range of 60 to 80) and 78% were male. Other tests for fatty acid supplements covered different ranges of age, and many focused on women. In fact, the Dutch researchers did find some indication that the women in the study benefited slightly from receiving ALA.
Another possible culprit (perhaps the most likely) is that all patients were receiving top of the line medical care. As all previously had experienced MI, they were being dosed with start of the art medications to prevent further heart attacks. 85% of the patients were taking statins. Kromhout and his colleagues suggest that this medical care may have had a profound enough life-saving effect that the bonuses from fatty acid supplements were negligible. If so, the experiment would not have been particularly insightful into the effects of omega-3s, but it would be a good sign that modern medicine really helps with MI.
The final major possibility is that the Dutch patients were outside the time in which fatty acids may have helped with heart disease. Patients had experienced their heart attacks an average of 4 years before the study began. Other trials for fatty acids had begun treating patients with supplements much closer to the original MI. There may be some optimal time after (or before) MI for taking fatty acids as a supplement.
I encourage you to read the NEJM article on this study – as far as medical publications go it’s pretty accessible. But I don’t think we can draw any definitive conclusions from this work. Yes, 4837 patients over 40 months is a good data set, but the study had its limitations as the authors discussed. As we mentioned earlier, a much larger study (20,000 patients) is forthcoming from the US National Institute of Health which should shed much needed light on the effects of fish oil and vitamin D. That study, however, will have its own limitations in terms of patient selection, just like the Dutch research. The truth is that while each study provides new data, we’re likely to need years of more trials before we can write the definitive word on fish oil. Hopefully, however, we’ll eventually collect enough information that we can reasonably understand if and when fatty acids will help protect your heart. When that happens we’ll have another tool in our kit for keeping us healthier and happier longer.
[image via thinkorthwim.com]
[source: Kromhout et al, NEJM 2010]
Comments
Well besides of fish oil krill oil is also a good source for omega 3 fatty acids, krill oil is 40 times much richer with omega 3 fatty acid than fish oil. Several studies had conducted wherein they had compared krill oil and fish and upon these comparisons krill oil had reign over fish oil. Check out this article http://krilloil.com/fish-oil-vs-krill-oil.html well in this article it shows why krill oil is way better than fish oil in several ways. Krill oil had been considered as the ultimate source of omega 3 fatty acid but besides of this substance krill oil could give you more.
http://mickelson.libsyn.com/thursday-september-30-2010 for more “new” study information on fishoil, but more importantly, the correct dose of omega 6/3 in the truly Parent Form…no durivatives here as those are made by our body as needed…
brianpeskin.com
The phrase “the horse has already bolted” springs to mind . . . .
The phrase “the horse has already bolted” springs to mind . . . .
wow. Agree with the commenter so far.
Also — are you kidding me??!!! They put 400 mgs of fish oil into a stick of margarine? Consuming an entire stick of margarine with its associated hydrogenated fats would probably have detrimental effects on the cardiac system all on its own. I hate poorly designed stuidies like this — waste of time and money and opportunity! Sheesh.
Absoloutly right Ishmael, I saw that too.
wow. Agree with the commenter so far.
Also — are you kidding me??!!! They put 400 mgs of fish oil into a stick of margarine? Consuming an entire stick of margarine with its associated hydrogenated fats would probably have detrimental effects on the cardiac system all on its own. I hate poorly designed stuidies like this — waste of time and money and opportunity! Sheesh.
Absoloutly right Ishmael, I saw that too.
eat butter!
Ok : its not so. Your headline is misleading? deliberately so to get people to read it?
The study says if you read it corectly, Elderly men who are already on maximual ( read expensive and side effects prone) drug therapy who start low dose fish oil an avearge of 4 years after they have their heart attacks show no decrease in heart attacks over the 4 drugs when the low dose fish oil is added. But don’t worry there is a job waitng for you in the pharmacuetical industry.
Or perhaps you should sell krill as that indsutry uses similar tactics to get attention for a poorly proven product.
An FYI: the Omega 6 to 3 ratio to shoot for is actually 0.79 or Paleolithic level. It would be virtually impossilbe for anyone using a modern food chain to “reduce their Omega 6 intake” to a point of correction of that level or even the modern Cypriot level of 4 to 1. Eating “enough”seafood will gurantee you mercury toxicity. Just ask actress Daphne Zuniga.
Ok : its not so. Your headline is misleading? deliberately so to get people to read it?
The study says if you read it corectly, Elderly men who are already on maximual ( read expensive and side effects prone) drug therapy who start low dose fish oil an avearge of 4 years after they have their heart attacks show no decrease in heart attacks over the 4 drugs when the low dose fish oil is added. But don’t worry there is a job waitng for you in the pharmacuetical industry.
Or perhaps you should sell krill as that indsutry uses similar tactics to get attention for a poorly proven product.
An FYI: the Omega 6 to 3 ratio to shoot for is actually 0.79 or Paleolithic level. It would be virtually impossilbe for anyone using a modern food chain to “reduce their Omega 6 intake” to a point of correction of that level or even the modern Cypriot level of 4 to 1. Eating “enough”seafood will gurantee you mercury toxicity. Just ask actress Daphne Zuniga.
As far as I know, it’s not so much about the absolute amount of Omega-3, but about the ratio of Omega-3 to Omega-6, which should approx. be in the range of 1-2. With all the Omega-6 rich vegetable oils people are consuming, the average ratio in the west is more like 1-20, hence a tiny supplement of Omega-3 shouldn’t make that much of a difference. If on the other hand you reduce your total intake of polyunsaturated fat by eating butter instead of margarine ect., fish oil could be a convenient way to get the right balance. The other way would be to eat lots of fish or just pasture raised beef and eggs, which isn’t that feasible for most people.
As far as I know, it’s not so much about the absolute amount of Omega-3, but about the ratio of Omega-3 to Omega-6, which should approx. be in the range of 1-2. With all the Omega-6 rich vegetable oils people are consuming, the average ratio in the west is more like 1-20, hence a tiny supplement of Omega-3 shouldn’t make that much of a difference. If on the other hand you reduce your total intake of polyunsaturated fat by eating butter instead of margarine ect., fish oil could be a convenient way to get the right balance. The other way would be to eat lots of fish or just pasture raised beef and eggs, which isn’t that feasible for most people.