Fish oil capsules
Blogfinger 2012 post: ABC World News reported, “The American Heart Association has long said that eating oily fish is good for your heart, so millions of people take fish oil supplements hoping for the benefit and, in fact, doctors often recommend the supplements for people who already have heart disease. But a big new study out tonight says those pills are not doing what they thought.”
On NBC Nightly News, chief science correspondent Robert Bazell said, “The research out today combined 20 previous studies involving more than 68,000 patients since 1989.”
USA Today reports the researchers “found no statistically significant association between all deaths, cardiac-related deaths, sudden deaths, heart attacks and strokes among people taking the supplements.”
MedPage Today reports that the study authors wrote that the results “do not justify the use of omega-3 as a structured intervention in everyday clinical practice or guidelines supporting dietary omega-3 polyunsaturated fatty acid administration.”
“There’s never been any compelling evidence of a clinical benefit,” said Dr. Steven Nissen, professor of medicine at the Cleveland Clinic Lerner School of Medicine.
“I still say it’s very important for my patients to have a plant-based diet with omega-3 rich fatty fish as part of a heart-healthy Mediterranean-like dietary strategy which holds benefits probably above and beyond individual omega-3 pill supplements.,” said Long Island Jewish Hospital’s David Friedman MD
Blogfinger post on fish oils for brain health
Blogfinger Medical Commentary: By Paul Goldfinger, MD, FACC (2012 commentary)
A word on terminology: the substances in question are supplements containing omega-3 polyunsaturated fatty acids (PUFAs). This research did not look at dietary sources of PUFAs which can be found especially in fatty fish (mackerel, sardines, lake trout, albacore tuna and salmon) as well as in walnuts, cashews, and flax seed.
What the summary above did not stress was that small benefits were found in this trial for the supplements, including 9% reduced cardiac death, 11% reduced heart attacks and 13% reduced sudden cardiac death. So, even though those authors did not find significant benefit in their end points, fish oil capsules are usually safe and can offer some potential small cardiovascular advantages as well as lowered triglycerides and perhaps some unproven benefits for other medical problems such as high blood pressure, blood clotting and arrhythmias. These real and potential benefits are no small achievement for a nutritional supplement as compared to actual pharmaceutical drugs.
This is what we said about fish oil supplements in our 2011 book, “Prevention Does Work: A Guide to a Healthy Heart”:
“Fish oil supplements: Capsules containing fish oils may offer the benefits of omega-3 fatty acids, but most of the evidence of benefit was obtained from studying people who ate fish frequently. Taking fish oil capsules may reduce the risk of heart attacks and other complications, but the evidence is still incomplete. One cannot assume that fish oil capsules will confer the same protection as eating fish. On the other hand, the Italian GISSI Trial found a moderate reduction in cardiac risk with fish oil supplements.”
Note that $1.1 billion is spent each year in the US on fish oil capsules.
My advice is to try to get the benefits of fish oil by eating fish. The American Heart Association recommends eating fish at least twice per week. There have been two large diet trials with over 1,000 patients, and these trials showed a benefit from eating fish.
We don’t have any fish oil music , but green tea is good for your cardiovascular health:
BEVERLY KENNEY:
Reblogged this on Blogfinger and commented:
This is what we said about fish oil supplements in 2011, but since then there has been some more information. See comments
The way fish oil works is very different from that of most drugs. It acts, in part, by competing with other dietary oils to alter the byproducts of fatty acid metabolism. The average diet is likely to have 40 to 60 grams of fat, and we are only giving 1 to 4 grams of fish oil. The impacts are unlikely to be detected in short-term studies (less than several years long) unless doses are very high.
Research continues in a number of areas, including the newly discovered classes of compounds resolvins and neuroprotectins which result from the metabolic pathways involved in fatty acid metabolism.
Meanwhile, the recommendations remain the same as they have been for years: eat a balanced diet with variety, go easy on the animal products, and ignore the claims of those bearing supplements, TV shows, and diet books with wild claims to sell.
Editor’s note: NYNutrDoc ought to know. He is a professor at one of New York’s most prestigious medical schools. We appreciate his participation in this discussion. PG
My doctor who is young, smart and whose husband is a cardiologist at Jersey Shore recommends fish oil—1000mg daily. I’m still here and in good health with no heart problems so I think will continue. Easy enought to do so.
It’s her other recommendations that are harder to follow such as low sugar and low cholesterol. By the way I prefer red yeast rice over pharmaceutical statins.
Vascepa is the newest fish oil prescription drug to be approved (currently awaiting word from FDA on whether or not it will be granted NCE status). The drug apparently compares favorably to Lovaza, will target a wider patient population, and may be used in combination with a statin in the future from what I have read (I think that will be examined in a future trial). It will hit the market in 2013.
Thank you for this comment. Lovaza is a prescription drug which contains high concentrations of omega-3’s and it was approved for specific uses by the FDA. It was not studied in the trial which we discussed. Lovaza is mainly used to treat high triglyceride levels. It evidently does that job quite well, but the clinical endpoints are another story, and there are some concerns about this drug. If you want to know about this pharmaceutical, you should ask your physician.
My guess is if fish oil didn’t have benefits then GlaxoSmithKline wouldn’t have gone out of their way to make Lovaza and get in on the profits.