Omega-3 Fish Oil: Separating Fact From Fiction

[andersenpa]

[h=1]Omega-3 Fish Oil: Separating Fact From Fiction

 

http://www.medscape.com/viewarticle/762318?src=mp&spon=38[/h]

 

Another dietary supplement is in the news recently, and it seems to be another flip-flop message where conventional wisdom is being overturned by randomized clinical trials. The study was published in the Archives of Internal Medicine ^[1] recently, a meta-analysis of 14 randomized trials conducted by the Korean Meta-analysis Study Group, reaching the conclusion that omega-3 supplements do not prevent cardiovascular disease.

Several points should be kept in mind. First, all of these randomized trials were secondary prevention trials. These were high-risk participants. Also, many of these trials were short-term, with an average duration of only 2 years. Some of the trials were as short as 1 year. A wide range of doses was tested -- as little as 400 mg in some trials -- with an average dose of 1.7 g daily. [Editor's note: Dr. Manson made these observations in a commentary on the study, also published in Archives of Internal Medicine. ^[2]]

But most important, because all of these trials were secondary-prevention high-risk studies, many of the participants were taking other medications, such as statins, aspirin, angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, and medications that may have interfered with the ability to detect a moderate benefit from omega-3s. This is why it is particularly important that randomized trials of omega-3s be done in primary-prevention trials, with average-risk populations. Such trials have not yet been published. Our research group is conducting a primary-prevention trial (the vitamin D and omega-3 trial) in a usual-risk population.

While waiting for the results from these additional primary-prevention trials, what can clinicians do? It is still important to recommend regular consumption of fish for our patients. The American Heart Association recommends at least 2 servings per week of fish, and it is best to recommend the dark, fatty fish that are high in EPA/DHA such as salmon, mackerel, tuna, herring, and sardines. A diet that is high in fish has been linked to a reduced risk for cardiovascular disease in many observational studies.

Furthermore, the fish would replace less healthful sources of protein, such as red meat or processed meats high in saturated fats. For patients who don't eat fish (eg, vegetarians and vegans), it would be worthwhile to recommend increased intake of alpha-linolenic acid (ALA) or plant-derived sources of omega-3, such as flaxseed, canola, and soybean oil.

Overall we should still be recommending a diet that is high in fish. The omega-3s still have a role in the treatment of high triglyceride levels, including the prescription omega-3s. This specific issue was not addressed by these trials. At the present time, there isn't conclusive evidence that recommending fish oil supplements will prevent cardiovascular events. Stay tuned for additional research.

 

[Walkoffshot]

There are always going to be studies that prove what seems to be something that is good for you, to not be the way we see it. The sad part of this is that people who are not well educated in nutrition are going to see the result of such a study in some form (through word of mouth etc) and move on to the next fad or "miracle" diet/supplement that prevents CV disease, or reduce weight/fat. Fact is, despite this study, foods that contain the omega 3's (other than the synthetic foods that are enriched with so called omega 3's) also contain essential macros that aid in optimal metabolisim, catabolism etc. Once a person sees that Omega's aren't as good as we thought they were, they deem those foods as not beneficial because all they saw was Omega 3, and Omega 3 has an attached benefit... they don't know why, but just because someone said so. It's complete ridiculousness. No wonder there is an obesity epidemic in America.

 

Who cares if it reduces CV disease or not.. it's healthy fats, and it's not a cheeseburger.