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Omega 3 supplements may not protect the heart: What about food?

Kathleen Blanchard's picture
Omega 3 supplements no help for heart attack, and stroke prevention

Omega-3 fatty acids that are sold in a variety of supplements including fish oil, a may not be any help for cardiovascular health after all, finds a new study. But a current study showing no benefit from supplements doesn’t mean omega-3 fatty acids from food don’t have heart healthy benefits.

In a new analysis, researchers found no difference in heart attack, stroke and death rates between people taking supplements and those given placebo.

The finding, published in the Journal of the American Medical Association (JAMA) included data from more than 70,000 people from 20 studies.

Lead study author Dr. Evangelos Rizos and his colleagues compared cardiovascular outcomes among people who took placebo and those who took omega-3 fish oil supplements.

The most common form of omega-3 supplements taken by consumers is in the form of fish oil. For this study, the fatty acid also came from other sources.

But the study may not be the final word for the role of omega-3 fatty acids for promoting heart health. Supplements have repeatedly failed to show the same health benefits that come from consuming whole foods versus a pill.

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One problem with the current study is that participants may not have been followed long enough.

Prescription doses of fish oil are available and many physicians prescribe high doses for patients with elevated triglyceride levels, known to contribute to cardiovascular disease.

The new study also supports past evidence that omega-3 fatty acids from supplements may not prevent cardiovascular disease.

The McMaster University ORIGIN-GRACE study that was published June, 2012 also failed to find any heart benefits for atherosclerosis progression among diabetics and people with prediabetes.

Rizos, from Greece's University Hospital of Ioannina, concluded omega-3 supplements can’t be justified for routine use for heart disease and stroke prevention. The take home message from the newest study is speak with your doctor about taking supplements. that may not confer the same benefits for health as eating a balanced diet.

JAMA news release
September 11, 2012

Image credit: Morguefile



I wish people who write about health matters on the internet would learn to read studies and do a tiny tiny little bit of research on the internet itself before writing misinformation. After thousands of studies have shown that fish oil supplements are at least as beneficial as eating fish and do not contain mercury you once again advance the ridiculous concept that there is something magical in fish that is not found in fish oil. The active ingredient is was and always will be Omega 3 fatty acids in both fish and fish oil when it comes to disease prevention. Next instead of placing all the weight on one or two studies it would make more sense to look at the big picture and comment on that. There are thousands of positive studies on fish oil. This one was NOT A STUDY. It was a meta analysis a tool used to generate quick inexpensive publications that are total dependent on data input. The data used in this one went back to 1987 long before any of the highly purified ethyl ester fish oils were available and no attempts were made to assure its validity other than "looking at the study". Next there was no attempt to control for some of the most important confounding variables like the increasing use of cardiovascular meds. Next no attempt was made at measuring the Omega 6/3 ratios to establish effective treatment levels- the usual dose was "one a day". These last 2 comments also apply to the Origin-Grace study which was NOT a fish oil study by design. It was used to study Glargine (lantus) insulin efficacy in diabetics and was funded by Sanofi the makers of said insulin. The fish oil group was a sub group analysis. The results of fish oil's "failure" ( actually it was reported as having no effect) were released as giant headlines weeks before a tiny headline noting the failure of Lantus to prevent progression of heat disease. In this study over 50% of the participants were also on statins aspirin and other anti-diabetic drugs. No attempt was made to look at the role these drugs might have played in the progression of heart disease or the interference with insulin or fish oil. The rash of the "Fish oil no good for your heart" clearly defrayed the public and physician (!) attention away from the failure of Lantus insulin. This emax piece is just another in a long line of "articles" that simply make conclusions based on parroting back misinformation. I know it takes a little time to actually read a study learn about what it really says and you might miss the window of public interest on the internet (god forbid) but you might actually have something valuable to add to reality.
Your wish is granted. Read the article again. However, there are not 'thousands' of positive studies re: fish oil supplements. This article does say it is an analysis - but thank you for bringing that out in your critique of the article - it also says there are shortcomings re: follow up time. It also points out the study is not the final word. I know it takes time to read a whole article to find out what it really says and you didn't apparently read this in it's entirety. Regarding public interest: There are more studies showing whole foods that are complex promote health and prevent diseases better than supplements. Yes, the active ingredient in fish is omega-3 and also in other foods. But when you extract an ingredient from food - plant or animal - you lose that complexity: Where are the 'thousands' of conclusive, controlled fish oil supplement studies? You didn't share that, but there are studies showing that people who eat fish have lower risk of coronary artery disease and multiple studies showing whole foods excel at preventing CAD, cancer and other diseases. Supplements have also been shown to cause harm and promote disease. Fish oil supplements can make triglyceride levels worse for some. Please don't proselytize the benefits of fish oil supplements to the public. People need to consider these studies and make their own decisions but only after they speak with their physician. Here are some positive studies that eating fish might promote heart health - not supplements - and it mentions confounding studies that have yielded mixed results. "The US Physicians’ Health Study did not show an association between fish consumption (or omega-3 fatty acid intake) and reduced risk of total MI, nonsudden cardiac death, or total cardiovascular mortality. In contrast, however, fish consumption was related to a reduced risk of total mortality. The lack of an association between fish intake and CHD incidence and mortality also was reported from an analysis of the Seven Countries data and the EURAMIC (European Multicenter Case-Control Study on Antioxidants, Myocardial Infarction and Breast Cancer) Study. In the Seven Countries Study, although an inverse association between fish consumption and 25-year mortality from CHD across several populations was observed when the confounding effects of saturated fatty acids, flavonoids, and smoking were considered, the association was not significant. In the EURAMIC Study, a large international case-control study, no evidence of a protective effect of adipose tissue DHA (a measure of long-term fish consumption) on the risk of developing MI was seen." http://circ.ahajournals.org/content/106/21/2747.full "Consumption of marine products, the main source of EPA and DHA, appears to beneficially affect some cardiovascular disease risk factors. The traditional Inuit diet, which is rich in n−3 fatty acids, is probably responsible for the low mortality rate from ischemic heart disease in this population." http://ajcn.nutrition.org/content/74/4/464.abstract At best, the studies are confusing, but again, worth considering as they emerge. This is the newest. Another point worth noting is that supplements are not regulated and you do not - ever - know exactly what you're getting. For now, there just isn't evidence to say fish oil or any other supplements should be taken for disease prevention, except for very high risk patients, and again, guided by a physician.