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Monday, Mar 30, 2015

Something fishy


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As regular readers here know, I sometimes get so ahead of the curve that you may, with all apologies to the Talking Heads, ask yourself:

". how do I apply this?

You may ask yourself, who is that crazy chef?

You may tell yourself, this is not an average doctor.

You may tell yourself, this food is too tasty to be good for me!"

But what the heck, that's why folks stop by and read the column. Y'all come by when you want answers - not just recipes! Along those lines, over a year ago, I wrote an article detailing the big business and little effect of fish oil supplements.

In a krill shell, the article details that fish oil and krill oil supplements, which can cost a whale of a monthly subsidy, provide no significant reduction in cardiovascular mortality.

They do, however, provide for big business sales. Despite the somewhat misleading advertisements, they are only approved by the FDA for the reduction of high triglycerides, not for the prevention or reduction of heart attacks. This is in contradistinction to the many studies demonstrating the positive cardiovascular benefits of a diet rich in fish and seafood that contain the omega 3-fatty acids (also known as n-3 fatty acids).One of the best studies to date was recently published confirming the conclusion I shared with readers more than a year ago.

The study comes from the group of Italian researchers who form the Risk and Prevention Study Collaborative Group. It was published in the May 9 issue of The New England Journal of Medicine. They examined more than 12,500 participants, about half of whom received 1 gram of polyunsaturated fatty acid fish oil (with both eicosapentaenoic and docosahexaenoic acids) daily. The doses were, at those levels, believed to reflect a more than adequate amount to show a benefit, if any existed.

The study looked at patients with multiple cardiovascular risk factors and those with coronary artery disease but no history of heart attack - in other words, those patients at an increased risk of a myocardial infarction or heart attack. After a median follow up of five years, there was no difference in outcomes between the groups. There was no reduction in cardiovascular death or disease for those taking the supplements.

This held true even if those who took the supplements did not take aspirin, statins or, at baseline, did not consume many foods rich in omega-3 fatty acids. If there was any group that should show a benefit, even a small benefit, it should have been apparent in this subgroup. The study also showed no benefit in reducing death from any coronary cause, lethal heart dysrhythmias (like ventricular fibrillation) or sudden cardiac death.

Dr. Eric Topol, a leading cardiologist with Scripps Clinic in La Jolla, Calif., now calls fish oil supplementation a "no-go . Fish oil does nothing . it is a nada effect."

Previous studies like the Alpha Omega trial had looked to see if this type of supplementation could provide benefit to those patients who had a heart attack in the past. The Omega trial looked at initiating this type of supplementation when patients presented with a heart attack. Those studies reached the same conclusion as the researchers for this study. They found that their "findings provide no evidence of the usefulness on n-3 fatty acids for preventing cardiovascular death or disease in this population."

So while eating a diet rich in fish and seafood has a clear benefit, spending a lot of change each month to try and supplement your way to good health simply does not work. As the Talking Heads might have noted, that fact is "the same as it ever was."

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