The Times
London, UK
24 March, 2006

FISH OIL may not quite be the elixir of life that we have been led to believe.
Analysis of all the best trials on the subject has found little evidence that eating fish, or taking fish oil capsules, cuts the risk of dying of heart disease, stroke or cancer.

The finding may come as a shock to those who believe that the benefits of omega 3 fatty acids, which are found not just in fish oils but also, in short chain form, in some plant oils such as linseed oil.

The analysis indicates that, despite a lot of work and a multiplicity of trials, it is difficult to show clear benefits. The better the quality of the trial, the lower the apparent benefit.

The findings, published in the British Medical Journal online by a team led by Lee Hooper, of the University of East Anglia, are unlikely to go uncontested.

Other analyses, including one published as recently as 2002, have shown benefits.

Dr Hooper’s team, which included Professor George Davey-Smith, of Bristol University, searched the medical literature for studies of fish oil. They found 48 randomised control trials and 41 “cohort” studies.

Randomised control trials (RCTs) compare the effects of fish oil capsules with a placebo, while cohort studies compare groups with high intakes of fish oil against those with low intakes. RCTs are considered the best source of evidence available in medicine, while cohort studies rank lower.

The team pooled all the data from the studies to increase statistical power. When this was done there was no strong evidence of a reduced risk of dying among those taking supplements.

When only the better studies, with a lower risk of bias, were chosen, the evidence of benefit became even weaker.

These studies were more consistent but showed no evidence of benefit. Overall, they suggested that a 2 per cent reduction in risk, but the error margin was wide.

The benefit could have been as great as 30 per cent, or the disbenefit as much as 36 per cent. So fish oil could reduce deaths, or increase them. The only conclusion possible is that it has no significant effect.

Why does the finding differ from earlier studies? The authors suggest some possibilities. In the cohort studies, which have in the past suggested there is a benefit, it is impossible to eliminate bias.

People who take fish oil capsules differ in so many ways from those who do not that it is impossible to correct completely for these differences. Or, as the team says: “The web of lifestyle, interest in health and social factors seen in the cohort studies included in our review provides an advantage to people taking most omega 3 fats and this makes adequate adjustment for confounding difficult, if not impossible.”

So reliance has to be placed on RCTs, where the bias is smaller. Here they acknowledge that one recent study, by Michal Burr, of the University of Cardiff, had a significant influence on the final result.

Dr Burr found no benefit of fish oil, in a study that included 525 deaths, the second largest conducted, and with the longest follow-up.
Attempting to explain why Dr Burr should have reached the conclusions he did, the team suggest that fish oil may have a short-term benefit, but a long-term disbenefit, because it contains traces of toxic methyl mercury as a contaminant. Another possibility is that the beneficial effects may be limited to small groups of people — such as those with heart failure or those who have had a heart attack — who were not included in the Burr study.

At present, the team says, British dietary guidelines recommend that people eat more oily fish, especially if they have had a heart attack. This advice should not change, they say, but should be regularly reviewed.

They add that it is probably not appropriate to recommend fish oil to people who have angina but who have not had a heart attack.

Trials show that people given the plant-produced version of omega 3 experienced no greater improvement in health than those taking fish oil.




http://www.timesonline.co.uk/articl...00878_2,00.html

I take Omeg3 supplements for two reasons:
1/ To ensure I get enough (2% of total fat intake), because most modern foods are defficient due to grain feeding.
2/ To try to remedy the imbalance of Omega6/Omega3 from modern foods due to grain feeding.

Another report of the analysis

http://www.forbes.com/lifestyle/hea...cout531738.html

FRIDAY, March 24 (HealthDay News) -- The belief that the omega 3 fats found in oily fish can help prevent heart disease is far from proven, a new British study contends.

U.S. experts agreed with that statement, but also stressed that people without heart disease will suffer no harm from consuming fish, and quite possibly could do themselves some good. And there's clear proof that omega 3 consumption helps people who already have had heart attacks or other cardiac problems, they added.

The report, published in the March 25 British Medical Journal, summarized findings from 89 studies aimed at assessing the effects of omega 3 consumption from fish or supplements on total mortality, heart problems, strokes and cancer.

The picture is "mixed," concluded Lee Hooper, a lecturer in research synthesis and nutrition at the University of East Anglia in Norwich, England, and lead author of the report. Two major studies did show a benefit, but the most recent large study did not, she said.

One problem in interpreting the findings is that most of the trials included people who already had cardiac problems such as heart attacks or angina. Putting all the studies together produced conclusions that could be described as equivocal, Hooper said.

"If you put the results all together, for every 100 deaths in the control group (those who didn't get omega 3), you see 87 deaths in those who took supplements," she said. "But that could be as low as 74 and as high as 102; our best guess is 87."

What's needed to determine the true preventive benefits of omega 3 consumption are more and larger trials, Hooper said. "At the moment we just aren't sure, so we should be cautious," she said.

That is pretty much the conclusion reached by an expert panel assembled in June 2004 by the U.S. National Heart, Lung, and Blood Institute.

"In terms of primary prevention, we still don't have the answer, and the conclusion of the panel was that additional studies were needed before making recommendations to the general public," said Dr. Eliseo Guallar, associate professor of epidemiology and medicine at the Johns Hopkins Bloomberg School of Public Health, and a member of the panel.

Those studies, which would be expensive, haven't been started yet, Guallar said. "And even if they were done, we wouldn't know the results for five, six, seven years from today," he said.

There's no question about the value of the omega 3 in fish oil for people with existing heart problems, Guallar said. One study of people who suffered heart attacks showed that taking 850 milligrams of fish oil a day substantially reduced their risk of sudden death, he said.

But while fish oils are "most promising for primary prevention" in people without heart disease, "we still don't know for sure," he said. Still, he endorses the American Heart Association's recommendation of eating at least two fish meals a week.

The heart association also recommends consumption of plants such as soybeans, canola and flaxseed, which contain a different version of omega 3 oils.

Alice R. Lichtenstein, professor of public health and family medicine at Tufts University School of Medicine and vice chair of the heart association's nutrition committee, isn't so sure about the plant part of the recommendation. It's not certain that the omega 3 in plants has the same benefits as the fishy kind, she said.

And even when it comes to fish consumption, "the jury is still out," Lichtenstein said. Nevertheless, eating fish is a good idea, in part because it keeps that much fatty meat out of the diet, she said, adding, that "the secondary benefit of what you don't eat supports moderate fish consumption."

But be careful about what kind of fish you eat, Lichtenstein added. Not all fish are rich in omega 3, and some commercial fish products are fried, which takes away a lot of the benefit, she said.

Mackerel, lake trout, herring, sardines, albacore tuna and salmon are good sources of omega 3, according to the heart association.

Same here. If my diet included more omega-3s, then I wouldn't need to supplement. Getting a good ratio of omega-3 to omega-6 promotes health in general.

eat grass fed beef!

I have read (in a book called "Heart Disease Breakthrough" by Thomas Yannios) that greater health benefits are shown by eating fish than by taking supplements. The book was published a few years ago, but the author seems reputable and isn't pushing a specific agenda in terms of diet.

I've been eating a lot more fish and flax over the last few months, and a few patches of rough skin I've had for as long as I can remember have gone smooth again. That doesn't prove anything, but I think it indicates a change in the right direction.

To avoid or reduce mercury contamination, eat fish at the bottom of the food chain - small fish like herring and sardines.

One thing I've learned researching low-carb and following this web site is that "reputable" people can, without any apparent agenda, be spreading absolute nonsense.

Lots of reputable people, starting with more than one of my own physicians, whose integrity I trust, have told people or have written that low fat equals healthy. Yet they are probably wrong, that is, recommending low fat diets to people may have the effect of reducing their overall health. I probably gained about twenty pounds as the result of such recommendations. But, hey, I lowered my total cholesterol by a few points!

A great deal that passes for nutritional science is little more than wishful thinking, conclusions extrapolated from way too little evidence.

Are fish and linseed oils good for health? RCTs, given the study reported here, seem to show that they do not reduce mortality. But RCTs that would clearly show the effects of something that has, for example, a strong taste, would be nearly impossible. Instead, without reading the studies, I would assume that the fish oil was in capsules so that there was no taste. But what if the oil is eaten mixed with food and, for some reason that we may not anticipate, it is the mixture and perhaps even the taste that produce a healthful effect? Further, as noted in the article, perhaps the beneficial effect is only for certain groups who were excluded from the study.

And, we must allow, perhaps there is no beneficial effect, perhaps it is only that the cohort studies were biased because people who consumed more fish oil were more likely to eat better in other ways, or even to have certain other aspects of their lifestyle that are beneficial.

What we really need is good nutritional research, funded directly by us. Governments are quite unlikely to do this for us, and certainly the pharmaceutical companies aren't going to do it! Nor will the food industry. How could we accomplish this? I have ideas. Write me at daniel~beyondpolitics.org if you are interested. No, I'm not collecting money!

I'm quite aware of that. My only point is that it's at least possible that eating the whole fish might be more beneficial than taking supplements. The study cited above found that supplements may not reduce mortality, but did not study the effects of eating the whole fish (or the whole flax seed, for that matter).

Rachel

Possibly they caught their own fish? As I understand it (and fervently hope), the good Lord doesn't count against you the time you spend fishing..

Just goes to prove once more that you can take any set of data you want, apply your own statistical analysis to that data, and find exactly what you want to find.

I have not found out exactly how much omega 3's were consumed in supplement form vs. real fish. Several iterations of the same analysis say different things.

Were the supplements proven fresh and non rancid? Really? Exactly how much REAL fish were those folks consuming?

And, like others have asked, were those folks eating their sardines with a salad? Or eating their cod breaded with chips/fries, and fried in WHAT?

Sadly, we never get those answers.

1. These are *essential* fatty acids.

2. Most people do not get half of what they should

and these people think we would believe that adding more in does not help?

This is just more FUD from the FDA, AMA, and pharma companies trying to prove that anything natural you do yourself:

1. does no good
2. is a waste of money
3. could be dangerous!

The lawsuits against pharma companies are going to make tobacco lawsuits look like chump change.

From my understanding of the whole omega 3 thing, you have to change your whole diet so that you consume far less omega 6s, because omega 6s are antagonists to O3s. So adding in O3s are not going to do a darn thing if you are still ingesting the O6s like mad.

Its about a drastic change in diet - away from vegetable oils, farm fed fish, grain fed cows, etc...not just adding in O3 supplements.

Linseed oil is great for furniture, but I would never ingest it. It has more O6s than O3s so using it would not help with O3s. Same goes for fish oil if you really look at the ratio of O6 to O3 in the fish oil itself.

They really did us in when they started feeding our livestock & fish grains and corn and selling us on the idea of "healthy" vegetable oils.

No mention that farm fed salmon (which is all I can usually find) has then same deficiencies in Omega 3s as beef and for the same reason - grain fed. Wild salmon isn't showing up in the stores very much these days. If they didn't add color to the farm raised salmon it wouldn't be nearly as dark pink as the real thing. That should tell us something is rotten in Denmark.

This BMJ study receives some hefty critique:

http://bmj.bmjjournals.com/cgi/elet...755.366331.2Fv1

Furthermore check this:

'Something fishy' about negative study on omega 3