The People's Perspective on Medicine

Fish Oil Fails to Prevent Heart Disease

Fish oil supplements do not protect against death from heart disease. That’s the conclusion from a large Italian study published in The New England Journal of Medicine. Previous Italian studies known as GISSI had suggested that fish oil might be a valuable way to ward off heart disease.
The researchers randomly assigned more than 12,000 high-risk subjects to take a daily dose of either 1 gram of omega-3 fatty acids from fish oil or a placebo pill containing olive oil. Both groups experienced fewer heart attacks, strokes and cardiovascular deaths than expected after one year.
After five years of follow up, there was still no difference between the groups with respect to these events nor regarding hospitalization for cardiovascular causes. The investigators conclude that in these patients at high risk for heart problems, omega-3 fatty acids did not prevent premature death from cardiovascular causes.
We discuss a variety of approaches to bolstering cardiovascular well-being in our Guide to Cholesterol Control and Heart Health.
[New England Journal of Medicine, May 9, 2013]

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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I read “The Metabolic Typing Diet”, in my opinion bogus and worthless for most people.
At least the book I read was not very believable –it relied on a series of questions to determine which diet was best. If you had some blood work, or other tests to help determine the “type”, that would be more reliable.
For some people a vegan diet doesn’t work, especially if they don’t get enough protein from their food via some vegetables, and beans and lentils, and if they don’t get enough fats which are present in certain plant foods. Also, one must take vitamin B-12 supplements (methylcobolamine, not cyanocobolamine)–the one nutrient (vitamin B-12) which one can only get from animal sources, and Omega-3 from ground flaxseeds or flaxseed oil.
And I guess some people cannot survive on a vegan diet. If you can eat all that animal fat and still keep your cholesterol low, good for you. I still think cholesterol levels are important–our bodies and brains do need it, but for most people the body produces enough for the bodies needs–maybe for people who thrive on a meat diet, their bodies don’t produce enough cholesterol on their own and require additional intake from food sources.
Dr. Esselstynes results speak for themselves with respect to cholesterol levels and healthy survival of his patients (“Prevent and Reverse Heart Disease”)
There are a lot of studies out there, many with conflicting results, and unless we can analyze them carefully for study design and flaws, it’s hard to tell which ones are really good, and which ones are full of errors and erroneous assumptions.
For the fibrillation, some holistic doctors, namely Dr. Adrew Weil, M.D. recommend some specific breathing exercises–they can’t hurt, and they are not invasive.
As you wrote, we all have our opinions.

MZ, I beg to differ. Different strokes for different folks and all that.
About 30 years ago I had a vegan friend and I tried her diet for about three months. I thought I was going to die! Felt like crap! Also gained weight. Now, I understand why. I am a protein type and need meat and fat! Read The Metabolic Typing Diet.
I eat Irish butter, meat, cheese and lots of organic coconut oil and my cholesterol is only 110. Unfortunately that low a number is NOT good for the heart. I have had a heart attack, stroke and ablation for atrial fibrillation. The heart problems started with trauma to the heart form my seat belt during an accident but if my cholesterol had been normal (200-250 or so) I wouldn’t have had such severe problems.
Have you ever seen the statistics of those who have had heart attacks or strokes? About 50% have very low cholesterol!

This sounds like a poorly designed study. It seems that olive oil, which is known to be heart healthy, is not an appropriate placebo for fish oil. A more valid conclusion of the study might be that fish oil protects against heart disease as well as olive oil.

Cindy MB There are a few other options for A-fibs’ clot threat. Nattokinase, gingko biloba and vitamin E are all helpful. I had ablation for my A-fibs and it worked well.
I am using the supplements and my blood is great. All the blood thinners didn’t work on me. The last one they tried, Xarelto, has left me with permanent muscle aches and pains and it didn’t work either.
The cardiologist was really upset with me because I wouldn’t even take aspirin. I told him what I had just started taking. No, I’m not going back to him. My family Dr. is quite happy with the results of my supplements and says my blood is great now.
I take Nattokinase and gingko 2X a day. I take three of the vitmine E capsules a day. Yes, I take Carlson’s cod liver oil as well as one of the krill oil daily.

I have atrial fibrillation, with occasional “breakthrough” AFib despite being on beta blockers. Against drs advice I have eschewed Coumadin, because it does accelerate aging. I would much rather die young than live old and decrepit, though I’d like to avoid both.
I am constantly on the web, studying ways to stay safe and not die of a stroke. Site after site after site — all respected and prestigious — say that FISH OIL IS VERY INSTRUMENTAL AND EFFECTIVE IN PREVENTING/LESSENING ATRIAL FIBRILLATION. Now, I don’t know how those people designed that study, or what specific factors they were evaluating, but I think they are full of crap. I will definitely continue taking the fish oil as I know it’s helping.
PS, Krill oil is considered better than fish oil as it’s less prone to mercury contamination and it’s less likely to oxidize before you take it. Cod liver oil is often recommended as well.

Fish oil by it self will not help much, no matter what brand or how it is processed.
This is all “magic bullet” one pill solution stuff–it does not address the underlying cause of the problem, which is the diet–“garbage in, garbage out”
Very simply, the body does not need any help adding cholesterol to the diet–it produces it’s own–and fats and cholesterol are the primary causes of cardiovascular disease (of course sedentary lifestyle, stress and genetics contribute to the problem.)
If one wants to prevent and/or reverse heart disease, the best way is to go on a permanent and strict vegan diet.
“Prevent and Reverse Heart Disease”, by Dr. Esselstyne, and “The China Study” by Drs. Campbell and Campbell is a good place to start for a thorough and scientific explanation.
The diet is strict and not fun, but it does yield results.

True to sonja.
I just signed up for a popular weight loss program and was shocked that they endorsed artificial sweeteners and fractionated oils.
BUT the one thing the moderator tried to drive home is that we need two tablespoons of olive oil a day (she would not comment on supplements).
While olives in the state we eat them — brined, etc. — might not be the healthiest, cold pressed olive oil seems good for consumption as well as topical!
Oh, and for the record, I take fish oil Omega supplements.

Maybe it’s the oil?

This is another case of trying to disprove a natural substance by having the subjects take too little of it. What a waste of research money!

It would seem that taking fish oil or real, Italian olive oil as sold in Italy, does indeed help. “Both groups experienced fewer heart attacks, strokes and cardiovascular deaths than expected after one year.”
Probably the “patients at high risk for heart problems” were given the advice to avoid saturated fats. Saturated fats are GOOD and yet are treated the same as trans-fats since they were grouped together in “scientific studies” for many years. There are other factors, like Vitamin D and Vitamin K2, which are ignored in these studies as if ONE THING is the determining factor. If you think you can eat all the sugar and “whole grains” and fruit and trans-fats (oil, margarine) you want and then take 1 gram of fish oil, you will be the dream candidate for one of those double-blind studies the drug companies love to show that their products are needed. I am not in a high-risk group but I sure wouldn’t take some synthetic drug with proven harmful side effects if I were.

Ok but what about studies for using fish oils for helping or preventing ARTHRITIS.
Is their any evidence that fish oils can help with Arthritis??

Since both groups in the study had a lower risk of heart problems than expected, did the researchers consider that olive oil was also beneficial, and perhaps as beneficial as fish oil?

I cannot help but wonder about their proclaimed results when olive oil has a reputation on its own for health benefits.
Maybe there was a benefit from BOTH rather than neither?
Or was it their way of stacking the deck against fish oil?

“Both groups experienced fewer heart attacks, strokes and cardiovascular deaths than expected after one year.”
If that statement is correct, how can they say fish oil fails to prevent heart disease? Certainly nobody would expect it to stop ALL heart disease.

Why would they use olive oil as the placebo, given its health benefits? it seems that the results should be that both olive oil and fish oil protect equally against heart disease.

The two statements, 1) “Fish oil supplements do not protect against death from heart disease,” and 2) “Both groups experienced fewer heart attacks, strokes and cardiovascular deaths than expected after one year,” seem to be contradictory. I don’t understand if both fish oil and olive oil were protective, or were neither? Can you publish a follow-up and explain this in more detail? Thank you.

“Both groups experienced fewer heart attacks, strokes and cardiovascular deaths than expected after one year.”
This is an interesting statement. Maybe olive oil is good for the heart?

I wonder what kind of fish oil they used and how it was processed. I don’t know what the best fish oil is, but I know they’re not all the same. For example, molecular distallation or not? I switched to a brand which is not mol.distilled and which supposedly was preserved in some way on the fishing boat, so it’s super fresh — couldn’t this make a difference? I wonder how researchers choose which brands of supplements to study. They vary so widely. Thanks!!!

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