Time to Throw Fish Oil Back

Another one bites the dust. 

At some point perhaps dietary supplement fans are going to wonder why they spent so much money on a bunch of stuff which ended up being useless once properly evaluated in human trials. Probably just about the time that Niagara Falls changes direction. Which would make it a whole lot easier for the fish to swim upstream.

Note the clever segue into fish (1), which was not irrelevant because an article in the latest JAMA has a message for all of you who took the bait (2) and went hook, line, and sinker (3) for fish oil because it was supposed to protect your heart - it doesn't.

The article. "Another Nail in the Coffin for Fish Oil Supplements" summarizes the results of a meta-analysis of 10 randomized trials, which were conducted to see whether omega-3 fatty acid supplements from fish had any impact on fatal heart attacks, nonfatal heart attacks, strokes and deaths from any cause (endpoints). 

The average length of a trial, all of which compared omega-3 fatty acid supplements to placebo, was 4.4 years and about 78,000 participants were involved. 

The results? Zilch. The supplement did not meet any of the study's endpoints. 

Lawrence J. Appel, MD, and David S. Siscovick were two of 12 authors of a 2017 advisory from the American Heart Association, which concluded:

Although recent RCT [randomized controlled trials] evidence has raised questions about the benefits of omega-3 supplementation to prevent clinical CVD [cardiovascular disease] events, the recommendation for patients with prevalent CHD such as a recent MI [myocardial infarction (heart attack] remains essentially unchanged: Treatment with omega-3 PUFA [polyunsaturated fatty acid] supplements is reasonable for these patients. 

Yet even Dr. Appel agreed with the results of the recent meta-analysis:

“They looked every way they could to find out if there was a signal and nothing panned out.” 

Lawrence J. Appel, MD 

None of this should be the least bit surprising. The results of two randomized studies, both from 2012, were reported in papers in JAMA  and Archives of Internal Medicine. The conclusions were the same. There was no discernable benefit from the supplements.

At the American Council, we have written dozens of articles (4) about the false promises, as well as potential harm, of dietary supplements, so to us, there is nothing even remotely surprising in the latest JAMA paper. 

And we are fortunate to have Dr. David Seres, Director of Medical Nutrition at Columbia University Irving Medical Center, NYPresbyterian Hospital as an advisor. Here is what Dr. Seres has to say:

The story is not as earth-shattering a result as readers and the author of the news story might think. The dose was about one-quarter of what we believe is required for a pharmacological effect. That said, taking that many fish oil caps per day is hard to adhere to. So the usefulness of fish oil for primary or secondary prevention will likely remain limited.

Fish oil has another downside, albeit, not obvious:

Furthermore, the decimation of fish populations so that people can take a useless dose of fish oil is immoral, just as is destroying rain forests to grow açaí berries when we know that antioxidant supplementation causes, not prevents, disease. Continued pushing of sub-therpeutic doses of fish oil ignores the harm the industry is doing. Siscovick and the AHA should reconsider their recommendations.

So, once again, when subjected to scrutiny dietary supplements continue to disappoint, yet US consumers continue to throw away money to the tune of $37 billion per year. It is more than a little ironic that people complain about the prices of prescription drugs, which actually do something while spending a fortune on junk in a bottle which does not. Strange world.

NOTES:

(1) It wasn't really that clever. Don't believe everything you read.

(2) Still pretty bad.

(3) No more. I promise.

(4) See "DSHEA Allowed 23 Yrs Of Disgraceful Cancer Claims By Supplement Makers"