2

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New study claim omega 3 has no benefit vs heart disease and stroke. Does this change anything?

Answered on September 12, 2014
Created September 12, 2012 at 7:19 PM

http://articles.chicagotribune.com/2012-09-11/lifestyle/sns-rt-us-heartbre88b04d-20120911_1_omega-3-fish-oil-pills-fatty-acids

I saw this and wanted to share. This study seems to claim omega 3 is not effective for lowering a person's risk of heart disease or stroke. Since a lot of paleo seems to focus on getting as much omega 3 as possible, does this change anything?

Or, can anyone explain why the study may be wrong?

9f54852ea376e8e416356f547611e052

(2957)

on September 13, 2012
at 02:00 PM

I've heard the claim about the ratio being the important factor, just scant research proving, or even supporting, that.

77877f762c40637911396daa19b53094

(78467)

on September 13, 2012
at 03:53 AM

@ The Quilt: what does it mean to you?

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on September 13, 2012
at 01:33 AM

it should cause you to ask better questions. many of them spring to my mind. I wonder if the paleo leaders get what this truly means.

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on September 12, 2012
at 11:50 PM

Metaanalysis? Moves along...

Dc8ec73989c7b37c006f2031dd648a61

on September 12, 2012
at 08:05 PM

well, isn't this based on mainly observational studies (considering they included "68,000" people... but anyway... my take on recent paleo "advice" is that we should strive to lower overall PUFA's but especially omega-6's... some in the last year or so have been either not recommending omega-3 supplementation or only in specific cases.

A2c38be4c54c91a15071f82f14cac0b3

(12682)

on September 12, 2012
at 07:45 PM

I'm trying to get the full text, but here's the abstract for anyone interested: http://jama.jamanetwork.com/article.aspx?articleid=1357266

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8 Answers

4
B9ae572069c0b93de0e8edada50a299b

on September 12, 2012
at 08:13 PM

Here's the original report: http://jama.jamanetwork.com/article.aspx?articleid=1357266

I'll caveat that I'm not an expert but my gut reactions are:

1 - The study is a meta analysis (a study of different studies) with no standard controls in place. We don't know if the subjects had pre-existing conditions, eating habits, how much Omega-3, etc. Were these people eating McDonald's every day or some other traditional inflammatory diet (wheat, trans fats, etc)?

2 - I need to validate this but Omega-3 alone doesn't dictate potential benefits to cardiovascular health. I think the Omega-3/Omega-6 ratio is more important (http://www.ncbi.nlm.nih.gov/pubmed/12442909). Not sure if this info was available from the different studies being reviewed

3 - Along the lines of Omega-3 amounts, I can't tell from the article how the subjects were receiving Omega-3 supplementation. Some methods are more bio-available than others. Was it actually supplements or did they look at people eating fish and count that as Omega-3?

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on September 12, 2012
at 11:50 PM

Metaanalysis? Moves along...

9f54852ea376e8e416356f547611e052

(2957)

on September 13, 2012
at 02:00 PM

I've heard the claim about the ratio being the important factor, just scant research proving, or even supporting, that.

3
77877f762c40637911396daa19b53094

(78467)

on September 13, 2012
at 12:30 AM

This study will have a big impact on clinical support for omega-3 PUFA dietary supplementation for improving cardiovascular health outcomes. It's an important study and it would be remiss to ignore it.

It's worthwhile pointing out the authors acknowledge there is evidence of the triglyceride lowering effect of omega-3 PUFA's - but given there is only a small association between triglyceride levels and coronary heart disease as per the two studies they cite (1) the triglyceride lowering effect alone may not significantly contribute to improving health outcomes.

The biggest source for bias was that almost half the numbers in this meta-analysis were derived from open-label studies.

Other issues were a lack of data on the EPA/DHA ratio and source of omega-3.

The biggest issue I have with this study, and, as is becoming apparent as time goes on with other nutrient-health interaction studies, is the nutrigenetic confounder (2). In other words, the nutrient-health outcome is only revealed when adjustment is made for genetic responders vs non-responders.

Personally, I would not be trashing the omega-3 supplementation just yet, but I would be following the research closely to determine if supplementation is of benefit for your type of nutrigenetic profile.

(1) 1992a 1992b

(2) 2006

3
4303a65967884e68bfae59817c227351

(1881)

on September 12, 2012
at 08:20 PM

No. Without seeing the study, I would very seriously doubt that there was anything other than Omega 3 as the change to the patients. As paleo people, I think it's the reduction of Omega 6 that is as important if not more important than just cramming a bunch of Omega 6 down our throats. Raising the good doesn't mean getting rid of the bad. Working out regularly is great, but if you're still blowing lines of coke every night, it's probably not helping you much.

So, if they were still eating whole wheat bagels for breakfast and pizza for dinner, thrown in with some fried anything for lunch. You're still taking in all that stuff. The added Omega 3 benefits would be hard to prove if at all effective in that scenario. At least that would be my assumption without further data.

1
Baa413654789b57f3579474ca7fa43d7

(2349)

on September 13, 2012
at 12:50 PM

Simply adding more Omega 3 onto a standard diet is unlikely to improve health.

Robb Wolf moderated his Omega 3 supplementation recommendations and explained why here: http://robbwolf.com/2011/10/05/fish-oil/

Here is a relevant quote (note, linoleic acid is an omega 6; EPA/DHA is omega 3):

"What I had not initially considered is signaling, be it anti or pro-inflammatory is a cell by cell affair, and this is based largely on the make-up of fatty acids in our cell membranes. In an inflamed, sick, standard American diet model, individuals have a significant overabundance of linoleic acid in their cell membranes. The idea of front loading more EPA/DHA to change the fatty acid profile of our cells is great until you run into the brick-wall of our metabolic machinery. Cell fatty acid turnover cannot be ???goosed??? from behind like shoving a bungee jumper off a bridge. Fatty acid turnover has a rate limiting step that is not ???substrate limited.??? Or, in non-geek-speak more fish oil will not make the process go faster. Instead we need to limit the intake of linoleic acid, keep a decent intake of EPA/DHA, but we need not, and in fact should not hammer that dosage, as we will see when we look at oxidative stress and free-radical chemistry."

Chris Kresser also wrote a great article on why reducing Omega 6 is more important than simply dosing up Omega 3's. http://chriskresser.com/how-much-omega-3-is-enough-that-depends-on-omega-6

Here is a great summary from that article:

To summarize, for someone who eats approximately 2,000 calories a day, the proper n-6 to n-3 ratio could be achieved by:

1) Making no changes to n-6 intake and increasing intake of EPA & DHA to 3.67g/d (11-oz. of oily fish every day!)

2) Reducing n-6 intake to approximately 3% of calories, and following the current recommendation of consuming 0.65g/d (three 4-oz. portions of oily fish per week) of EPA & DHA.

3) Limiting n-6 intake to less than 2% of calories, and consuming approximately 0.35g/d of EPA & DHA (two 4-oz. portions of oily fish per week).

Although option #1 yields 60% tissue concentration of EPA & DHA, I don???t recommend it as a strategy. All polyunsaturated fat, whether n-6 or n-3, is susceptible to oxidative damage. Oxidative damage is a risk factor for several modern diseases, including heart disease. Increasing n-3 intake while making no reduction in n-6 intake raises the total amount of polyunsaturated fat in the diet, thus increasing the risk of oxidative damage.

This is why the best approach is to limit n-6 intake as much as possible, ideally to less than 2% of calories, and moderately increase n-3 intake. 0.35g/d of DHA and EPA can easily be obtained by eating a 4 oz. portion of salmon twice a week.

1
96440612cf0fcf366bf5ad8f776fca84

(19413)

on September 13, 2012
at 10:40 AM

Yes, indeed, maybe some of the participants thought those fish shaped crackers that contain zero fish counted as fish. Maybe as Quoc Ngo mentioned, fish sandwiches at McD's. Maybe it was low quality fish oil that was cut with soy oil. Maybe they ate GMO farmed fish that's been fed soy/corn and had no exposure to their normal diet and had the same n3:n6 profile as CAFO chicken?

Maybe the participants lied. Maybe the sponsors of the study were subscribers to the "Heart Healthy" logo for their grain crap-in-a-bag products.

As Harry mentions, the study will have some impact, the question is, does it match reality, or will it serve to sway opinion away from the truth?

Maybe n3's don't have an effect on heart disease and stroke, but they're likely beneficial in other ways. Not everything is a cure to a disease. Sometimes removing the cause of a problem (cough, cough, SAD eating, especially hydrogenated industrial seed oils) is more important than supplementing with something that's beneficial.

1
7a6529ea25b655132fe58d793f95547a

(2030)

on September 13, 2012
at 03:49 AM

I don't think you should get as much 3 as possible anymore, I think AA has some benefit and DHA too but that's about it. Keeping them low in the diet is more important than the ratio, they oxidize and that's not really a good thing. Just my opinion though.

http://raypeat.com/articles/articles/fishoil.shtml

http://www.cholesterol-and-health.com/PUFA-Special-Report.html

0
8894ece18cd108655ed18f2056172c1c

(250)

on September 12, 2012
at 09:41 PM

This study does make me wonder about the efficacy of fish oil supplementation. There was a similar study done in April that questioned the benefits of fish oil supplements and reached similar conclusions. Still, the data does not discredit the benefits of eating wild fish, only the benefits of consuming those fatty acids in supplement form. It may be the case that though a diet high in fish promotes wellness, consumption of the same Omega 3s in isolation does not. Sometimes taking a supplement just isn't as effectual as eating real food. I'm no scientist, and, at least for now, I'll continue taking my supplements; but the prudent move is likely to employ a preference for eating actual fish. That's what I'm going to try to do because, as I said, this study does indeed have me wondering.

0
1edb06ded9ccf098a4517ca4a7a34ebc

on September 12, 2012
at 08:33 PM

It doesn't change anything if you don't eat fish to prevent strokes and heart attacks. Also, that's just one study. I'd look at the blue zones and see their diets and relative risk of said complications.

Omega 3 is good for other uses, like fighting systemic inflammation, ensuring proper brain development and nervous system function, improving insulin sensitivity, and increasing thermogenesis. I don't eat fish too allegedly "improve endothelial function"... I work out (exercise alone improves endothelial function AND increases endogenous NO production) and eat foods known to increase endogenous NO production (like most fruits and vegetables).

Also, seafood provides a wide array of important nutrients aside from the omega 3- notably zinc, an easily digested form of complete protein, iodine, selenium, and b-vitamins. Plus, who doesn't like lobster?

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