Tip:
Highlight text to annotate it
X
"Is Fish Oil Just Snake Oil?"
Are purported benefits of fish oil supplementation
for the prevention and treatment of heart disease
just a "fish tale"?
Thanks to recommendations like this
from the American Heart Association,
that individuals at high risk for heart disease
ask their physicians about fish oil supplementation,
it's grown into a multi- billion dollar industry.
We now consume over 100,000 tons of fish oil every year.
But what does the latest science say?
A systematic review and meta-analysis published in
the Journal of the American Medical Association
looked at all the best randomized clinical trials
evaluating the effects of omega-3s
on lifespan, cardiac death, sudden death, heart attack, and stroke.
Either advice to eat more oily fish
or to take fish oil capsules.
What did they find?
Overall they found NO protective benefit
for overall mortality, heart disease mortality,
sudden cardiac death, heart attack, or stroke.
What about for those who've already had a heart attack, though,
and are trying to prevent another one?
Still NO benefit.
Where did we even get this idea
that omega-3s were good for the heart?
Well, if you look at some of the older studies,
the results looked promising,
For example, the famous DART trial
back in the 80s, involving 2,000 men–
those advised to eat fatty fish had a 29% reduction in mortality.
Pretty impressive.
No wonder it got a lot of attention.
But people seem to have forgotten about the sequel–
the DART II trial.
Same group of researchers
and even bigger study – 3,000 men.
And those advised to eat oily fish,
and particularly those supplied with fish oil capsules
had a HIGHER risk of cardiac death.
Put all the studies together...
and there's NO justification...
for the use of omega-3s as a structured intervention
in everyday clinical practice
or for guidelines supporting more dietary omega-3s.
So what should doctors say
when their patients follow the American Heart Association advice
to ask them about fish oil supplements?
Well, given the new meta-analysis and other negative meta-analyses,
our job as doctors should be to STOP
highly marketed fish oil supplementation in ALL of our patients.