14 ms·

Fish Oil Claims Not Supported by Research

45 points by pk2200 12y ago

tghw 12y ago
The title is a little misleading. Claims about fish oil and its potential decrease of cardiovascular events in high-risk populations is not supported by research. The article does not address other potentially beneficial effects, such as decreased inflammation.
- evo_9 12y ago
  Or it's more profound, positive effects on mood. My wife takes fish-oil daily as a mood stabilizer. When she skips a day or two all hell breaks lose in our house. Hell I take a smaller dose myself and it's amazing how much better I am at keeping my mood in check; I've never had much trouble but I have always gotten little edgy when hungry. That doesn't happen anymore.
  - r00fus 12y ago
    I wonder if the mood stabilization effect has anything to do with blood sugar levels?
  - drzaiusapelord 12y ago
    >My wife takes fish-oil daily as a mood stabilizer. This is why I take it as well. Its incredible how well it works. I hate to engage in conspiratorial thinking, but some of these overly critical analysis really seem to be coming from a big pharma "tell them the shit doesn't work" perspective. In a country with for-profit medicine, non-patented or low-profit treatments often get demonized. Especially by "useful idiots" who follow this ultra skeptical mindset where only what they hear from an authority like the government or academia, has any real value. They refuse to believe these institutions can have institutional fraud, incompetence, groupthink, or unfair motivators to getting published. As someone who works in a healthcare related field, its pretty obvious that industry controls the narrative, at least to me. Or can be gamed by private industry and other benefactors who have a bias or agenda.
    - WalterSear 12y ago
      And I've taken it daily, in sufficient quantities, for several months at a time, without noticing any difference at all.
      - moveroovee 12y ago
        Did you consider quality as well as quantity?
        WalterSear 12y ago
        Yes, I compared brands and didn't buy cheap stuff.
    - lanaius 12y ago
      Dietary supplements are, if anything, not low profit.
      - scott_s 12y ago
        Indeed. To close the loop, for those who don't see it: the companies that make "dietary supplements" have all the same incentives that Big Pharma does.
  - cjensen 12y ago
    It is nearly impossible to be objective about your own brain. If you suspect X makes you happier, then it probably will. After it works once, you will probably believe X makes you happier, and if definitely will. In other words, even if fish-oil does work as a mood stabilizer, there would be no way for you, as a consumer of fish oil, to be even slightly certain it works.
    - vinceguidry 12y ago
      I used to play a trick on myself where I'd hold a particular hand position and meditate on a state of mind, one intended to clear my mind and get centered, the other to get me amped up to go do some work. (I worked in construction at the time) It worked amazingly well, and I spent several weeks / months feeling no other emotions. I'd feel the state slipping, and just hold the hand position and the state would come back. Only reason I stopped was that the emotional monotony got old after awhile. I have no trouble believing that fish oil as a mood stabilizer can work fantastically, and yet have no physiological effect whatsoever.
    - narrator 12y ago
      >It is nearly impossible to be objective about your own brain. People can't trust their own perceptions? Isn't that what gaslighting is about? Why do we accept eye-witness testimony in court cases if people should not trust their own perceptions? If a person saw another person strike another person, should we trust their testimony? No! We should have a double-blind placebo controlled experiment where we go back in time and have a large sample size of identical people watching the same person getting struck and not struck in alternate universes and ask them if the person was struck to determine if their perceptions can be trusted.
      - jsprogrammer 12y ago
        Eye-witness testimony is mostly bunk and is often not trusted in court. It's been shown over and over that eye-witnesses can be manipulated (even without their knowledge) and are not reliable. No, you can't trust your own perceptions. You can only really trust that you are having a perception at this moment in time.
  - sedachv 12y ago
    > When she skips a day or two all hell breaks lose in our house. Only a "day or two?" Sounds like the placebo effect. Try swapping her fish oil capsules for something else and see if there is any difference.
- deleted 12y ago
  [deleted]
- ggchappell 12y ago
  > The article does not address other potentially beneficial effects, such as decreased inflammation. I'm wondering about that. Particularly given the increasing interest in the anti-inflammatory properties of statins & whatnot, an effective, easily obtained anti-inflammatory supplement should be very much worth looking at. The article does not say any thing about how well tested the claimed anti-inflammatory effects of fish oil supplements are. Does anyone know?
- Zancarius 12y ago
  The article does mention reduced inflammation, albeit somewhat indirectly (referring to the omega-3s in fish oil). Otherwise, it's rather dismissive. That seems to be a side effect of headline fads along the lines of "studies show X is bad/has no benefit" or "studies show X is good for you!" The best answer, of course, is "we need more data." However, I did find this gem buried quite a ways down toward the end of the article: > Dr. JoAnn Manson, the chief of preventive medicine at Brigham and Women’s Hospital in Boston, said the large clinical trials of fish oil focused only on people who already had heart disease or were at very high risk. If that's true, then it appears TFA is looking at it from the wrong angle. In other words, fish oils may have no effect on someone who's already suffered from a heart attack (or is at high risk), but someone who is aiming to use it as a preventative treatment might reduce their risk. Should this be the case, studying at risk populations who may have already had heart problems might not be the best starting point. It's a bit like fretting over a nutritious diet and plenty of fluids being of little use for someone who already has the flu, regardless of how poor their diet was prior. On the other hand, jimrandomh [1] near the top of these comments links to the study and warns there may be something more at work here. This is in the thread where magic5227 points out a comment on the NYT article that the statistical work in the study raises some considerable questions because it may have established too high a burden of proof. jimrandomh's comment suggests otherwise. So, who knows. It's worth reading through that thread as well. Personally, I think the truth is probably somewhere between these two extremes. It's apparently clear the Inuit's diet has influence on their cardiac health, but is it really just the omega-3s and not the wider range of benefits from eating fish? Or is it possibly tied to a lifetime of omega-3 intake rather than starting supplementation on a whim or only after serious health problems? If that's the case, shouldn't long-term supplementation (on the order of decades) be a focus of study instead? (Note: I have never followed fish oil studies, nor do I take it, so perhaps someone will be kind enough to link to such a study.) Anyway, I'm no nutritionist, and I'm kind of an idiot, but it seems to me that it's the long-term dietary (or supplementation) choices we make that are most the important, hence why I am increasingly more inclined to approach studies examining short-term effects (or lack of) with caution.
magic5227 12y ago
Notable comment in the post: Bill Harris Sioux Falls, SD 56 minutes ago As a long-time researcher in omega-3s, I've watched the fish oil rollercoaster since the mid 1980s. This most recent posting by O'Connor continues the trend. The best meta-analysis (grand summary of many studies) published to date was from Rizos et al. in JAMA 2012;308:1024-1033). They concluded that fish oil capsules offer “no benefit” for heart patients. Unfortunately, Rizos used a highly controversial statistical maneuver. In their actual data (Fig 2) there was a highly statistically significant reduction in cardiac death associated with fish oil use (p<0.01 for the stat-saavy). So fish oils DID reduce risk for cardiac death. Why the "no effect" conclusion? Rizos et al. decided to set the statistical bar higher than I’ve ever seen it in meta-analyses. They defined a significant p-value as <0.006, instead of the universally accepted p<0.05. This trick changed a positive finding into a negative one and generated a media storm of "fish oils don't work." More recent meta-analyses (Chowdhury et al. Ann Intern Med 2014;160:398-406) reported that higher dietary intakes AND higher blood levels of omega-3 fatty acids were both significantly linked to reduced risk for heart disease. The problems with the recent fish oil studies are legion, and include using a low dose for a short period of time in older, already-ill patients who are also being treated with up to 5 heart medicines. In this setting it’s nearly impossible to show a benefit. With 0 risk, I still recommend fish oil.
- raverbashing 12y ago
  And also, the lack of Omega-3 fatty acids may have some important effects. Example: http://www.ergo-log.com/margarine.html http://www.ergo-log.com/margarine.html
- bobcostas55 12y ago
  The most interesting part of this text is that 5% significance is "universally accepted" for medical meta-analyses.
  - xkcd-sucks 12y ago
    The vast majority of medical researchers don't have a deep understanding of statistics. The ones that do understand statistics comply with the "universal expectations" of their editors and reviewers.
seattlegal 12y ago
My Colon disagrees.
- salibhai 12y ago
  lol!
cbd1984 12y ago
April Fool!
therealdrag0 12y ago
An independent overview of the research: http://examine.com/supplements/Fish%20Oil http://examine.com/supplements/Fish%20Oil
aresant 12y ago
Short term, ranged, and non-clinical studies always remind me of the story of the "Shoe-fitting fluoroscopes" (1) AKA - x-ray machines placed in shoe stores so you could stick your foot in, dial up the radiation, and see your wiggling toes in the shoe. Invented in the 1920s. Debates raged for decades. Outlawed finally in most states in the 1970s. So for 50 years people thought taking your kid to the shoe store and blasting their feet with radiation was a good idea. Largely because they had limited data and ability to measure the outcome, as the data became available it became crystal clear that these had the potential to be dramatically harmful. Even with this lesson in mind I took fish oil for years, despite a lack of clear data. The study a couple of years ago that linked fish-oil (natural and supplemental) to a 41% increase in prostate cancer / 71% increase in aggressive prostate cancer, reminded me of the flouroscope story. (2) This Harvard health article, a couple of years old, puts it best: "How food, and its component molecules, affect the body is largely a mystery. That makes the use of supplements for anything other than treating a deficiency questionable." (3) (1) http://en.wikipedia.org/wiki/Shoe-fitting_fluoroscope http://en.wikipedia.org/wiki/Shoe-fitting_fluoroscope (2) http://jnci.oxfordjournals.org/content/early/2013/07/09/jnci.djt174.abstract http://jnci.oxfordjournals.org/content/early/2013/07/09/jnci... (3) http://www.health.harvard.edu/blog/fish-oil-friend-or-foe-201307126467 http://www.health.harvard.edu/blog/fish-oil-friend-or-foe-20...
- mrfusion 12y ago
  Would it be possible to replace the shoe fitting flouroscopes with ultrasound?
- rudolf0 12y ago
  There's a slight difference. Even in the 20s, I believe there was a proposed mechanism of action for X-rays to emit harmful ionizing radiation. Has there been any alleged mechanism of action for how ALA and EPA may cause harm?
- magic5227 12y ago
  Not sure that comparing x-rays to fish oil is a good comparison of risk/reward. People (like myself) take fish oil for a variety of reasons, in my case to lower the risks of serious heart disease over the risks it might contribute to prostate cancer. There are even studies that show fish oil could reduce the chances of prostate cancer: http://www.ncbi.nlm.nih.gov/pubmed/12540506 http://www.ncbi.nlm.nih.gov/pubmed/12540506 Ultimately each person has to judge the benefits/risks for themselves until better data is available. It's also worth noting that prostate cancer is increasingly a risk for all men as they age, fish oil or not.
palidanx 12y ago
What I'm really curious about is the research for fish oil and dry eyes. After I had lasik, I was told to take fish oil 4 times a day for a long time. My dry eyes seem to have gotten better, but I don't know whether that is due to the fish oil or from just a general recovery.
- wellpast 12y ago
  I use fish oil for dry and red eyes and I also notice a big difference. Seem to notice, I suppose...
  - palidanx 12y ago
    I'm kind of curious, which brand do you use?
    - wellpast 12y ago
      Nordic Naturals Ultimate Omega. My eye doctor was specific on this brand--emphasizing the EPA and DHA levels.
  - rudolf0 12y ago
    I've never had any issue with dry eyes. I started taking fish oil (algae oil actually, but the active ingredients are identical) a month before my LASIK surgery and continue to take it today, and I've still never had any problems with dry eyes, including immediately after the surgery. So, can't say whether it helped or not, but it certainly hasn't hurt.
mqsoh 12y ago
I take it because it might benefit my myelin sheath. That association is probably bunk, too. https://en.wikipedia.org/wiki/Myelin https://en.wikipedia.org/wiki/Myelin
jheriko 12y ago
interesting, not entirely surprising given how we love to jump to conclusions over these things, and the history of fish oil as a 'common knowledge' 'good thing'. slightly disappointed that the headline was not fish oil is actually snake oil? or something suitably witty... :)
- pbreit 12y ago
  It looks like you've just jumped to a conclusion. That may be wrong.
moveroovee 12y ago
One^H^H^H Fish Oil Claim Not Supported by Research
cbd1984 12y ago
This is still an April Fool's joke.

45 points by pk2200 12y ago

tghw 12y ago

The title is a little misleading. Claims about fish oil and its potential decrease of cardiovascular events in high-risk populations is not supported by research. The article does not address other potentially beneficial effects, such as decreased inflammation.

evo_9 12y ago
Or it's more profound, positive effects on mood. My wife takes fish-oil daily as a mood stabilizer. When she skips a day or two all hell breaks lose in our house. Hell I take a smaller dose myself and it's amazing how much better I am at keeping my mood in check; I've never had much trouble but I have always gotten little edgy when hungry. That doesn't happen anymore.
- r00fus 12y ago
  I wonder if the mood stabilization effect has anything to do with blood sugar levels?
- drzaiusapelord 12y ago
  >My wife takes fish-oil daily as a mood stabilizer. This is why I take it as well. Its incredible how well it works. I hate to engage in conspiratorial thinking, but some of these overly critical analysis really seem to be coming from a big pharma "tell them the shit doesn't work" perspective. In a country with for-profit medicine, non-patented or low-profit treatments often get demonized. Especially by "useful idiots" who follow this ultra skeptical mindset where only what they hear from an authority like the government or academia, has any real value. They refuse to believe these institutions can have institutional fraud, incompetence, groupthink, or unfair motivators to getting published. As someone who works in a healthcare related field, its pretty obvious that industry controls the narrative, at least to me. Or can be gamed by private industry and other benefactors who have a bias or agenda.
  - WalterSear 12y ago
    And I've taken it daily, in sufficient quantities, for several months at a time, without noticing any difference at all.
    - moveroovee 12y ago
      Did you consider quality as well as quantity?
      - WalterSear 12y ago
        Yes, I compared brands and didn't buy cheap stuff.
  - lanaius 12y ago
    Dietary supplements are, if anything, not low profit.
    - scott_s 12y ago
      Indeed. To close the loop, for those who don't see it: the companies that make "dietary supplements" have all the same incentives that Big Pharma does.
- cjensen 12y ago
  It is nearly impossible to be objective about your own brain. If you suspect X makes you happier, then it probably will. After it works once, you will probably believe X makes you happier, and if definitely will. In other words, even if fish-oil does work as a mood stabilizer, there would be no way for you, as a consumer of fish oil, to be even slightly certain it works.
  - vinceguidry 12y ago
    I used to play a trick on myself where I'd hold a particular hand position and meditate on a state of mind, one intended to clear my mind and get centered, the other to get me amped up to go do some work. (I worked in construction at the time) It worked amazingly well, and I spent several weeks / months feeling no other emotions. I'd feel the state slipping, and just hold the hand position and the state would come back. Only reason I stopped was that the emotional monotony got old after awhile. I have no trouble believing that fish oil as a mood stabilizer can work fantastically, and yet have no physiological effect whatsoever.
  - narrator 12y ago
    >It is nearly impossible to be objective about your own brain. People can't trust their own perceptions? Isn't that what gaslighting is about? Why do we accept eye-witness testimony in court cases if people should not trust their own perceptions? If a person saw another person strike another person, should we trust their testimony? No! We should have a double-blind placebo controlled experiment where we go back in time and have a large sample size of identical people watching the same person getting struck and not struck in alternate universes and ask them if the person was struck to determine if their perceptions can be trusted.
    - jsprogrammer 12y ago
      Eye-witness testimony is mostly bunk and is often not trusted in court. It's been shown over and over that eye-witnesses can be manipulated (even without their knowledge) and are not reliable. No, you can't trust your own perceptions. You can only really trust that you are having a perception at this moment in time.
- sedachv 12y ago
  > When she skips a day or two all hell breaks lose in our house. Only a "day or two?" Sounds like the placebo effect. Try swapping her fish oil capsules for something else and see if there is any difference.
deleted 12y ago
[deleted]
ggchappell 12y ago
> The article does not address other potentially beneficial effects, such as decreased inflammation. I'm wondering about that. Particularly given the increasing interest in the anti-inflammatory properties of statins & whatnot, an effective, easily obtained anti-inflammatory supplement should be very much worth looking at. The article does not say any thing about how well tested the claimed anti-inflammatory effects of fish oil supplements are. Does anyone know?
Zancarius 12y ago
The article does mention reduced inflammation, albeit somewhat indirectly (referring to the omega-3s in fish oil). Otherwise, it's rather dismissive. That seems to be a side effect of headline fads along the lines of "studies show X is bad/has no benefit" or "studies show X is good for you!" The best answer, of course, is "we need more data." However, I did find this gem buried quite a ways down toward the end of the article: > Dr. JoAnn Manson, the chief of preventive medicine at Brigham and Women’s Hospital in Boston, said the large clinical trials of fish oil focused only on people who already had heart disease or were at very high risk. If that's true, then it appears TFA is looking at it from the wrong angle. In other words, fish oils may have no effect on someone who's already suffered from a heart attack (or is at high risk), but someone who is aiming to use it as a preventative treatment might reduce their risk. Should this be the case, studying at risk populations who may have already had heart problems might not be the best starting point. It's a bit like fretting over a nutritious diet and plenty of fluids being of little use for someone who already has the flu, regardless of how poor their diet was prior. On the other hand, jimrandomh [1] near the top of these comments links to the study and warns there may be something more at work here. This is in the thread where magic5227 points out a comment on the NYT article that the statistical work in the study raises some considerable questions because it may have established too high a burden of proof. jimrandomh's comment suggests otherwise. So, who knows. It's worth reading through that thread as well. Personally, I think the truth is probably somewhere between these two extremes. It's apparently clear the Inuit's diet has influence on their cardiac health, but is it really just the omega-3s and not the wider range of benefits from eating fish? Or is it possibly tied to a lifetime of omega-3 intake rather than starting supplementation on a whim or only after serious health problems? If that's the case, shouldn't long-term supplementation (on the order of decades) be a focus of study instead? (Note: I have never followed fish oil studies, nor do I take it, so perhaps someone will be kind enough to link to such a study.) Anyway, I'm no nutritionist, and I'm kind of an idiot, but it seems to me that it's the long-term dietary (or supplementation) choices we make that are most the important, hence why I am increasingly more inclined to approach studies examining short-term effects (or lack of) with caution.

magic5227 12y ago

Notable comment in the post: Bill Harris Sioux Falls, SD 56 minutes ago As a long-time researcher in omega-3s, I've watched the fish oil rollercoaster since the mid 1980s. This most recent posting by O'Connor continues the trend. The best meta-analysis (grand summary of many studies) published to date was from Rizos et al. in JAMA 2012;308:1024-1033). They concluded that fish oil capsules offer “no benefit” for heart patients. Unfortunately, Rizos used a highly controversial statistical maneuver. In their actual data (Fig 2) there was a highly statistically significant reduction in cardiac death associated with fish oil use (p<0.01 for the stat-saavy). So fish oils DID reduce risk for cardiac death. Why the "no effect" conclusion? Rizos et al. decided to set the statistical bar higher than I’ve ever seen it in meta-analyses. They defined a significant p-value as <0.006, instead of the universally accepted p<0.05. This trick changed a positive finding into a negative one and generated a media storm of "fish oils don't work." More recent meta-analyses (Chowdhury et al. Ann Intern Med 2014;160:398-406) reported that higher dietary intakes AND higher blood levels of omega-3 fatty acids were both significantly linked to reduced risk for heart disease. The problems with the recent fish oil studies are legion, and include using a low dose for a short period of time in older, already-ill patients who are also being treated with up to 5 heart medicines. In this setting it’s nearly impossible to show a benefit. With 0 risk, I still recommend fish oil.

raverbashing 12y ago
And also, the lack of Omega-3 fatty acids may have some important effects. Example: http://www.ergo-log.com/margarine.html http://www.ergo-log.com/margarine.html
bobcostas55 12y ago
The most interesting part of this text is that 5% significance is "universally accepted" for medical meta-analyses.
- xkcd-sucks 12y ago
  The vast majority of medical researchers don't have a deep understanding of statistics. The ones that do understand statistics comply with the "universal expectations" of their editors and reviewers.

seattlegal 12y ago

My Colon disagrees.

salibhai 12y ago
lol!

cbd1984 12y ago

April Fool!

therealdrag0 12y ago

An independent overview of the research: http://examine.com/supplements/Fish%20Oil http://examine.com/supplements/Fish%20Oil

aresant 12y ago

Short term, ranged, and non-clinical studies always remind me of the story of the "Shoe-fitting fluoroscopes" (1) AKA - x-ray machines placed in shoe stores so you could stick your foot in, dial up the radiation, and see your wiggling toes in the shoe. Invented in the 1920s. Debates raged for decades. Outlawed finally in most states in the 1970s. So for 50 years people thought taking your kid to the shoe store and blasting their feet with radiation was a good idea. Largely because they had limited data and ability to measure the outcome, as the data became available it became crystal clear that these had the potential to be dramatically harmful. Even with this lesson in mind I took fish oil for years, despite a lack of clear data. The study a couple of years ago that linked fish-oil (natural and supplemental) to a 41% increase in prostate cancer / 71% increase in aggressive prostate cancer, reminded me of the flouroscope story. (2) This Harvard health article, a couple of years old, puts it best: "How food, and its component molecules, affect the body is largely a mystery. That makes the use of supplements for anything other than treating a deficiency questionable." (3) (1) http://en.wikipedia.org/wiki/Shoe-fitting_fluoroscope http://en.wikipedia.org/wiki/Shoe-fitting_fluoroscope (2) http://jnci.oxfordjournals.org/content/early/2013/07/09/jnci.djt174.abstract http://jnci.oxfordjournals.org/content/early/2013/07/09/jnci... (3) http://www.health.harvard.edu/blog/fish-oil-friend-or-foe-201307126467 http://www.health.harvard.edu/blog/fish-oil-friend-or-foe-20...

mrfusion 12y ago
Would it be possible to replace the shoe fitting flouroscopes with ultrasound?
rudolf0 12y ago
There's a slight difference. Even in the 20s, I believe there was a proposed mechanism of action for X-rays to emit harmful ionizing radiation. Has there been any alleged mechanism of action for how ALA and EPA may cause harm?
magic5227 12y ago
Not sure that comparing x-rays to fish oil is a good comparison of risk/reward. People (like myself) take fish oil for a variety of reasons, in my case to lower the risks of serious heart disease over the risks it might contribute to prostate cancer. There are even studies that show fish oil could reduce the chances of prostate cancer: http://www.ncbi.nlm.nih.gov/pubmed/12540506 http://www.ncbi.nlm.nih.gov/pubmed/12540506 Ultimately each person has to judge the benefits/risks for themselves until better data is available. It's also worth noting that prostate cancer is increasingly a risk for all men as they age, fish oil or not.

palidanx 12y ago

What I'm really curious about is the research for fish oil and dry eyes. After I had lasik, I was told to take fish oil 4 times a day for a long time. My dry eyes seem to have gotten better, but I don't know whether that is due to the fish oil or from just a general recovery.

wellpast 12y ago
I use fish oil for dry and red eyes and I also notice a big difference. Seem to notice, I suppose...
- palidanx 12y ago
  I'm kind of curious, which brand do you use?
  - wellpast 12y ago
    Nordic Naturals Ultimate Omega. My eye doctor was specific on this brand--emphasizing the EPA and DHA levels.
- rudolf0 12y ago
  I've never had any issue with dry eyes. I started taking fish oil (algae oil actually, but the active ingredients are identical) a month before my LASIK surgery and continue to take it today, and I've still never had any problems with dry eyes, including immediately after the surgery. So, can't say whether it helped or not, but it certainly hasn't hurt.

mqsoh 12y ago

I take it because it might benefit my myelin sheath. That association is probably bunk, too. https://en.wikipedia.org/wiki/Myelin https://en.wikipedia.org/wiki/Myelin

jheriko 12y ago

interesting, not entirely surprising given how we love to jump to conclusions over these things, and the history of fish oil as a 'common knowledge' 'good thing'. slightly disappointed that the headline was not fish oil is actually snake oil? or something suitably witty... :)

pbreit 12y ago
It looks like you've just jumped to a conclusion. That may be wrong.

moveroovee 12y ago

One^H^H^H Fish Oil Claim Not Supported by Research

cbd1984 12y ago

This is still an April Fool's joke.