A few months ago I wrote a blog/newsletter entitled “Don’t Swallow It!”
It was lamenting the lack of a BS detector on the internet and how easily factoids can spread misinformation. Today’s little gem fits right in with that theme.
The latest round of “Fish oil No Good for Heart Disease” studies was published this week by the prestigious New England Journal of Medicine (NEJM). The NEJM has long been considered the pinnacle of medical journals the world over. It is of course solely supported by Big Pharma advertising.
Like the other big Journals, JAMA and the Archives of Internal Medicine, it maintains an “anti-supplement” stance, rarely publishing anything positive about anything that is not a Big Pharma drug.
Since most allopathic doctors do not apply critical standards to what is published in these journals, the word of these journals is gospel.
Not surprisingly the latest “Fish oil no Good For…” study will get a lot of air time and be virally spread on the internet with even less critical thinking and even more acceptance from the general populace.
One site that repeats internet nonsense is already saying, “The pendulum is swinging away from fish oil!”
While I don’t normally bother with this because it has been coming and going for the past 10 years, I will admit there really seems to be an “anti-fish oil” campaign out there.
The “Just eat fish” crowd has conveniently forgotten the issues of lead, mercury, arsenic, cadmium and plastic-derived xenoestrogens and toxins that are found in most oily fish in quantity. A few have even suggested that the “other oils” in fish, the stuff that is not EPA and DHA, have value. They sure do!
They are valuable for calories! They make no contribution to the biochemical pathways and are otherwise non-essential, however.
Getting back to the study aspect of things, I’ve said it a thousand times but I am forced to say it yet again.
Any study that does not…
1) Use a dose of fish oil that actually matters
2) Does not measure blood or tissue levels (the finger stick Ideal Omega test is soooooooooooooo simple but they don’t bother!)
3) Attempt to achieve the ratios of Omega 6 to Omega 3 that parallel the populations that have almost NO HEART DISEASE compared to ours. (It’s in the neighborhood of a 10 fold reduction).
…IS DESIGNED TO FAIL
So let’s look at the particulars of the study:
A) Dose? 1 gram. The study population was Italian, clearly a Waster diet based group. No, they were not on the “Mediterranean Diet”, a Health/Marketing concept created by Dean Ornish. They were clearly eating pasta!
B) “Eligible patients were men and women with multiple cardiovascular risk factors or atherosclerotic vascular disease but not myocardial infarction.” In other words, they were ticking time bombs waiting to have their heart attacks. Their doctors already knew they had heart disease in many cases.
C) What was the type of fish oil administered? It does not say; so it could easily have been a non-concentrated “natural cold pressed triglyceride” fish oil, which provides only 30% EPA and DHA. I need to try to find this out because it makes a huge difference.
Why? Because they may have actually been only getting 300 mg of the active oils for cardiac disease prevention. You have heard me say the average Westerner needs at least 6 grams a day to fix their Omega 3 deficit and balance out their excess Omega 6’s.
D) No levels were measured in these people – if they were, they would not have even scratched the surface with the dosages they chose to give people.
E) The GISSI Prevenzione study also done in Italy over a decade ago using 2 to 3 grams a day of the highly concentrated ethyl ester form, like mine, (still an under dosage but better than this one) showed a far different 35% reduction in Cardiovascular Death.
Two other things of note: The placebo was Olive oil, which is appropriate since Olive oil is Omega 6 dominant (21 to 1 Omega 6 to Omega 3). Next, they had to fiddle with their chosen end point: “At one year, after the event rate was found to be lower than anticipated, the primary end point was revised as time to death from cardiovascular causes or admission to the hospital for cardiovascular causes.” This kind of last minute post study fiddling makes the entire study questionable in my opinion!
At least this was a study, however, and not a “meta analysis” – a computer generated file based on cherry picked data that can prove anything the authors want without spending more than a few dollars in computer time and many hours of doctoral candidate slave labor!
So what should this study have been titled?
UNDER DOSING WITH FISH OIL IN A HIGH RISK POPULATION DOES NO GOOD TO PREVENT THE PROGRESSION OF HEART DISEASE
Frankly, this kind of study, done in an era where the data already exists for both primary and secondary prevention with Omega 3’s, constitutes malpractice in my opinion.
Also, I am not insensitive to the fact that my study title would probably not get many people to be interested, so here is another one which might intrigue the reader more – something you have to do for a sound bite society.
I would call it the Educated Authors Trying to Suppress Healthy Interventions Trial. You may be aware it is customary in medicine to use the first letter of every capitalized letter in a trial to create an acronym for the trial’s name. I will leave you to that.
I will also comment that acronym is pretty much my opinion of this study, which was designed to fail, adds nothing to our knowledge base and will undoubtedly contribute to the misinformation database out there in cyberland.
Finally, I will say that if you actually do figure out the acronym based on what I told you above, you might anticipate a new Meta analysis that will tell you this practice is actually healthy for you! I doubt it will make it into the NEJM, however, unless there is a Big Pharma drug somehow involved.
Don’t swallow it!!!!
Reference articles: n–3 Fatty Acids in Patients with Multiple Cardiovascular Risk Factors
The Risk and Prevention Study Collaborative Group
N Engl J Med 2013; 368:1800-1808 May 9, 2013 DOI: 10.1056/NEJMoa1205409
J Toxicol Environ Health A. 2007 Nov;70(22):1897-911.
Heavy metals in Pacific cod (Gadus macrocephalus) from the Aleutians: location, age, size, and risk.
Burger J, Gochfeld M, Shukla T, Jeitner C, Burke S, Donio M, Shukla S, Snigaroff R, Snigaroff D, Stamm T, Volz C.
Division of Life Sciences, Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, New Jersey 08854-8082, USA
“If a subsistence fisher from one of the Aleut villages ate one meal of cod per week for As, or one meal per day for Hg, they would exceed the U.S. EPA reference dose for As and Hg” As is Arsenic, HG is mercury!