A recent piece published in the Australian newspaper reviewed a scientific article recently published on this issue. This particular article was a meta-analysis of 10 randomised controlled trials involving just under 78,000 people average age 64, all at significant risk for heart disease. As these were different trials in somewhat different populations there were varying doses of omega three fatty acids ranging from 226 mg per day up to 1800 mg per day.
The average length of these 10 trials was only 4.4 years with only one of the 10 trials going beyond five years. This meta-analysis showed no benefits whatsoever, as far as statistics are concerned, from supplementing with omega three fatty acids. Thus, should we clear out our cupboards and ignore all of the very good evidence accumulated over the years purely because one particular study tells us that there is no benefit?
Firstly, without wishing to sound too pedantic, the journalist writing this article couldn’t even quote the correct journal where the article was published. The journalist said it came from the Journal of the American College of Cardiology when, in fact, it was published in the Journal of the American Medical Association-Cardiology Journal. A minor point, but still important when you review the overall results and their implications.
Here now is the major issue. The Mayo Clinic in the January 2017 Mayo Clinic proceedings published a large meta-analysis showing the short-term randomised controlled trials i.e. shorter than five years, showed no benefits from fish oil supplementation. But the longer trials (which admittedly were not randomised i.e. there were no placebo groups, purely the comparison of people who did or did not take fish oil) showed that the ingestion of omega three fatty acids beyond five years led to a statistically significant 18% reduction in cardiovascular disease risk.
The very long term studies of fish consumption which in some cases have been followed for over 30 years have shown on average around a 30% reduction in cardiovascular disease in the people who had 2 to 3 fish meals per week. A large meta-analysis published by Hooper et al in 2004 again suggested no benefit from either the intake of fish or omega-3 supplementation.
Again, the longer term trials were ignored because the short term trials negated the benefits purely by more numbers in the short-term trials. Also, over the past decade or so there has been increasing concern around fish consumption because of the heavily polluted shipping corridors in the northern hemisphere leading to significant levels of dioxins and methylmercury found in fish from these areas.
As I have stated on numerous occasions, short-term supplementation whether it be omega 3 supplementation, multivitamin or the vast majority of supplements available is of no great value because the supplements do not have the strong effects of pharmaceutical agents and should be considered supplements to a healthy lifestyle. Again, the benefits of dietary interventions, exercise, high quality sleep or the cessation of smoking, to name a few healthy lifestyle practices showed benefits over a number of years but minimal benefits in terms of cardiovascular death and morbidity over a short period of time.
I see supplementation somewhat like paying insurance. You may not be benefiting right now from doing so but if you have a problem in the future that’s when you will see the benefits from having paid your regular insurance bill. With supplements, you won’t feel better, you won’t prevent a heart attack in the short-term but anything beyond five years have shown benefits, proven in a variety of different studies.
To quote “the Donald”, I believe studies such as the one reported in the Australian are just another example of fake news that should be ignored.
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