2,000iu of D3 is miniscule. Six minutes of skin exposure to the sun in Miami, FL will give you 1,000iu of vitamin D, according to the Vitamin D Council. The Vitamin D council has also determined that the optimal level of vitamin D in the body is around 65-80ng/ml and that 80-90% of patients tested are deficient in vitamin D. It takes a daily dose of 5,000iu-7,000iu to reach and maintain optimal serum D levels. Most people who take a paltry 2,000iu D3 will remain deficient too.
2
1g of fish oil is not a therapeutic dose. As usual, bad journalism when it comes to deciphering literature. Just looking for sensationalism in headlines trying to save a failing media form.
2
Vitamin D and its role in mitigating osteoporosis, insulin resistance, autoimmune disorders also needs to be examined.
1
Food and vitamins are not medicine. I take fish oil for my knees, and heart, have been for many years. Knees are great now. Hope it helps my heart. Food and vitamins are about decades, not two years.
1
Yes, but what about a combination of supplements. I eat lots of olives and 10 almonds a day (I also take small dose of fish oil). When I added the almonds to my diet, my cholesterol dropped 60 points to moderate levels. Is it the almonds by themselves, or the combination (a so-called Mediterranean diet)?
2
Are there studies that look at folks who eat lots of fish and get daily doses of sunshine and their cardiovascular and cancer outcomes?
2
I discovered that vitamin D and calcium supplementation can alleviate cramping, muscle cricks in my neck and back, and those annoying tiny muscle fiber twitches near my eyes, and occasionally in my hands and elsewhere. I am at an age where I must avoid overexposure to the sun and use daily sunscreen and wear a full brim hat.
Of course this is anecdotal, but if I notice the twitches, or if my feet cramp more often, I take the supplements and these things fade away. I don’t take D for heart health. That’s what a dog is for.
I hope new studies may look in to predilections towards cramping and twitches.
2
It seems that most vitamin studies by MD's use dosages the are too low to be effective. 2000 units of vit. D seems very low and the results could be lost in the natural variations of this vitamin.
In another area, there are many medical studies of Vit C, most done with a low 500mg and of course, minimal effects were found.
Many "treatment" studies do not show significant results because the effects are lost in a sea of natural variation. Because of ethical and practical problems, doing a proper study where "variation" is controlled, is almost impossible. Several other comments, here, have similar opinions.
I would advise people to spend some time studying various authoritative info on vitamins. and experiment. Also consider that the needs for older people are probably greater.
1
I have dry skin and eyes so I take fish oil, and my dry skin is vastly reduced. I am often sluggish. I take vitamin D and it's as if my metabolism has changed. Please don't throw the baby out with the bath water.
4
I recall there was one piece of gross data to support the anti-oncogenic benefits of vitamin D: the high incidence of aggressive, early onset prostate cancer in African American men. Darker skin, being acclimatized to tropical sunlight replete with UV-B year-long, doesn't have the same ability to synthesize vitamin D. It doesn't need to. The hypothesis was that vitamin D had anti-mitogenic properties. Also, UV light has long been used as a treatment for psoriasis, a disease characterized by brisker mitotic rates than most cancers, presumably through increased vitamin D synthesis. I don't know if the vitamin D-mitosis relationship has been established by subsequent science.
In the past, at least, darker-skinned people living in temperate climates were presumed to be vitamin D-deficient, which was also believed to be the cause of osteomalacia endemic among South Asians living in Britain. Therefore I would still think it prudent for dark-skinned people living north of the Tropic of Cancer to consider a vitamin D supplement.
Lastly, as I recall a lot of endocrinologists consider 2000 IU vitamin D a drop in the bucket. 10 minutes of noonday sun on an exposed face and forearms makes between 5-10,000 IU.
Another study I'd like to see would be a comparison between physiologic, skin-made vitamin D and PO D3 supplements. How much of the latter makes it past the liver? Might there be better extra-portal delivery systems, like ointments or suppositories?
4
Seems a fundamental error in study design. The question isn't whether taking the supplements reduces disease incidence. The questions are: whether maintaining the body's ideal levels of D and EFAs reduces disease incidence; what the optimum body levels are; and what supplement dosages get which people to those levels.
The fact is, we do know that low body levels of both compounds tested are associated with increased disease risk, including some cancers. Keeping the levels optimum is a health benefit. That may or may not include supplements (at individualized dosages) depending on diet (EFAs) and sun exposure (Vit D), among other factors.
Flash from the newsroom: supplements don't cure cancer.
No word on whether moderate supplementation over many years can prevent or delay chronic, age-related illness.
3
THIS is what the study showed:
supplements do not lower cancer rates in healthy adults.
It should not be interpreted any broader than that.
3
@catherine I think the vitamin-D study should have focused on at-risk populations for specific cancers, and the fish-oil study on ones at high-risk for CVD (+FamHx, hyperlipidemia, DMII, smokers, etc.)
In 2004, I started taking 3000 IU/day vitamin D during the months where the sun is too low in the sky for vitamin D synthesis in the skin (roughly end of sept to mid-April in Massachusetts). In the warmer months, I run shirtless ~45 minutes five days a week.
Since then, instead of a cold or two a year, I get maybe one cold every 2-3 years. I can't remember the last time I got flu.
Interestingly, my blood level of D in summer, when I take no vitamin D but have ample sun exposure, is in the 50s (NG/ML). And in winter, when I am taking 3000 IU, it's also in the 50s.
7
There are significant methodological issues.
If you give the same low dose to a variety of people, there will be widely variable serum levels. In addition, folks with low starting levels need bolus dosing to bring levels up (daily consumption exceeds daily input).
Only the serum levels count, not the dose (which should vary by body weight).
Sure, you can make D naturally with UVB exposure, but UVB varies by latitude, season, time of day, and weather. There is zero UVB in Boston in the winter for example. So, if you expose 40% of your skin at solar noon at a UVB sufficient latitude and season, you'll have sufficient D. Army recruits in SC in summer saw their D levels decrease (McClung et al). Why? Wearing uniforms.
Diet? It is almost impossible to get sufficient D in your diet. Sure if you eat wild caught salmon 3-4 times/week, but otherwise....
Or you can use a Sperti UVB lamp... the body self-regulates D levels through skin production.
Measuring serum levels is also important to control for compliance (a big problem in treatment studies).
I'm not sure a vitamin can cure cancer or CVD at the age of 50, but the subset of data done after 2 years of treatment is relatively impressive. Do you really think folks will leap out of bed on day 2 saying:"I'm cured!"?
Look at the NHANES D data. Lots of folks are low.
3
Overlooking ATS Constitution-Dependent, Inherited Real Risk of CAD, bedside diagnosed with a common stethoscope from birth, and removed by inexpensive Reconstructing Mitochondrial Quantum Therapy, all researches are fundamentally biased.
1
The article is seriously misleading. Participants started with D levels at the high end of the “normal” level, so all this study shows at best is that more doesn’t help, not that those on the low end wouldn’t be helped. And while the 5-year results are reported accurately, what’s left out is that after year 2 the cancer death rate was 25% lower than with the placebo. The latter jibes with other studies.
5
I don't see how you can whipsaw the general public with decades of contradictory diet advice, and then sell them on something entirely model-based like, say, climate science.
Q/ What if climate science is no further along than saturated fat science was in the 1960s?
1
What about affect on triglycerides?
Great news. Relieved of guilt over not consuming yet another bunch of pills.
Look at the eighth paragraph of the article: "... another analysis looking separately at heart attack found a 28 percent reduction among those taking fish oil". Isn't that enough to encourage everyone to take fish oil supplements?
9
@Horace. I was scratching my head over that one, too.
2
Low serum Vitamin D is a marker for insufficient time being physically active outdoors in the sun, the wind, and the rain, wearing minimal clothing.
If your Vitamin D is low, then you don't need to pop a pill. You need to change the way you live.
1
@Colenso
Wrong. Of course in Cairns, probably almost everyone gets sufficient vitamin D all year round just from being in the sun.
In much of the US, that's not the case. Since I started taking 3000 IU/D in the darker months, I almost never get colds or flu.
5
'The trial is of the kind considered the gold standard in medicine.'
Not so. The gold standard is the double-blind, placebo cross-over, where everyone gets either the placebo or the drug, but nobody knows at the time, then later switches from drug to placebo or vice versa. This trial was not a cross over.
4
Most readers—me included—think of cardiovascular disease and heart attacks as the same thing, with the first leading to the second. That's why this article gives you whiplash when you read the headline and this, at the end of eighth paragraph:
But she said another analysis looking separately at heart attack found a 28 percent reduction among those taking fish oil, with a 40 percent reduction in people who eat little fish and a 77 percent reduction in African-Americans. She said the 28 percent reduction was “pretty amazing. That’s what you see with statins.”
11
@Bridgman Cardiovascular disease is much more than heart attacks. As well as heart attacks, it includes brain attacks aka strokes, damage to the heart wall, damage to the heart valves, damage to the major arteries, arterioles and capillaries, damage to the veins. If you've got varicose veins, for example, then you have cardiovascular disease.
Chronic insufficiency of oxygenated blood to the brain is likely the key factor in the development of brain disease resulting in the dementias, including Alzheimers. Insufficiency of oxygenated blood to the other organs, including the skin, liver and kidneys, leads to long term damage to those organs.
Insufficiency of oxygenated blood to the extremities, including the finger tips, leads to damage.
Think of the oxygenated blood in our body as being the source of all our vitality. When the transport system, consisting of pump and pipes, starts to malfunction, then we've got major problems.
Our body is an organic machine. Without proper maintenance, it will fail. That means proper sleep, proper nutrition, proper forms of physical, mental and spiritual activity and exercise.
4
@Bridgman statins provide 28% MI reduction?!
Vitamin D is my happy pill. My mood is much better when I take it one regular basis. I am glad my doctor recommended Vitamin D testing when I moved to California. My level was lower than the government recommendation. It was 14! Now, I hover around 60 and I feel much better.
As an African American from the Northeast, lives in the Bay Area, and lactose intolerant, I NEED this supplement.
8
@Concerned Citizen With respect, no, you don't. You need to spend more time outdoors, being physically active, wearing fewer clothes.
2
@Concerned Citizen, look into taking vitamin K2 along with the vitamin D. It will make sure that calcium ends up in your bones and not your arteries. Check it out for yourself.
3
@Colenso
So what does she do in the winter?
And where is she going to expose 40% of her skin at solar noon?
Folks who work in offices rarely have time for lunch.
1
Once again, it has been the consistent result of studies that dietary supplements show no significant benefit to people taking them for health promotion. Be wary of secondary findings or subgroup analysis, such as the small benefits cited, as that is statistical noise from data mining in most instances rather then primary endpoints of the study.
2
@RIO
Read the Wagner studies in SC.
Achieving 40-60 ng/ml (100-150 nmol/L) blood serum levels:
59% lower risk of preterm birth
60% lower risk of preterm birth in twins
Virtually eliminates pre-eclampsia
Supplementing up to 6400 IU/day is safe and effective during pregnancy & lactation
Reduction in many conditions of pregnancy – Gestational diabetes, bacterial vaginosis, post-partum depression
Eliminates racial disparity – In the US the preterm birth rate among African American women is 1.5 times that of Caucasian women
Benefits to baby
70% lower prevalence of common cold
66% lower prevalence ear infections
62% lower prevalence lung inflation
Improved language development
Reduction in type 1 diabetes (in adulthood)
2
A few observations from a person who has coronary artery disease and has had a double bypass. First, no history of heart disease in my family, save for my maternal grandfather who survived a stroke and lived 13 more years, dying at age 83. He drank and smoked a pipe most of his life. Second, after bypass surgery my internist recommended I take a vitamin D3 supplement and fish oil capsules as well as psyllium (Metamucil) to keep my gut active and clean. It does. I take a statin to keep my LDL lower and it works. No side effects. Third, the most important change in my life after bypass surgery was starting and continuing a regular exercise program at a gym. I have lost some weight, kept it off, and increased my strength and stamina. My cardiologist likes what he sees from tests every six months. No serious accretion of arterial plaque and dynamic stress tests show all heart functions are normal. Right now I am taking Vinyasa yoga lessons (again) and enjoying the challenge of learning new movements. Fourth, I exercise and take the supplements as much to preserve my cognitive faculties as to help my heart. If I have one fear it’s losing my mind. While the big study has delivered some helpful information, it has not shown the value of regular exercise as one of the best “supplements” to living well for years.
5
Please ask the author to reconsider the headline in light of her actual words.
Fish oil reduces the risk if heart attack
Vitamin D reduces the risk of cancer (if used for 2 years)
11
This study found a 28% reduction in heart attacks but only an 8% reduction in significant cardiovascular events. That implies that consuming fish oil increased the risk of other cardiovascular events by 20%, does it not?
@MRod — I don’t think so. Two examples, using arbitrary numbers:
Say there are 45 heart attacks and 55 other serious cardiovascular events, for a total of 100 events. If heart attacks are reduced by 28%, or by 12.6 heart attacks, then other serious events must INCREASE by 4.6 events, or 8.3636% in order for total serious events to decline by 8%, or 8 events.
Say there are 25 heart attacks and 75 other serious cardiovascular events, for a total of 100 events. If heart attacks are reduced by 28%, or by 7 heart attacks, then other serious events must ALSO DECREASE, by 1 event, or 1.3333% in order for totsl serious events to decline by 8%, or 8 events.
1
Since we keep on being told supplements are less effective than the "real thing," shouldn't someone be looking at cardiovascular/cancer impact of eating high Omega 3 foods and getting plenty of sunshine generated Vitamin D?
If there are plenty of studies that already have done this, wouldn't it be interesting to see their findings contrasted with the findings of this study?
1
Many of us who take a "holistic" approach to health see highly informed Integrative MDs who can provide a variety of scientific evidence for the benefits of 1) a healthy diet and lifestyle--this is where clean foods are essential (No: GMOs are not safe); 2) High quality supplementation including "Krill oil," which is much more effective and safe than cheap Fish oil supplements, and Vitamin d-3. I suggest people take some time to explore other sources of information beyond the latest NTY article dismissing supplements. This is not "either or"; I would raise a flag of caution when a study uses products from Big Pharma or cheaper synthetic forms of supplements, e.g. studies on Vitamin E uses synthetic (dl) forms instead of high quality natural forms. There is a difference.
3
The comments prove what previous studies seemed to suggest: that if you tell people their current habits might be a waste of time or money, they won't be happy. Not even a little bit.
1
@Luke - The conclusions were that those taking Vitamin D were 25% less likely to die of cancer, and significantly less likely to have a heart attack. That's why you see a lot of disagreement in the comments -- the profoundly negative headline does not match the results.
12
Simply change your diet to plant based and you will avoid creating cancer triggers in your body and prevent or cure your heart disease. The data is pretty conclusive.
@Scrumper--A "plant-based" diet (assuming people mean vegan) is not a cure-all. I've known some vegans (and otherwise health-conscious people) who still got cancer or heart disease. There is no cure-all diet. Sometimes it's genetics or other factors.
I'd like to know what data you think is "pretty conclusive" because real-life statistics show otherwise.
2
Read Katherine Boo’s magnificent book, “All the Beautiful Forevers.” You will never eat a fish oil supplement again.
All my life I had problems with getting my fingernails to grow until a few years ago when I started taking Vitamin D at my doctors recommendation. Despite all the articles that try to debunk the benefits of Vitamin D, I continue to take it. It seems that a substance the has substantially improved my nail health is bound to have other benefits.
4
I recommend omega/3 supplements to all my dry eye patients. It works. And probably the only thing it works for....
2
It is interesting that fish oil brought a significant reduction for African Americans.
However: What in fish oil helps? What contaminants such as mercury or fire retardants have been removed?
What is the omega-6/omega-3 ratio of the participants? Many eskimos and some fishermen who eat a lot of wild fish already are almost too low in the ratio and vulnerable to infection and bleeding.
A 2.5-1.5 ratio as was traditional with many Japanese has a much lower cardio incidence. The 17-22 ratio of many Americans who eat corn fed meat (which lasts the grasses and bushes that have omega-3) rather than wild graze is might shifted towards repair and inflammation and low in EPA and DHA, so important in neural health and limiting inflammation.
Now the Japanese on the coasts do not have to take fish oil supplements. Few eat heavily of grain fed steak. That is a celebratory food.
Please, this is embarrassingly bad science. Measure your before and after omega-6/omega-3 ratios.
The higher the ratio of omega-3 DHA and EPA in the fish oil, the lower the toxins! They have been carefully removed. And for a person with average SAD (Standard American Diet) diet and no arthritis, cardio, or arthritis, 2.5 gm is the least I can find anywhere recommended, mostly EPA and DHA. (Unless the earlier mentioned ratio is less than 1.5) For a history of heart attack—5 gm/day. For serious arthritis often 7.5/day.
For severe TBI or carbon monoxide poisoning in coal mines disasters and such, as much as 15
Hmmm - I'm retired now but worked as an R.N. in many settings with many physicians. An over-all impression gained over the years is that doctors are jealous of their hard-earned knowledge and prefer being in charge of making decisions for their patients. It was "No one needs supplements if they eat a well-balanced diet." Research and testing over many decades has proven that isn't true. The idea that the public can read informative articles and make decisions for themselves about their health tends to be questioned. Overall your doctor likes to be the decision maker, even when not up to date on nutrition, and doesn't care to have his position usurped by a lay person - that would be you.
8
@DianeLouise
I love the old joke 'What's the difference between a doctor and God? God doesn't think he's a doctor.'
But it's just a joke. You point out that doctors' knowledge is 'hard-earned.'
It is, and so is yours. No doubt you yourself were ordinarily ready to overrule unlearned patients when your own learning suggested they were wrong.
Professionals (doctors, engineers, nurses, architects, accountants) ought to be open to doubt, but they have a responsibility to doubt laypersons' judgment more than their own. Making nice is good but it's less important than safety. Better slighted feelings than a collapsed building or a sicker patient.
Observing that your last sentence characterizes doctors as men, I wonder if you minded when female doctors went against your judgment or that of their patients, or if you just didn't notice so much.
1
Remarkable how different media can arrive at starkly different interpretations of the same study. For balance, Times readers might want to consider Lenny Bernstein's article in the Washington Post. Notes Bernstein 'Two major studies released Saturday provide evidence that medications derived from fish oil are effective in protecting people from fatal heart attacks, strokes and other forms of cardiovascular disease.'
It now appears that the omega-3s came in the form of ethyl esters concentrates produced by pharmaceutical companies - not the natural triglyceride form extracted from fish. The ethyl esters are thought to be less bio-available than the natural fish oil. Why the study went with the former as opposed with the latter is anybody's guess. Does it have anything to do with the fact that the process for making esters is patentable and therefore much more expensive?
Just as sunshine is the preferred source of vitamin D, so too oily fish (or marine mammals in the case of Inuit peoples) is the most reliable source of fatty acids. The further we get from nutrition in its native form, the less beneficial - and more costly - it is likely to be.
3
The fact is that if people LACK vitamin D, we get sick more easily. When we are low in vitamin D immune system is affected. So it is important to have the vitamin D level in normal range. I've seen many people who are very low in vitamin D and after taking vitamin D supplements, they slept better and got sick less. This study can be taken as you do not need vitamin D for certain people. The article needs to make sure that people do not get confused about that.
5
The headline of this article almost constitutes journalistic malpractice. So much so that the Times's public editor should be contacted. Ineffective? The article itself states:
"But she said another analysis looking separately at heart attack found a 28 percent reduction among those taking fish oil, with a 40 percent reduction in people who eat little fish and a 77 percent reduction in African-Americans. She said the 28 percent reduction was 'pretty amazing. That’s what you see with statins.'"
13
A misleading headline for the results of this study. Note the discrepancy between the headline and the actual results:
"But she said another analysis looking separately at heart attack found a 28 percent reduction among those taking fish oil, with a 40 percent reduction in people who eat little fish and a 77 percent reduction in African-Americans. She said the 28 percent reduction was “pretty amazing. That’s what you see with statins.”
" Secondary analysis of the data found, for example, a reduction in cancer deaths for people who took vitamin D for at least two years, and fewer heart attacks in people who took fish oil."
9
The NIH should have realize that the form of fish oil that was "donated" from BASF is considered a drug (Lovaza) and is in the ethyl ester form. Fish oil supplements can come in good, better, best form. Ethyl ester is good but the triglyceride form is the best for absorption and increasing blood levels.
The dosage recommended for Lovaza is 4 capsules a day to lower triglycerides. https://clinicaltrials.gov/ct2/show/NCT01180764
So clearly the NIH could have included a higher dose of EE fish oil or the same dose of a better bioavailable form to show better results.
5
Why isn’t the lead “77 percent reduction in African-Americans? ” You would literally be saving lives to get this information out. I am struggling to see why you are virtually ignoring the parts of the study that show benefits to African Americans.
16
The concept that fish oil is beneficial came after 2 Danish chemists reported in 1970's that Greenland Eskimos whose diet is rich in fish have less incidence of heart disease, which later was proven wrong. The theory was made into a fact by marketing industry. Some of the theories do become facts.
We have to understand the medical statistical design. For
example, it took more than 10 years of treating thousands of patients, and more studies to prove a strong agent like statin will decrease heart disease.The effect of fish oil on cholesterol in normal persons is minimal. There are many major factors like cholesterol, blood pressure, diabetes, obesity, family history and smoking that effect heart disease. As such, it is nearly impossible to prove a minor effect of fish oil even with thousands of persons given for many years. Smaller studies with short duration give false positive and negative results. This is also seen in this study when they looked into subgroups. NIH is at times is forced to do studies because of public enthusiasm, although these are very difficult to prove. As a physician, I do feel it is good to continue a balanced diet and healthy practices than taking many supplements which can cause harm in the long run. For example, although antioxidant in diet is felt to be good, when taken as multivitamins, the excess can stimulate cells which can result in cancer and heart disease. There is concept that that something is good, a lot of it is very good .
4
Vitamin D, (D3 to be exact) is not taken to prevent cancer or heart attacks, so this study was unnecessary and misguided. Unfortunately it will give some people, not well-educated on the benefits of D reason to stop taking it. Vitamin D is needed to prevent bone loss, along with calcium and vitamin K.
Mainstream medical personnel are famously known for ignorance when it comes to nutrition and supplement usage. And the fish oil study, which promotes a prescription version as superior (and significantly more expensive) than OTC supplements seems only superior because the dosage was so much higher than found in OTC supplements. Had they given equivalent doses of supplemental fish oil as part of this study the results would've most likely not favored the prescription version.
9
This is a misleading title and the beginning of the article is disingenuous in an attention-grabby way. While Fish Oil + Vitamin D might not reduce the technically defined "composite of symptoms", it reduces risk by 28% in general, 40% in non-fish eaters and 77% in African-Americans? Hello? Why wasn't this article vetted for misleading conclusions?
22
You could wait a few years for more conclusive research and know whether you should have started now or not.
3
As is often the case, the popular press does not adequately interpret these types of studies, omitting significant interpretation. My doctor's comments: "A secondary analysis showed taking fish oil lowered the risk of heart attack by about 28 percent, " That's better than statins in primary prevention. Both D and omega 3's need to be dosed by blood levels, not by straight one-size-fits-all dosing, and both have pleomorphic effects. Studying for 1-2 end points, though admittedly important end points, for only 5 years is not adequate. D works to prevent cancer in the earliest stages, which is many years (in most cases) before it becomes invasive...there are many other problems with the design and conclusions of this study, I hope they continue it out 20 more years.
7
In the case of fish oils, one should not ignore the global epidemiological evidence of benefit - where reductions In risk among populations consuming diets high in omega-3 fatty acids - and it is important to note in very long chain fatty acids such as eicosapentanoic and docosahexanoic (EPA And DHA) - are well documented. Reductions in type 2 diabetes as well. To make the BOLS ASSERTION from a clinical trial of ZERO benefit does a disservice to all Americans looking to reduce RISK. To dismiss because fail to prevent is medical arrogance - cancer is so complex all one can hope is reductions in risk.
3
Hints of benefits? If a 77% reduction in MIs for black men was due to a drug, Pharma would be screaming “blockbuster” and spending billions in advertising.
16
Have your vitamin D measured as part of your routine physical.
If deficient in vitamin D, then ask your doctor about taking supplement.
3
@david
And also getting it from the sun. I know there are fears of skin damage and skin cancer from the harsh sun rays; I use coconut oil, palm oil, or castor oil to protect my skin from the sun while also allowing my skin to produce vitamin D from the UVB rays. Sun screen blocks the UVB rays.
Vitamin D created from the sun is much more effective to supplements. Even when one lives in northern latitudes, you should have sufficient vitamin D through the winter so that by the time spring comes around, your body will have depleted its vitamin D stores and can replenish. That is relevant only to those who made sure they were out in the sun throughout the spring and summer months.
I have medium brown skin complexion so I know the importance of sun exposure to make vitamin D and how long I should remain in the sun.
1
Another study showing the uselessness of supplements in preventing disease. Other studies show that multivitamins don’t prolong life in otherwise healthy individuals who eat a balanced diet.
The wellness industry is shameless in promoting needless supplements to the tune of billions of dollars a year.
6
I hope they do publish the results of other tests. There are a lot of us out there who use these not because we think we're going to be immune to cancer but because they have other helpful effects which are less exciting news wise but pretty important for the individual. For me personally skin issues on my hands due to work are relieved greatly but the two supplements and it is not just a feeling, it's visually provable. I get a little annoyed when foods or supplements are suddenly shunned because they don't cure the biggest diseases. Sometimes boring maladies can be pretty miserable and though they are not exciting news they are still important to the people suffering from them. I also know two people who feel noticeably less depressed when taking regular (not massive) doses of vitamin D. And as Maurie Beck below mentioned the depletion of fisheries I will mention that plant derived omega 3-6-9 oil works every bit as well as fish oil.
5
@Rachel my not sexy malady helped by fish oil is dry eye
5
Just go to Medline or PubMed and cross the key words "vitamin D" and "infection" and limit the results for humans and English and start reading. There would not be hundreds of studies if something was not beneficial. I am surprised that infections were not mentioned in your article as a benefit of optimum levels of vitamin D. Normal range is 30 to 100, optimum is above 50.
1
@Jerry
Many if not most studies are driven by where the funding comes from. Companies that make Vit-D supplements have a great interest in proving its benefits.
1
"There would not be hundreds of studies if something was not beneficial."
What kind of logic is that ? Embrace of the confirmation bias logic or something ?
@steve -
You can get a year's supply of daily 5000 IU vitamin D3 capsules for $20.
A year's supply of prescription Lovaza, the "fish oil" used in this study, at the recommended 4 capsules/day, costs about $1,000 per year.
You can be cynical about pharmaceuticals, but vitamin D and its protective effects on infections, immunological diseases, and secondary cancer prevention is an absolute steal.
2
Unfortunately, no one considers the true cost of fish oil. Most of the fish are anchovies off the Coast of Ecuador and Peru. These small fish are the basis for the food chain. Overfishing these small fish for fish oil as well as feed has had far reaching effects on fisheries.
11
@Maurie Beck a good point. It's worth noting that you can get omega 3-6-9 from plant sources too and it works just as well. I have very noticeable results with skin issues I have on my hands due to work. It doesn't help anyone in the long run to deplete fisheries or other natural resources for a fad.
2
The NEJM article does point out that some effect of omega-3 fish oil might be to replace or balance other, less desirable, fats such as omega-6, just as eating more fish might benefit by reducing red or processed meat. However, the VITAL study was not designed to detect this. It was, however, sufficiently large and long and randomized double-blinded with placebo and funded by the NIH and published in a peer-reviewed journal so deserves praise compared to most reviews of supplements.
3
2000 iu of Vitamin D per day is probably not enough to get many adults (especially the elderly and the overweight) into the optimal range, which might explain the lack of benefit reported by this study. The results would have been more meaningful if they reported before and after blood Vitamin D values, and stratified their results to see if there was a significant difference in health outcomes between those in the deficient/insufficient range and those whose values were sufficient/optimal.
5
@Perki2 Also whether the D was effective. D has to be taken in an oil.
The constant stream of ill-informed news articles reporting on the results of this study or that study merely create chaos in personal health care. The study of Omega-3s is ignorant because it is Omega-6s that provide the most benefit. I just saw a report praising these very things. Give us a break. Doctors, thankfully, don't follow every little new study, and sometimes that is a great thing! I told my doctor about the recent articles saying to wait on the flu shot and he replied, "take it"!
2
A 28% reduction in heart attacks was observed, said the doctor who led the trial.
I find it strange that this is not the headline of the story.
Indeed, the headline calls the supplements 'ineffective for preventing heart disease, and this is repeated a few times in the article.
I also find strange the implied assertion that heart attacks have nothing to do with cardiovascular disease. I must be missing something. I wonder what it is.
37
I was told to take flax seed oil for dry eye by one eye doctor and fish oil by another. I have GERD and could never find a fish oil that I wasn’t urping up half the day. Disgusting. So I switched to flax seed oil and that works fine. Regardless of these studies, I’ll keep taking it since I assume it’s not hurting anything, and maybe I’ll be getting some of that non-existent heart health benefit while I’m at it.
7
@Kally Was it Physician Recommended Pharmaceuticals? I was "prescribed" this for dry eye by a doc who could hardly keep a straight face. This company has been very aggressive in marketing this to doctors, who get kickbacks from it. Also, there is some evidence that fish oil pills are not benign. The potential for harm is not yet determined.
3
One study says this and another study says something else. Meanwhile the public has to decipher which study is best, trust the opinion of the doctor and/or wonder which pharmaceutical company might have sponsored the study. (yes, I read where in this study who sponsored the vitamins)
I worked for a pharmaceutical company at one time. Lobbyists, FDA approval, years of research, blind studies, etc, etc, etc all have impact on the outcomes. Recouping the research money is another issue.
Sorry to be negative but I don't know who or what to believe any more. And all physicians have their own opinions.
So many different opinions, different studies, and so much media hype that basically it all feels like lies and misleading the public.
And how are we to know if our physician is up to date on his knowledge and these studies?
Frustration more than help when I read articles such as this.
12
Fish oils are not worth it. We are draining the ocean of fish to help people who are too lazy to eat right and get exercise. We are all going to die of something, why kill a fish to give you false hope of living to 100?
3
Omega-3 fatty acids accumulate in fish, but are actually made by algae. They merely accumulate in the fish. We can get all the "fish" oil we need by growing the algae directly.
1
Presumably we'll get a more coherent interpretation of the results of this study in the days to come. A couple of observations in the meantime.
The one gram a day regime of omega 3 referenced in the article is actually a gram of fish oil. The omega 3 content of fish oils varies considerably but is typically in the 300 mg range (EPA + DPA). The trial apparently used a product containing 840 mg which is unusual. Even the higher intake is quite small in relation to our likely need for these essential fatty acids.
The absolute intake of omega 3 is less important than its ratio to other fatty acids. It should be no less than 1:4 and preferably 1:1. More commonly it is 1:20 or more. So barring a high fish diet (a typical salmon dish will contain 2 grams of omega 3), a gram of fish oil a day is inadequate - perhaps woefully inadequate for those with comorbitities (half the people in this trial were already hypertensive).
And then there are the stark, unexplained results demonstrating enormous protective effects of even this small omega 3 intake against myocardial infarction. 28% in the general population, 40% among those who eat little fish, and 77% among African-Americans. And still the authors seem bent on dismissing the benefits of omega 3.
My personal take on this study, barring better evidence to the contrary, is that we should drastically increase our oily fish intake and at the same time double or triple supplementation with omega 3 fatty acids.
6
@PJ Stamp -
Though not well-noted in the article, the "fish oil" drug used in this trial is Lovaza, which is NOT the same thing as the unregulated fish oil capsules that you can buy without a prescription.
Lovaza costs about $300 for 120-capsules, so if you take 1 capsule-per-day, it will cost you or your insurance about $1,000 per year. If you take 4 capsules-per-day, it will cost about $3,600 per year.
(And note that while literally billions of dollars of Lovaza have been sold, this trial indicated that it did not add a year to anyone's life...)
Note that his is not the same thing as what you buy without a prescription at the drug store. Those fish-oil capsules have been shown to be useless garbage. See PMID 29387889 ("Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks: Meta-analysis of 10 Trials Involving 77, 917 Individuals" at https://jamanetwork.com/journals/jamacardiology/fullarticle/2670752), or, alternately, PMID 30019766.
2
@PJ Stamp
The lead investigator has given a very coherent summary of what this gold standard study proves and does not prove.
Sorry, omega-3 did not make the cut.
End of story.
My mother lived long life. She was 90 years old and she never took vitamin D or Fish oil. She did not have so much stress like people have now.
5
My dog is living a long life too and it never took a single of vitamin D and fish oil.
4
So are you saying that if I continue to work like a dog I can dispense with the fish oil and Vitamin D?
The title of this article is all wrong. Should be: Large Trial adds New Data to Vitamin D and Omega 3 Value. Supplements were clearly proven effective in some patients for certain events [heart attacks] which matches some of what FDA trials have shown for prescription versions.
15
Study was seriously flawed:
1) Study subjects were not tested for vitamin D & omega-3 deficiencies prior to study.
2) Dosages were low, so deficient individuals would be unlikely to benefit much.
3) Median follow-up of 5.3 years was too short.
However, despite flaws, there’s this in article from Dr. JoAnn E. Manson, who led the trial, “...looking separately at heart attack [the trial] found a 28 percent reduction among those taking fish oil...the 28 percent reduction was ‘pretty amazing. That’s what you see with statins.’”
So, clearly, NYT headline was misleading. In fact, Reuters article on study had this headline:
“Fish oil cuts heart attack risk, vitamin D lowers odds of cancer death”
16
This headline is misleading. The article states: “Taking fish oil lowered the risk of heart attack by about 28 percent, which is a ‘statistically significant’ finding, says Dr. JoAnn Manson, who is chief of the division of preventive medicine at the Brigham and Women's Hospital in Boston.” Which is true, benefit or no benefit?
15
Vitamin D enhances mood. Although that is not at all what is being addressed here, it's worth mentioning. A happier state of being is a hedge against all maladies.
11
@Nadia I get more of a benefit from DD
@Menno Aartsen
Or CBD? Also beneficial.
The reason this study didn’t show results is because they gave each person 2000 units of vitamin D rather than measuring the amount in the blood. It’s analogous to giving a person a fraction of the dose of an antibiotic and saying it didn’t work. There are many good studies done that show the benefits of vitamin D that use the amount in the blood.
2
One person commented below that this article is 'clear as mud' and I agree. No reduction in cardiovascular disease.....yet a 28% reduction in heart attacks? That makes a lot of sense. And oh by the way if you are black that is 77% reduction? This article seems to confirm that everyone should be on a supplement! And I wonder how hard it is to find those so called 'healthy americans' that have normal vitamin D and no risk factors for heart disease? Most people in my everyday medical practice wouldn't qualify.
26
@Elizabeth Frost
Vitamin D is generic. Available over the counter. Ditto fish oil. Why improve human health with relatively inexpensive supplements when costly treatments may perform as well?
3
Eat a healthy whole foods plants based diet and you will not need vitamin D or Omega3 supplements, plus you will feel a lot better.
2
@David Binko Vitamin D from milk and Omega 3s from Salmon and/or other fish
@William Smith
Milk is not necessarily a healthy food and the Vitamin D is added not naturally occurring.
2
I take flaxseed oil every day. I do not expect miracles from such supplements. Strokes, heart attacks and other serious health events are not even under consideration for me as far as the supplements go. I take them for general health especially if I haven't had enough fish. My opthamologist recommended fish oil for my eyes. It's a help but not a cure all. People should be smart enough to realize this.
4
@Suzanne Wheat I tried that, but fish oil makes my eyes swim
@Menno Aartsen That's really interesting. Sounds like increased oils went right to your eyes. Consult opthamologist perhaps.
'Well, that's clear and informative' said NO one who read the article. Omega-3s are of no help, but that's overall "cardiovascular events." Apparently, they don't reduce major cardiovascular events, except when they do (if one considers a heart attack a major cardiovascular event). Ok, then, clear as mud. Yikes! And, I understand the scientific method pretty well. No wonder folks don't pay much attention to what the "experts" say.
27
This is a good example of why studies such as the one described in this article often confuse the lay public. Another study presented concurrently and published in NEJM (the REDUCE-IT trial) described beneficial effects of one type of fish oil supplement (EPA) for people with high triglycerides despite statin therapy, lowering the risk of cardiovascular events including CV death.
Previous data suggested that Vitamin D may reduce the incidence of the common cold, especially in individuals who were judged to be Vitamin D "deficient: https://www.npr.org/sections/health-shots/2017/02/16/515428944/a-bit-more-vitamin-d-might-reduce-winter-colds-and-flu
Will be interesting if this study bears up the previous analysis....
5
2,000 IU of vitamin D is a very large dose. When my blood tests showed low readings, my doctor recommended 400 IU per day. My next blood test 6 months later showed my levels smack in the middle of the normal range, over ten points higher than the previous test. The vitamin supplement industry may not want to hear it, but sometimes less is more, normal doses are better than mega doses.
2
@CCC
Many people need much more than 400 IU per day to make any change at all in their serum level.
9
@CCC--That may have been enough for you, but someone with an autoimmune illness, for example, will probably have to take more. It depends on the individual's health.
1
One principle to remember about the benefits of supplements and, in a different way, of prescription meds: They are very individualistic, affecting different people in different ways or not at all.
Take Vitamin D, investigated in these studies. There are five kinds of Vitamin D; the two that affect the health of humans are Vitamin D2--ergocalciferol--and Vitamin D3--cholecalciferol. The body makes D2 after exposure to sunlight. In places like the Northeast, where there is not so much sunlight for a portion of the year, supplementation is needed by most people. In function, D2 and D3 overlap quite a bit. The benefit best known is Vitamin D's relationship to bone health (although there are many others). It helps the body absorb calcium, which taken alone is hard for the body to absorb; i.e., in a 12-hour period, the body can absorb only 500mg. That is why, when calcium is prescribed by a medical doctor, the directions say to take 1,000-1,200mg in two divided doses 12 hours apart. Helping the absorption along is the addition of magnesium and Vitamin K2 (menaquinone); the latter helps calcium bypass the walls of coronary arteries on its way to bones, teeth, etc. The range of D3 levels ranges from 30-100; the optimal level is from 60-80. Over 100 can be toxic.
7
We know UVB varies by latitude, season, time of day, weather, and altitude. There is zero UVB in Boston in the winter for example.
In order to get sufficient UVB, you need to expose 40% of your skin at solar noon at a UVB sufficient latitude & season. In the USARIEM D study in Army folks in sunny SC, their D levels dropped (McClung et al). Why? They're wearing uniforms all day.
The avg D blood levels in community dwelling natives in Africa is 40-60 ng/ml.
The methodological problem is that researchers do fairly odd dosing regimens. They'll give 800 IU D3 to folks without testing serum levels, then conclude D is ineffective. Or give folks 500,000 IU once a year.
If you read the CDC NHANES data, there are wide ranges in D blood levels.
So, given the NHANES hard data, and a variety of poorly done studies, you're left with some well-done studies that show significant effects in specific areas. Look at Wagner et al work with pregnant women in SC.
5
For the fish oil results, I believe the dose was too low. While the researchers claim that they used the dose advocated by the AHA, that group did not conduct such a large scale study. Granted adding a dose response to this trial would have affected the statistical power, but without higher doses included, it is not fair to say that there is no effect ‘period.’
3
@Kim Barke
The American Heart Association President John Warner suffered a heart attack during the organization's annual conference in Southern California.
Best to do the opposite of whatever the AHA recommends.
6
I notice that lots of people are impressed by "the omega-3 fatty acid intervention lowered the risk of heart attack by 28% and the risk of fatal heart attack by 50%".
As matter of a fact, 50% of us, adult Americans, are suffering from either diabetes (9%- Hb A1c level 6.5% or higher) and pre-diabetes (astounding 41%-Hb A1c level between 5.7% and 6.4%) according to Dr. Brian Mowll, a diabetes specialist. Some scientists found out, "each 1% reduction in HbA1c was associated with reductions in risk of 21% for diabetes, 21% for deaths related to diabetes , 14% for myocardial infarction ( heart attack) , and 37% for microvascular complications." Many people don't know that they are diabetic because they have never tested HbA1c level because they have never heard of it.
If you lower HbA1C by 2%, you would lower risk of heart attack by 28%.
https://www.ncbi.nlm.nih.gov/pubmed/10938048
Hemoglobin A1c, often abbreviated HbA1c, is the glycation (protein attaches to sugar molcule) percentage of hemoglobin (a blood pigment that carries oxygen) that is bound to glucose in the all hemoglobin.
If I were to worry about CVD/stroke risk, I would rather lower refined carbs/sugar intake instead of omega-3 supplementation.
5
Causality is nearly always suspect. There are so many threads involved in good health, that isolating single factors is unlikely to tell us much of anything. Good genes, good diet, exercise, good sleep, lowering stress and just plain good luck are all instrumental in maintaining good health. And they can all go out the window suddenly. How many times do we hear of some young person who does everything right, yet still comes down with some rare and pernicious form of cancer, or even drops dead? I am 68 active, fit and in top health. I average 25k steps a day in various activities. I have made a study of substances and food and what seems to work best for my body. I meditate and do yoga and spend all winter on the beach in Mexico. There is longevity in my family. And as a good Buddhist, I try to be aware that it could indeed all go out the window tomorrow.
13
My Mother used the shovel cod liver oil into me as a child, and I have continued to take it right through my life - I am 73 now. I don’t take just one capsule, but usually 3 or 4 because I like the taste - no science involved. I seldom become ill with anything thankfully, and as far as vitamin D, as I am in Australia I get out walking the dog every day in the sunshine.
5
@Sharon Phillips
Vitamin D absorption depends on:
-- the season
-- what you're wearing including solar protective clothing
-- using sunscreens.
The 'slip, slop, slap' campaign has affected Vitamin D levels in the Australian population.
If you're old, it's worth having your various vitamin & mineral levels tested when you have an annual blood test.
As we age we develop absorption problems. Low vitamin D affects calcium absorption, as does eating meat & dairy in the same meal.
3
I know exactly when I need Vitamin D3, I have pain in my feet. Within 12 hours of taking one high dose, the pain is absolutely alleviated. Blood test revealed my level was high so I stopped taking it. In 6 weeks, I could not walk. It took nearly 2 weeks of massive doses to relieve the pain. There are several different and old injuries on each foot all activated at the same time. Never will I believe a blood test and levels again. When I feel that familiar onset of slight pain, another massive dose works every time. Also, restless leg syndrome I have suffered all my life has totally disappeared. Listen to you body if you have learned how to hear it.
9
@Anne Elizabeth
Many people have one or two vitamin D receptor polymorphisms- mutations. The simple fix is to take more than other people.
Some people need to take a thousand times more of one vitamin than someone else just to feel normal. Schizophrenics, for example, need very high doses of niacin.
2
@Fourteen
The idea that schizophrenic individuals have low niacin levels is based on old and non-credible "orthomolecular" studies.
1
These large studies take a lot of time to analyze properly and early results may not tell the whole story. Also, starting at age 50, and following “healthy” adults for only 3.5 years doesn’t generate a lot of events. It may take longer to see an emerging benefit. Maybe starting earlier in life helps. Maybe some people benefit and some don’t, due to genetic factors or other lifestyle differences. You can’t accept any one study as gospel, which is why science is so confusing to lay-people and even to doctors. Sometimes, you just have to let the studies run their course and do the best you can to understand the results.
12
I do not understand how you get from "... Vitamin D and Fish Oils Are Ineffective for Preventing Cancer and Heart Disease ... they did little to prevent cardiovascular disease ... (to) ... Secondary analysis ... a reduction in cancer deaths for people who took vitamin D for at least two years, and fewer heart attacks in people who took fish oil ... another analysis looking separately at heart attack found a 28 percent reduction among those taking fish oil, with a 40 percent reduction in people who eat little fish ..." How is that headline ('ineffective', "did little") related to those reductions in heart attacks? Ya lost me, kids.
42
All studies that use self-selected participants start with a biased sample. The only reason for such “studies” is to push another pill on gullible public. However, the benefits from placebo effect are real. So, if you are a believer - good your you...
Concerning 'sustainability' of consuming fish oil supplements:
Fish don't generate EPA & DHA, they eat algae, which Do make the components of 'fish oil'.
The best (sustainable & mercury free) DHA comes from 'bioreactors' which incentivise carefully chosen algal strains to produce DHA.
As related by Robert Able, Jr., MD, in book "The DHA Story",
NASA researched nutritional value of DHA during Apollo program. Martin-Marietta had a division which produced DHA from algae for Apollo personnel.
MarTek Biosciences was 'spun off', eventually acquired by Netherlands Royal DSM NV {and Dan Loeb's Third Point?}.
I believe the brands are 'Life's DHA', and 'Neuromins'.
Must shop carefully for the 'vegan' / 'algal produced' DHA !
Dr. Able includes a chart in his book which indicates that people do well by consuming about 600 mg/day of DHA.
2
The known facts about vitamin D are that it plays a role in calcium metabolism and that many genes are regulated by it. Whether or not it has a role to play in cancer and heart disease isn't known and the results of this study has cast doubt on it.
However, vitamin D at approximately 3000 to 6000 IU a day is what a normal daily dose would be if you are outside for most of the day at a latitude that match your skin type:
https://doi.org/10.1017/S0007114511007161
Breastfeeding mothers have sufficient vitamin D in their breastmilk for their babies, if they get about 6000 IU/day of vitamin D:
http://pediatrics.aappublications.org/content/136/4/625
The question is whether it would be wise to stick to an unnaturally low vitamin dose that is good enough for the known benefits, just because we haven't found out about any benefits for the natural dose, other than providing breastmilk with enough vitamin D, making supplements for babies unnecessary.
In case of newly designed drugs that have no natural role to play in human biology, a skeptical attitude where no benefit of doubt is given to the drug, is appropriate. But natural mechanisms such as those involving vitamin D at natural levels should be given the benefit of doubt.
Absence evidence of harm, we should strive to be at natural levels, even if there is a lack of knowledge about any benefits over and above much lower levels.
3
Lots of eye doctors recommend fish oil capsules for eye health. Is anyone studying this?
11
77% reduction of heart attack risk in african americans? At that point fish oil should be free to african americans.
19
I'll bet if big Pharma sold these supplements, the test results would have been different.
23
@Lillies - Got cynicism?
@Lillies
Exactly ! These supplements appear to be more effective at reducing morbidity and mortality rates than statins, but statins are recommended by Big Pharma and their lackey doctors for practically everybody. Just follow the money.
6
@Lillies -
Big Pharma does sell the fish oil used in the study:
"Pronova BioPharma of Norway and BASF donated Omacor, a fish oil sold under the brand name Lovaza in the United States."
The Lovaza that was used goes for about $2.50 per capsule.
This isn't the useless generic stuff you buy without a prescription.
(Of course, the vitamin D3 IS super-cheap. Generic 5000 IU pills are about $20 per YEAR. Which is why the press seems so against them...)
1
The vast majority of Americans are deficient in vitamin D and 2,000iu is a minuscule amount that it will never raise one's levels to the optimal range of 60-80ng/ml if one's levels are below 30ng/ml. If Rosen had bothered to read any of the studies by the Vitamin D Council founder Dr. John Cannell. And Rosen would have found out that the levels needed to fight cancer is 100ng/ml.
It really irritates me when these fly-by-night studies are herald as definitive proof that a supplement is worthless when it's just one study. Whereas real studies like Dr. John Cannell's work of 29 peer-reviewed scientific papers on vitamin D is not even mentioned.
17
@Libby:
This was hardly a fly-by-night study. I know- I participated. It was 5-years of taking capsules and periodic health questionnaires. As stated in the article.
9
@Jim
It was an insignificant and poorly designed study. Five years or five minutes wouldn't have made a difference.
3
@Libby For the Vitamin D true believers there will never be a study that undermines their belief that Vitamin D supplementation is good for you. Convince a (wo)man against her will, she is of the same opinion still......
At least Vitamin D, in reasonable doses, is not super toxic, unlike some of the other quackery available from your local, non-FDA regulated vitamin and supplement stores.....
2
I'm looking forward to more analysis concerning autoimmune disorders and vitamin D. There's a lot of talk about this connection in "natural medicine" circles, and I would love to see a golden standard research exploring this topic. Autoimmune diseases appear to be on the rise, and western medicine struggles to find answers for many of the sufferers who then look for help in various alternative treatments, with or without merit...
8
Wait, 77% reduction for African Americans?! Interesting how the title and focus of the article is geared to only one segment of the population. Kudos to the researchers for having African Americans as a part of the group as we are often left out of the trials that ultimately impact our health. Hopefully there were more than 2. NYT editors, think about your readers.
34
Swedish studies have shown that fish oil supplements are good for brain health.
11
If goal concerns cardiovascular issues, flax seed is Much less inflammatory.
If goal is mental health, DHA a better bet. DHA associated with increased VLDL, so more risky for circulation.
If goal of vitamin D is bone mineralization, also take some vitamin K... that will obviate need for more than a little of D.
Vitamin K, in combination with omega-3 oils, helps clear cardio system; vitamin C (in quantity) and a tad (40mg) of vitamin E, also improve cardio.
1
So, iff you make a big enough marketing promise to sell your trash, some people will buy it in hopes that it will do a fraction of what you promised.
Thanks, I never understood why people were -- and still are -- such suckers for travelling medicine show ... whether the show is run by a prestigious drug company or a Times Square con artist.
1
These results lead me to believe that my daily 1000 IU of D3 and a gram of Omega 3 is likely doing some me good and certainly no harm.
I'm good with that.
22
For anyone interested, the authors of this study are reporting this:
"Specifically, the omega-3 fatty acid intervention lowered the risk of heart attack by 28% and the risk of fatal heart attack by 50% but had no benefit on stroke or cardiovascular deaths not related to heart disease. Additionally, omega-3 fatty acids reduced the rate of angioplasty procedures by 22%. "
22
I was a participant in this study. As an academic and researcher I understand that research can’t be successful without volunteers. I took my pills for 5 years and agreed to other health data collection i.e. blood pressure. After the close of the trial I found I had been taking Vit D and a placebo. There is a vast amount of data that was collected. I look forward to more analysis and dissemination of the findings. This initial report seems right.
9
Hi Lynne,
Active vitamin D and placebo Omega-3 here too. Also waiting to hear more.
1
@Lynne & @Barry -
I know it is just anecdotal, with a sample size of two, but did you two taking the vitamin D3 supplements note any decrease in your respiratory infection rates over the five years, compared to the five years before you started?
Did the researchers query you on respiratory infections or asthma? This is where there appears to be big effects with vit D in randomized trials...
1
I take fish oil supplements for my dry eyes and it really helps. I know when I have missed a dose. Vitamin D on the other is a huge question mark. My levels were very low so I dutifully take my pill every day. Do I feel any different? No, but I do so because the doctor said I should for bone health.
9
One area that vitamin D has shown promise in is in helping with muscle cramps aka "charley horses." I get them not just in my legs and feet but my torso. I've tried everything - magnesium, quinine (tonic water) calcium, etc but nothing has come close to stopping them like vitamin D.
13
The practice of small fish and krill being factory-trawled for the fish oil supplement reduction industry is ripping the foundation out of the marine food chain. Please stop taking fish oil supplements.
Research has shown that you can increase omega-3s via a healthy balanced diet. Canola oil and walnuts are two examples. Normal seafood consumption helps also. You don't need fish oil supplements.
33
@PA Blue, let me say "Amen" to this, whatever benefits to heart health are obtained by taking fish oil supplements can be matched by lifestyle and dietary modifications that do not require the massive harvesting of small fish and other creatures that form the basis for the food chain within the ocean. I've been preaching that to my patients in primary care for several years when they ask about which supplement I recommend, either fish oil or krill Oil. Sadly I am usually met with a blank stare when I tell them neither has been shown to have clear benefits but has serious environmental consequences. Now I can use this very well designed and well performed study to encourage people to get away from the use of these environmentally damaging substances. Thanks to Dr. Manson and her team.
7
@PA Blue
The omega 3 oil is "molecular distilled" to remove mercury, PCB. But I believe that "molecular distillation" also removed whatever is considered good for you as my N+1 testing with 3 different brands showed no impact to my lipid profiles. In contrast, taking 3-6 tablespoons of "cold pressed" flax seed oil or olive oil showed a doubling of my HDL within a month. Takeaway is: get your omega 3 from flax seed oil or olive oil.
6
Canola oil is high in omega-6 fats which are fine for healing but bad for inflammation if more than 2.5/1 ratio with omega-3 its anti-inflammatory and neural sheath building.
4
This study just prove that there is no magic pill(s) to cure our health issues. We need to simply eat a variety of foods, cut back our comsumption of red meat, exercise regurlary and see our doctors for routine checkups once a year. This will keep you healthier than any magic pill(s).
10
@Anthony White
and don't smoke.
6
@Anthony White: Living longer may not be worth it if you have to give up the things you like in order to get a few extra months or years being demeaned in a nursing home.
2
@Kathleen and do sleep
2
So, "the only thing that works with hearth conditions and cancer is us, keep coming to our practice, we need to buy another yacht."
What doctors do not understand and they need to work on prevention of sicknesses; but, the money is not there...Shame.
8
This report seems to be a bit at odds with a similar report from the Washington Post published on Nov 10, 2018 entitled: "Fish-oil drugs protect heart health, two studies say."
18
I got the message about Vit D but Fish Oil seems to be a bit contradictory. A 28% reduction was found, more in other groups. That seems counter to the rest of the article.
22
Perhaps the real take home message for Vitamin D is its role for the immune system as mentioned by Cynthia Aranow in 2011. Dr. Aranow states: "Deficiency in vitamin D is associated with increased autoimmunity as well as an increased susceptibility to infection." Getting back to the recent NEJM JoAnn Manson study, even the author herself says: "If you're already taking fish oil or vitamin D, our results would not provide a clear reason to stop," For more see: https://jeffreydachmd.com/2014/01/stop-vitamin-d-joking/
8
"...another analysis looking separately at heart attack found a 28 percent reduction among those taking fish oil, with a 40 percent reduction in people who eat little fish and a 77 percent reduction in African-Americans. She said the 28 percent reduction was “pretty amazing. That’s what you see with statins.”
Ineffective? Like STATINS?
The NYT is consistently anti supplement, anti integrative medicine, and a shill for for Big Pharma. While you claim that fish oil is ineffective, you trumpet VASCEPA, a PATENTABLE version of fish oil as being effective in preventing those very things , "Cardiologists may one day have a new tool to help prevent heart attacks and strokes in some high-risk patients: a prescription drug that contains large doses of EPA, an omega-3 fatty acid contained in fish oil.."
A large clinical trial found that the drug, called Vascepa, sharply reduced the rate of cardiovascular events in people with a history of heart disease or Type 2 diabetes, according to early results that were announced on Monday.
https://www.nytimes.com/2018/09/25/well/fish-oil-heart-attack-stroke-triglycerides-omega-3s.html
So why the seeming confusion?
How were the trials conducted? What were the dosages? what was the term. What was the placebo?
The "drug" was administered in mega doses,(4 grams per day)
The OTC fish oil at only 1 gram.
Worse, the article on Vaspeca is cribbed directly from Amrin's "investors relations"
The NYT promotes disinformation on health and nutrition,
9
Without a dose-ranging study to determine a pharmacological range of doses for Vitamin D and omega-3, these studies do not yield much useful information. Does taking 10 mg of Tylenol cure a headache?
9
My wife, dog, and myself all take Fish Oil - for JOINT HEALTH. Never have considered it for Heart or Cancer issues.
We are very surprised by this "news" piece, as well as a similar one I heard on - gasp - NPR a couple of years ago. Same thing: research says no benefit for Heart, Cancer, etc, and no mention what so ever about Joint Health.
Could someone research that?
In closing, I think this report is somewhat irresponsible to focus on such a specific aspect of Fish Oil's use - and completely ignore what we and many of our friends regularly do - consume Fish Oil - for our knees, hips, shoulders, etc.
13
It is vital to note that this is a study from the NIH, a governmental organization that routinely pushes big Pharma, while eschewing any and all Eastern medical or more holistic approaches. Forgive me for being suspect of their "results". A couple of thoughts: Never trust a doctor or scientist who uses a study of random people to get to words like "Period". The Sean Spicer of proclamations. And, 25k plus is a nice big number. But the results got diluted by 4. So, now I'm basing my health care choices on just over 5 thousand people, most of whom are nothing like me? Nah, I'll keep taking the fish oil.
6
O. K. doctors.
I see little, very little effort to prevent sicknesses. You guys seem oblivious about the air quality, noise and light contamination, climate change effects on humans, as we see in the sudden disappearance of animals, frogs, among them.
It seems that I see efforts to discourage people to protect themselves from sicknesses.
5
Surely supplements can have beneficial effects short of curing cancer or heart disease? Vitamin D's role in facilitating calcium absorption seems like a decent justification to try to get levels up to where they would be if we were eating a primal diet.
8
Two thoughts: One, the headline is understating the possible benefits found; yes, omega-3 fats are no panacea, but can have significant benefits for many, with few if any adverse effects.
Two, it is unfortunate that the Vitamin D trial used a dose of 2000 units/day. What really needed testing was the potential health benefits of supplementing with larger doses of Vitamin D (about 5-10 times the dose used here) . There is reason to believe that those benefits only occur at significantly higher blood levels than required for bone health, once a threshold blood level is reached. The present trial addressed whether supplementing vitamin D at mildly elevated doses would show additional benefit, and it did not. The question whether larger doses of Vitamin D (10,000 - 20,000 units per day) have benefits remains unanswered, and that is unfortunate.
5
Incomprehensible article to this reader. Rabin writes, "Now a large and rigorous government-funded randomized trial ... has found the supplements do not lower cancer rates in healthy adults. Nor do they reduce the rate of major cardiovascular events, a composite of heart attacks, strokes and deaths from cardiovascular disease ... Secondary analysis of the data found ... a reduction in cancer deaths for people who took vitamin D for at least two years, and fewer heart attacks in people who took fish oil."
So are the supplements helpful to reduce cancer deaths but not in prevent the onset of cancer? If so, still worth it. Fewer heart attacks but not a reduction in the "cardiovascular events," described here as a composite measurement of heart attacks, strokes, and deaths from cardiovascular disease indicates a rise in strokes and/or deaths from cardiovascular disease.
And did the study evaluate the effects on cancer and cardiovascular events of each of the two supplements - Vit. D and fish oil - separately? If not, I'm not sure how useful it is.
10
@Reader Your confusion i reasonable, but the statements made are not mutually exclusive, especially in light of statistical interpretation of study results. Take, for example, the finding that cardiovascular events are not significantly reduced, but that "another analysis," showed reductions in heart attacks. If the study was designed to look at one possible outcome (cardiovascular events), and after analyzing the same data for effects on different outcomes (eg, heart attacks), the possibility that the results are due just to luck and not because of the treatment variable (fish oil) at all. The commonly used bar of 5% for a p value in determining whether a result is due to the treatment varied in the study means that about 1 in 20 times, you would get a result that strong just from chance, even if the thing you're studying actually doesn't do anything. That 1/20 may be pretty convincing if that's what you said you were going to check for before the study started. But now let's say you take the same data after the study and start looking for other correlations between taking fish oil and other things - were people taking fish oil more likely to vote? to make the Olympic team? to buy a new coat? to get divorced? If you check enough things, you will eventually find some that look to be significant at the level of p < 0.05. In fact, if you think about it, for every 20 things you look at, one should look significant by chance at the 5% level.
2
@Reader @Reader That's why the article correctly states that these secondary findings need to be examined in separate studies to be sure they are real.
2
@Robbie
12,900 people took the oil for five years, Another 12,900 took a placebo for five years. How many people in a well conceived and executed study are needed before the heart attack count can be considered real?
Other people should run other trials, yes for various reasons. But is fear of sampling error in this study a main reason?
Even though there's only a 95% chance the heart attack rate was 28% lower, you can be sure the chance that it was 20% lower is a lot closer to 100%. The odds that the heart attack rate difference was actually not there at all can't be far from zero.
2
The primary benefit of omega-3 is a lowering of LDL cholesterol (the bad) and a raising of HDL cholesterol. A general mortality study is less useful than a study that shows the effects on cholesterol levels, because it limits the variables. And the study results are not nearly as definitive as the headline and following article suggest; a 28 percent reduction in heart attacks is a big deal, equal to the result achieved by statins.
19
@Prazan I agree! Pretty sure that sentiment is shared by the 28% who were spared from having a heart attack. The (disappointed) expectation that any supplement or even medication would drastically change outcomes is irrational, and that irrationality is reflected in the headline. In the real world, most interventions will have mild-moderate benefits, which is why changing morbidity and mortality from cancer and heart disease is a slow slug, and not a quick, glorious Sprint.
3
If fish oil was promoted as helping people "swim like a fish" and that caused them to swim regularly, the exercise alone would be of greater benefit.
7
Since the creation of the so-called "health awareness" in our society for about the last four decades, the supplement industry has been very successful marketing vitamins and other snake oil products with promises and questionable studies of the benefits of same. This has grown to a multi-billion dollar industry due to aggressive lobbying to keep this industry free of FDA regulation. This is unfortunate because the promotion of the health benefits of most of these supplements do more harm than good.
It is universally agreed by the medical community, dieticians that a well rounded diet provides all the basic vitamins our bodies need
3
@Andrew Henczak
While I appreciate that a well rounded diet is probably best, we don't have as public policy a food program that makes well rounded diets likely for many in our population.
USDA promotes diets that agribusiness can get rich on. Congress gives producer supports for the foods dietitians recommend we eat less off: grain carbs and sugar. We need to separate food policy from profit.
1
@Andrew Henczakb-- Way too simplistic a view!
2
@Don Juan
I don't know. Americans are just about the fattest people on earth (with Canadians and the British not that far behind them.) And they swallow 45% of all the drugs taken in the world.
If they were doing things right, supplements wouldn't provide much protection, as such protection wouldn't be needed. Health and the obesity rate would already be wonderful.
There is a distinct difference between RDA for vitamins and nutritional supplements and levels required for OPTIMUM function. Vitamin D3 supplementation may not postpone cancer but it will prevent a lot of other maladies.
7
Americans are primed to pop pills. We are inundated with advertisements on the benefits of this or that supplement to the point where swallowing pills is the norm, and has taken on what amounts to biblical authority. The supplement culture is not the norm in Europe where people live longer, and healthier than in the U.S. and Canada. In the U.S and Canada our grains are so "enriched" with vitamin and mineral supplements, that some nutritionists say cereal boxes should come with a warning label not to allow a child to eat more than one serving a day for fear of vitamin overdose.
4
@an observer
Supplements are not the answer and shouldn't be the pirmary source for nutrients. More of us should strive to get our vitamins and minerals from foods superfoods like kale, spinch, chard, Brussel sprouts should be our daily goal. All vitamins and minerals are in the right amounts and we're also feeding our gut microbiota, which extracts more nutrients from these vegtatables.
4
I think there are enough known benefits to Vit C, such as Calcium absorption and bone density, to maintain supplementation. Plus, based on prior Vit C studies benefits have been shown. However, what needs to be kept most seriously in mind with the present study is the time frame of 5 years. Both cancer and heart disease take decades to develop. A snapshot of people in a study later in life may minimize a real positive for people who start changes in nutrition and lifestyle earlier. I do not plan on stopping my daily 2000 units of Vit C based on this study.
@Barry
You're right cancer is likely to strike in later ages. It would have been better if the study lengten the time it followed the subjects to 10 or 20 years. Cancer is a silent disease that accumulates after years of DNA damage, so a 5 year study isn't enough to make up for the substanctial difference in decades of damage already done.
@Barry what has Vitamin C to do with this study?
@Barry do you mean Vitamin D?
Otherwise fairly healthy person until that point, two years ago at age 49 I was beset with a series of respiratory infections that were ultimately leading me to develop asthma. A scientist friend shared with me several studies that low vitamin D can cause tendency to develop respiratory infections. Got tested; had low D, Dr. prescribed 1x week megadose. Upshot: 2 years later, no more respiratory infections, asthma development halted in its tracks. Anecdotal on my part, yes, but there are other things besides cancer and heart disease D may assist with. So relieved to be healthy and be able to breathe again.
21
@Stephanie Vanderslice My anecdote is that vitamin D helps with pain in my small joints; another thing I've never seen studied.
4
@Jennie that would explain another commenter who said she took it for foot pain. I did notice it contributed to overall well being, as does rarely getting sick any more.
2
Vitamin D to work with calcium from food to keep bones good. Fish oil to help with arthritic knees. Don’t know if the D does anything, but the fish oil certainly does - result of an on-again/off-again process of self examination. BTW, ditto for a cheap probiotic.
7
@kw, nurse I’ve found omega-3 (DHA EPA) found in fish oil to be enormously useful in reducing pain and swelling in my osteoarthritic knees. I have no illusion they make my knees better but it helps set the stage for my intense exercise routine designed to strengthen the muscles in the upper leg as well as stimulating the knee to help heal itself. As my GP says, osteoarthritis is not a “wear and tear” disease but a “wear and repair” one. 10 years ago I couldn’t walk 200 meters without intense pain bringing tears to my eyes and pain easily seen in my contorted face as I struggled with the pain. Now I can walk 10 miles with virtually no pain (exercise plus omega-3)
This article uses the term 1 gram of fish oil which is meaningless. The critical factors are the omega-3 DHA and EPA. In the study they used 840mg of the two combined. I take 1200mg of the two combined. Research done by the EU commission shows the safe limit is around 3grams. Even this report shows no ill health effect from the fish oil.
Others can rant about how we shouldn’t need supplements, fine for them to say. They changed my life. I already eat a very healthy diet and I’m of a healthy weight. I can now do intense cardio rowing (erg), walking and dancing daily.
One issue though is that the demand for fish oil has grown so much that these creatures used for their oil are being over-fished. Look for fish oil from sustainable sources and be prepared to pay more.
9
@Eric Try borage oil, active antiinflammatory being GLA. More effective than fish oil and good sode effects re skin and nails.
the latest in what seems to be a steady stream of studies upending what the public has been told about many things about nutrition.
3
My doctor told me to take the fish oil and Vitamin D suppplements as well as the baby Bayer asprin everyday and when I talked to him about the research saying they don't really work he said that take them anyway because the won't hurt you and they might help, so I take every morning, but I realize that something will get me in the end .
13
@Richard -- Not just you. No one gets out of here alive.
1
There is no evidence that Vitamin D or fish oil supplements are beneficial. It's all wishful thinking. There is lots of evidence that Vitamin D supplements can be harmful (as well as calcium supplements, with no benefits at all; Google it please; I have no time to list citations but there are many, many recent studies.)
Want to stay healthy? Consume a diet containing calcium and fish as well as ample produce and nuts. Exercise every day and get some sun daily. Get adequate sleep. Hope for good family genetics. Avoid supplements and unnecessary medications.
5
@A. Hominid - Here's 10 seconds on Google:
https://www.arthritis.org/living-with-arthritis/treatments/natural/supplements-herbs/guide/fish-oil.php
So what is your point? FYI I've done probably years worth of "Google" on this, as well as paying for a certified, licensed health care professional to discuss the conditions and behaviors involved in my efforts to help my knees and other joints.
The good behaviors you cite are obvious and have been for millenia.
That Fish Oil could help joint pain and function, and be
empirically verified is a new thing, don't you think?
So give it a chance.
There are people who will use your words in the worst way.
3
The study I read that showed the efficacy of Vitamin D3 showed it for a couple of relatively small groups. But did at least one physician take that info and run with it, becoming a champion of D3 for the many - and possibly well compensated?
I'm a bit confused - Dr. Manson said that "since fish oil did not reduce the risk of stroke it did not have an impact on the overall risk of cardiovascular disease". She is then quoted as saying "another analysis looking separately at the risk of heart attack found a 28 percent reduction among those taking fish oil". Does this indicate that the risk of stroke, a cardiovascular disease, increased by an amount in those taking fish oil to fully offset the beneficial impact on heart attack risk? If not, it would seem the more accurate finding is that fish oil does reduce the overall risk of cardiovascular disease to at least some extent, although only by reducing heart attack risk, not stroke.
25
@Michael "If not, it would seem the more accurate finding is that fish oil does reduce the overall risk of cardiovascular disease to at least some extent, although only by reducing heart attack risk, not stroke." This would be true if we knew that the effects were due to the fish oil. But for studies of this type, when the researchers (or journalists reporting on them) say "did not reduce the effect" they mean it did not reduce the effect significantly, i.e. enough that we believe the reduction is really due to the fish oil and not just random chance.
3
Great observation. I hope that NYT changes the misleading headline and also clarifies the issue you raise.
3
The American Heart Association recommends eating fish frequently. How frequently? Please specify.
4
@nom de guerre According to their website, "The American Heart Association recommends eating fish (particularly fatty fish) at least two times (two servings) a week."
3
Lots of what some of us do is driven by popular media and being so "into our bodies" that we go to extremes. I suspect that moderate exercise and a Mediterranean type diet plus learning how to cope with stress is the gold standard for health. Of course, good sleeping habits, wearing a seat belt, not smoking and keeping blood pressure in bounds would be the icing on the (not too much) cake.
9
I was advised by my nutritionist suggested flaxseed oil for omega-3's. Fish oil can contain toxins such as mercury.
4
@Paul Lief Any high quality fish oil has been purified.
3
@Paul Lief many fish oil products are filtered and are mercury free.
4
If substantial amounts of Vitamin D and fish oils were powerful prevention tools for cancer human beings would have evolved to develop a strong taste for fish and for being in the sun.
Those who ate massive amounts of fish and were in the sun a lot would have survived and passed their genes along to subsequent generations.
But it hasn't happened, which argues against these two substances being the magic pill that many believe they are.
3
@Dan, human beings have instead evolved to crave sugar, fat and salt as much as possible. According to your logic does that mean those foods are healthy?
15
@George Bernard
Human beings who ate sugar, fat and salt in "massive" quantities did indeed have a survival advantage. The only difference is that those types of substances were in short supply until only recently. But they ate fruit and meat, which created an evolutionary advantage.
There is a theory that the people in Europe who craved alcohol the most had the strongest survival opportunities because they drank less of the polluted water--hence that resulted in difficulties for people, but was also an evolutionary advantage.
Your logic, I'm afraid, is flawed. The evolutionary advantage I am talking about is before industrialization could provide people with those substances in massive quantities (e.g., sugar, carbs, etc.). So, in essence, you have proved my point instead of refuted it.
Those humans who had the strongest cravings for sugar, fat and salt did indeed survive. And now we are paying the price for it when those substances can be provided in quantities unimaginable 1000 years ago.
3
@Dan There's still a fault in this evolutionary reasoning. Cancer and heart disease tend to kill people after their reproductive years. Thus, there would be little selection pressure to increase vitamin D titers. Also, people DO crave fatty fish, and a branch of humans did mutate to have less melanin in their skin, probably at least in part to make it easier to produce vitamin D from UVB.
3
Ok gang, let's go over it again, it is not rocket science.
1-Get a psychical every year or so and a blood test that includes a Vit. D count.
2-If you are low, below say 20 or 30 take a Vit. D supplement especially if you are having symptoms like I was, ie leg jerks, electric type impulses in the leg. It was cured.
3-If not, avoid the hype of the billionaire dollar big pharmaceutical industry and its holistic brothers. They just want to make money off you.
9
@Paul
too much vitamin D, especially from brewer's yeast, can give you leg cramps and cause liver damage. My Doctor now thinks D between 20-30 is fine and no supplements needed
2
@an observer- agreed, too much can be as bad as too little. A count between 20-40 is good. Only if one's count is not in that range, one can take a supplement but not go crazy with it.
2
@Paul
Actually I think it's more complex than rocket science. Clearly science is at sea about nutrition; it's one of the most vexing things to fully understand and no, gang, we're not there yet.
3
Anybody who takes fish oil for mental health does not need WAPO, or a Lovasa funded study to rule out or rule in the beneficial effects fatty acids have on mental health.
This incomplete analysis of the benefits of fish oil on the body, falls short when it comes to mental health.
The brain, being mostly fat, is benefited with the addition of fats to the diet, supplemented fats. Fats are the building blocks of the brain.
Eat fish, eat greens, eat well, and if you can't eat well, supplement with fish oil, to stay balanced, to reduce the need for large doses of psych drugs, and to stay 'lubed up' for a positive spin on life.
Don't believe everything you read, believe what you feel and verify..
9
@Monkeymatters And avoid sugar- poison to the brain, heart, bones, feeds cancer and causes inflammation which is the cause of most diseases.
1
One thing fish oil does wipe out is fish. Small fish at the bottom of the food chain. With fewer of those, we get fewer tuna, swordfish and other tasty large predator fish. Once stocks collapse badly enough, no more fish for us.
28
@Chip
Finally someone points this out. Is it morally acceptable to wipe out populations of fish so we can fell a little better, or exist a year or two longer? Is this really that much different than what the Chinese have done to tigers, elephants, bears, or any number of other animals they've wiped out in the name of "health?"
And since so many supplements (as much as 50%) have been found to be adulterated, I wouldn't be surprised to find that many brands of fish oil just contain rancid blends of leftover corn, soy, or olive oil.
12
@Scott Cole - Adulterated as well with contamination from the oceans - synthetic chemicals, microbeads, plastics, etc.
6
@Scott Cole fish oil testing by reputable firm Labdoor. https://labdoor.com/rankings/fish-oil Note that purity and sustainability rankings
1
The author could have assisted by explaining why post-hoc analyses are seldom replicated. Here the combined cardiac risk - the object of the study - was not improved by treatment, but when the authors split the risk group apart they found the 28% improvement. It’s like shooting at a target and moving the target so one doesn’t miss. That said, there will always be folks who want to believe in something, nutritional supplements being one of those things. Problem is the gut has a mind of its own and decides what to asborb - hence the old maxim that the dumbest intestine is smarter than the smartest nutritionist.
9
No, the analogy is more like saying the average person has dark hair, but the subgroup of scandinavians are mostly blonde. Also, this study used "healthy" subjects, but most Vitamin D benefits are associated with deficiencies, which may have skewed the results. Many people are D deficient for a variety of reasons, and a supplement is a cheap easy fix.@LTJ
1
@KD I disagree; LTJ's characterization is fair. If we looked at all the other thing blond hair might be correlated, and found that in the group we looked at people with blond hair were more likely to enjoy word games, or get tattoos, would that mean there's any causal relationship there? No, because if I look at enough possible correlations, some of them will be strong enough to appear significant. It's not fair to run a test looking for one effect, then look at the same data to see if there are any other effects that might be in there, because chances are, random chance will make it look like some effects exist.
1
@LTJ
Columbus didn't find India. Locating the New World was moving the target so... what?
28% seems pretty useful in such a short term study. Maybe heart attacks can be prevented in less time than strokes...
My dermatologist said V D deficiency has been linked to skin cancer. This isn’t mentioned in the article. Also, you make less in your skin as you age.
8
I would think most women who take vitamin D do so to aid the absorption of calcium. If you want a magic bullet for cancer, start by choosing your parents wisely.
12
@Chip sorry, the last time i checked, parents are none refundable or exchangeable. But did you mean your partners instead of parents?
1
@dchow
I believe Chip was choking.
@Tim
Paging Doctor Heimlich!
1
What I took from this study when I read about it yesterday at another venue is that fish oil was extremely effective in reducing cardiovascular events for people who might otherwise not eat fish - like vegetarians.
I know personally that I've watched my LDL/HDL ratio normalize since I began taking taking a single fish oil capsule containing a moderate amount of DHA-EPA every day.
10
@Matthew Carnicelli
>>fish oil was extremely effective in reducing cardiovascular events for people who might otherwise not eat fish - like vegetarians.<<
Most vegetarians will eschew fish oil capsules as well as fish. The oil comes from animals, right?
I'm a longtime vegetarian and now a vegan, for the most part (serious but not religious about it). For my heart health, I would sooner eat a fish I can see with my own eyes is [x ] species (presumably sustainable - I'd research it) than pop fish oil capsules full of who knows what poor creatures, caught who knows where.
Unless you are dangerously malnourished, supplements are not nearly as good as whole foods.
1
Read an account of what seems to be the same study in the Cleveland Plain Dealer (from WP) yesterday. Results were almost the exact opposite. ???
3
What appears to be more important than omega 3 supplementation is the ratio of omega 3 to omega 6 foods that we eat in our diet. Historically, hunter-gatherers consumed a 1:1 ratio while the agricultural revolution increased that to 1:2. With processed foods, not surprisingly, that ratio for a typical American has risen to 1:25. It is virtually impossible to eat enough omega 3s to lower the ratio (one estimate is that you would have to eat 17 cans of sardines daily!). The best advice is to stop consuming processed foods and thereby lower the ratio by lowering the omega 6 consumption.
10
In the case of fish oil for "major cardiovascular events", the rate among people receiving fish oil was 8% less than among those receiving placebo. Major medical problems are fairly rare in a healthy population: there were few enough that if the effect were anywhere from 20% lower risk to 6% higher, the number observed could still show up by random chance.
What's weird is that this 8% observed decrease is presented as though it were absolute proof of an exactly 0% effect, instead of as merely inconclusive. Fish oil is cheap enough, and major medical events are expensive enough, that many people would consider an 8% decrease to be worth it.
10
@dsws
Dr Rosen seemed determined not to find anything positive in the results. Interestingly, this news was given a different slant in the Washington Post two days ago. Same numbers, but with more emphasis on the benefits that were seen.
12
Unfortunately, five years is too short a time for effects to manifest themselves. In addition, supplements can help, but a good diet is more important.
4
"As for vitamin D and omega-3’s effects on other conditions, stay tuned. The researchers expect to publish additional findings about diabetes, depression, autoimmune disorders and cognitive function over the coming months, Dr. Manson said."
Indeed. There are enough conditions or illnesses which inhibit natural absorption of Vitamin D and which require therefore extra doses. And this might be critical as one gets older and fractures (Osteoporosis) become a greater danger.
8
It sounds like Dr. Rosen from Maine, needs to read the rest of this article, where the study finds a 28% reduction in heart attacks with fish oil, putting its effectiveness along side statins (which are harmful to humans). Also, this study included just 1,000 mg fish oil per day. That is about 1/3 of what most people who are serious about fish oil are taking. Its also nice to remember that no one said Fish Oil prevents heart attacks, before this study said so, it is very helpful to the brain. The brain is 60% fat, the same fats in fish oil.
27
@Gerry Yes, good points. And the study on Vit D was 2000 milligrams. I’ve seen recommendations in the 25k - 50k area from holistic doctors. So, this study used what could be considered non-therapeutic doses. It will be look at as useless and a waste of a great opportunity had the study been constructed differently.
7
@MichaelT
Vitamin D was 2000IU, which is equal to 50 MICROgrams.
This is a low dosage. It increased vit D blood levels from 30 to 40 ng/mL. Thats not enough to have large effects.
Not mentioned is the fact that vitamin D reduced cancers deaths by 37% in the final 3 years of the study. This is a huge result!
the rate of death from cancer was significantly lower with vitamin D than with placebo (hazard ratio, 0.79 [95% CI, 0.63 to 0.99], and hazard ratio, 0.75 [95% CI, 0.59 to 0.96], respectively). In analyses restricted to 153 deaths from cancer in patients with medical records or other adjudication of the cause of death beyond the NDI coding, the hazard ratios were 0.72 (95% CI, 0.52 to 1.00) over the total follow-up period and 0.63 (95% CI, 0.43 to 0.92) after the first 2 years were excluded
8
@Gerry
Fish oil supplements may contain mercury. Mercury is bad for the brain. Humans have so polluted oceans and waterways that our bodies now contain toxins that were absent in the bodies of our grandparents. Americans have to be over 60 to be able to remember what chicken or beef could taste like. Now you have to disguise the taste with condiments.
2
Not all vitamin D and fish oil supplements are created equal. I wonder what type of supplements were used. Studies like this are difficult to determine a positive correalation due to our different metabolisms; some people may require high levels of supplements to get adequate levels.
It's disappointing the study didn't control for these confounding factors. or maybe they have I have yet to read the full study.
3
@Woodley
They stated they used Omacor/Lovaza which is pharmaceutical grade fish oil and sold by prescription. I think if is very high quality omega 3 supplementation. They also stated D3 which is better absorbed than D2 but, to you point, I don't know about the overall purity/quality of the brand.
2
@Woodley click the link to the actual article, they give the details you mention.
2
Vitamin D reduced death from cancer by 37% when first two years of the study are excluded. This was a statistically significant result.
Excluding the beginning portion of a study is standard practice in long term experiments. This is because it takes a while for the intervention to have an impact. At the beginning, the intervention does nothing.
The NTY reporting on this study is highly misleading.
Quote;
the rate of death from cancer was significantly lower with vitamin D than with placebo (hazard ratio, 0.79 [95% CI, 0.63 to 0.99], and hazard ratio, 0.75 [95% CI, 0.59 to 0.96], respectively). In analyses restricted to 153 deaths from cancer in patients with medical records or other adjudication of the cause of death beyond the NDI coding, the hazard ratios were 0.72 (95% CI, 0.52 to 1.00) over the total follow-up period and 0.63 (95% CI, 0.43 to 0.92) after the first 2 years were excluded
17
The headlines says one thing, but the article says another. Vit D lowers your risk of cancer after taking it for two years. Fish oil lower the risk of heart attack by 28%.
Then the article says just eat fish.
Media propaganda at its best.
It also does not say how much it lowers the risk of cancer in 2 years. Was it 50%? More? Less?
Perhaps a higher dose would’ve worked better. 2000 IU’s is still a relatively low amount. What were the blood levels and the end? 50 ng/L would be a healthy level according to the latest research. You need higher doses to get there depending on your weight.
Perhaps the cancer rates would have dropped even more over 5 to 10 years.
Another horrible study put out by the medical history.
16
@Trace Farley
The vitamin D increased blood levels from 30 to 40ng/mL. Not a large enough increase to see strong effects, IMO.
Cancer death was reduced by 37% in the final 3 years of the study. But NYT didnt mention that!
3
I can’t piece any of this article together to match the headline. How can fish oil be ineffective with the following quote from the article? I think the same will be found with Vit D. Something seems extremely skewed with these studies and the follow up reports:
“But she said another analysis looking separately at heart attack found a 28 percent reduction among those taking fish oil, with a 40 percent reduction in people who eat little fish and a 77 percent reduction in African-Americans. She said the 28 percent reduction was “pretty amazing. That’s what you see with statins.”
32
First of all, I don't see the approach that scientists view both cancer and heart disease as multi-factorial diseases, One component of nutrition is not a "miracle drug", and I think expecting some miracle prevention from vitamin D or omega-3 fats is a wrong approach.
Nowadays scientists view atherosclerosis as " inflammation of artery as a result of long and complex events with the artery including some autoimmune factors", saying "This chronic inflammation may start early in life and be perpetuated by classic atherosclerosis risk factors." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3984678/
On the other hand, a group of scientists led by Dr. Thomas Seyfried of Boston College view "cancer as mitochondrial metabolic disease, not a gene mutation disease", saying "Emerging evidence indicates that cancer is primarily a metabolic disease involving disturbances in energy production through respiration and fermentation. The genomic instability observed in tumor cells is considered downstream epiphenomenon of the initial disturbance of cellular energy metabolism. The disturbances in tumor cell energy metabolism can be linked to abnormalities in the structure and function of the mitochondria." "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3941741/
Both diseases seems to be caused by long (not 5 years) and complex causes after all.
6
Roni Caryn Rabin dropped the ball on this one.
Washington Post coverage of the same study:
"Fish oil drugs protect heart health, two studies find"
"Researchers followed nearly 26,000 people for a median of more than five years. The results suggested that people given the drug were 28 percent less likely to have heart attacks than those given a placebo and 8 percent less likely to have a variety of cardiovascular events."
http://www.washingtonpost.com/national/health-science/fish-oil-drugs-protect-heart-health-two-studies-say/2018/11/10/bcdf0f52-e442-11e8-b759-3d88a5ce9e19_story.html
62
I am confused now. The first half of the article makes it look like a waste of time, and the second-half looks like there may be some benefit.
20
Readers are rightfully asking why some reports are calling the study negative, while others are touting a new miracle, "as effective as statins.
Here's what happens: when scientist design a study, they choose an outcome to examine, like less heart disease. Suppose I do a study to try to show that when I flip a coin 10 times on my new drug, heads will predominate. Then the findings show there was no effect; the study was negative.
Researchers then engage in what is known as post-hoc analysis, also known as "data dredging." They look for associations that were not part of the original hypothesis. For example, I might find that my first three coin tosses were all heads, so my drug worked in early testing. The problem with this kind of analysis, is that the finding may have occurred by chance alone. Maybe fish oil worked on people born on Tuesdays.
Post hoc analysis showed that fish oil was effective in African Americans. This is interesting to know, but not considered statistically valid. It can be tested in a new trial designed to look at this hypothesis. Enthusiastic endorsement of these findings is irresponsible journalism. This article is balanced and correct. Good job NYT.
149
@Doctor thanks. Didn't understand.
6
@A Doctor
But a main endpoint (major cardiovascular events) did show an 8% reduction. That's small enough to be inconclusive. But it's not absolute proof that the real effect is exactly zero, which is how the article makes it sound.
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@A Doctor Sorry, Doc--but while I appreciate your effort to enlighten us as to secondary analysis, I don't think it's consistent to say that omega 3's do not reduce major cardiac events and at the same time say that omega 3's reduced heart attacks.
Maybe there's a difference between major cardiac events and heart attacks, but I tend to think that heart attacks are the worst kind of major cardiac events. If omega 3 takers have the same number of major events, but fewer of those major events are heart attacks, that sounds like a benefit.
I don't understand why heart attacks weren't considered a study end point. It's not like they discovered that omega 3's reduced the heartbreak of psoriasis or something.
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And yet the Washington Post has a different headline:
"Fish-oil drugs protect heart health, two studies say"
https://www.washingtonpost.com/national/health-science/fish-oil-drugs-protect-heart-health-two-studies-say/2018/11/10/bcdf0f52-e442-11e8-b759-3d88a5ce9e19_story.html?utm_term=.322aacd827d0
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The Washington Post’s article today was titled:
“Fish-oil drugs protect heart health, two studies say.”
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@Peter Silverman
Actually there are about 10,000 fish oil studies that conclude that fish oil is most likely beneficial.
The geniuses at harvard had no idea what they are doing with this study.
The dose of vitamin D (2000iu) was foo small. This low dose aill have little effect on vita in D levels.
Even so, the vitamin D supplementation was associated with 25% lower cancer mortality, and 25% lower cancer in black study subjects.
So the reporting about this study is as idiotic as the study design.
Way to go guys!
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What are you smoking author? A 28% reduction in heart attacks is significant. Read today's Washington Post they say the fish oil results provide evidence for a significant benefit !
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Why do they keep doing studies on fish oil caps when they should do the study with eating the actual fish. It isn't just the fish oil that is healthy but the interaction of other chemicals in the fish.
You can't take Vitamin C out of the orange and say that it's the healthy chemical when other chemicals interact in the orange to make us healthy. Eat the entire food not parts you think are good for you.
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All the mention of vitamin D and omega-3 supplements, but no talk of their natural sources; well at least for vitamins D. Vitamin D obtained from the sun is far superior to taking it in supplement form, and not all supplements are created equal.
You really think our ancient ancestors were taking vitamin D from supplements?
We make vitamin D much more effienctly from the sun; vitamin D processing is 100% when made from the sun. The same can not be said with supplements where just over half of vitamin D is absorbed. We also cannot get vitamin D toxicity from the sun because our bodies have a system of breaking it down. On the other hand, we can get vitamin D toxicity from ingesting supplements.
I'm no expert on this subject, but I do read and follow Dr. Rhonda Patrick through her FoundMyFitness podcast, which can be found on Youtube and on iTunes. She has published research on vitamin D and she goes into detail about vitamin D and vitamin D levels.
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WaPo reported just the opposite yesterday. This is what drives me crazy about health-related news. One day it’s one thing, the next day it’s the opposite...here, literally one day apart, I’m told precisely two competing results of these studies. Who should I believe?
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@Barbara
Copy and paste this link on Youtube:
The "Vitamin D Sweet Spot" and Its Relationship To Aging
Dr. Rhonda Patrick is a biochemist and expert on this topic and general nutrition and wellness.
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The more important study coming out of AHA this weekend was Reduce-It study findings, showing that prescription Vascepa (a purified form of fish oil) dramatically lowered risk of cardiovascular-related death, heart attacks, and stroke in at-risk cardiovascular population.
“Honestly, I’ve been doing clinical trials for a long time. And I’ve not been involved in a trial that has this much potential to improve the lives of perhaps tens of millions of people,” Bhatt said.
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If eating "little fish" offers a 40% reduction in heart attacks, then maybe I'll switch from salmon to sardines/anchovies.
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@John Booke
I appreciate your play on words, but you actually might be right for another reason (or two)!
Salmon tends to be from farms, therefore basically qualifies as a processed food, not a wild product, the way all fish used to be. Sardines and anchovies, however, are wild. They reproduce more quickly than salmon and are closer to being a sustainable wild fishery. Their oil is full of omega-3 fatty acids, great for us.
That all said, we could all benefit by cutting out the middleman (middle fish) by eating the algae - seaweed - that the fish eat in order to get those oils. That would really ease up on fish populations and allow more equitable sharing of good dietary sources (not everyone can eat fish, and we would hardly want 7+ billion humans to try doing so).
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A high percentage of food in stores is vitamin fortified. So supplements are not good to take unless recommended by a doctor, but the same supplements are good for you, if industry adds it to your food. White rice is fortified and brown is not so that label readers think the white is better. Perhaps people would buy brown rice that has been fortified, hard to say until that make it and put it on the shelf. What I am trying to point out the mixed message of supplements vs fortified foods. So many articles about how supplements are useless, but fortified foods get little scrutiny. I believe fortified food labels have, perhaps unintentionally, promoted the consumption of supplements.
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@Sutter, in my opinion, eating foods fortified with vitamins is no different from taking a supplement -- except that I can control the amount in a supplement, if I want to take one. But since I avoid processed foods, eating plant based whole foods, I don't get vitamins from fortified "food," I get them from whole foods. Vitamin D3 from the sunlight -- and sunlight has beneficial effects beyond simply making D3. I do take a vitamin B12 supplement, since I am older and don't eat animal products, both of which can contribute to deficiencies.
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@Sutter
Vitamin D is not useless. The NYT reporting is wrong.
Vitamin D reduced cancer deaths by 37% in the final 3 years of the study.
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There are many types of fatty acids from both plant and animal sources. Who knows, perhaps studies like this did not measure the right one. Or maybe it's a combination of them that provides the health benefits. If any of these possibilities were true, the best thing to do would be to eat a balance of healthy plant and animal food such as fish. Again, why take a pill when good foods supply it all?
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@Emergence
Its practically impossible to obtain enough vitamin D from food soirces. UV exposure or supplements are necessary.
And in most of the USA, the sun does not provide sufficient UV for vitamin D production about 4-6 months of the year.
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28 percent reduction in heart attack. Yup, that's ineffective. Considering one gram a day of fish oil is a pretty puny dose, I would say that is amazing. It is clear that the study, by using such a small dose was designed to fail and clearly shows a bias by the researchers. No wonder they chose to ignore the positive result and declare fish oil ineffective.
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@Alan
In the final 3 years of the study, vitamin D reduced cancer deaths by 37%!
Vitamin D works. This NYT article is false and misleading.
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@Alan The article did a bad job explaining this, but secondary analysis are extremely unreliable. It suggests something worth testing. However, if prior results in heart attack prevention have not been so positive--as I believe is the case, this result is likely an artifact.
3
"Secondary analysis of the data found, for example, a reduction in cancer deaths for people who took vitamin D for at least two years, and fewer heart attacks in people who took fish oil. And people do need vitamin D in order to absorb calcium and for other bodily functions."
Indeed 28% reduction(77% for blacks) in heart attack ,is as stated here, similar to statins.
How is this reported as "ineffective" and a different ,perhaps more harmful statin,advocated for nearly everyone?
The headline is a public disservice and not supported by the articles content
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@Mike P Perhaps it is because the drug companies make more money selling statins.
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@Mike P
The key here is "secondary analysis." Their original hypothesis was not supported by the data. They then went back to look for associations that were not part of the original study design. "Look, it worked in people with red hair!"
I tried to explain this in my (perhaps clumsy) post. Feel free to read it and see if it makes sense.
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@Mike P - My thoughts, precisely. Those data compare favorably with expensive pharmaceutical statins, and with no apparent risks that statins produce.
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A 28% decrease in heart attacks with no serious side effects sounds pretty good to me.
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@Peter Silverman
Fish oil can contain mercury. So can fish. Moderation and quality of the product is the key to safe consumption.
That's a promising lead. However, secondary analyses aren't particularly reliable. This report isn't clear, but it likely means that someone looked through the results after the fact for potentially interesting differences and that the study was not designed to pick up such an effect. There will have to be a new study to see if that's real.
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@an observer Yes, it can. If one is taking fish oil supplements, make sure that it is "molecularly distilled". That process removes any mercury or other contamination. If it doesn't say that on the bottle, either don't buy or contact the manufacturer to confirm.
4
Science like politics are very much based upon whos funding and desired result. Unless these studies where life long or at least 10-20 year studies then there is no true findings also the control group to fnd so many people with same genome type blood type pre-existing conditions for a stable test group and stable control group there is no real scientific finding there is simply another scientists opinion in test form based on as i said before who is funding and desired report. Ive done hollistic healing for 7 years now and have seen these findings disproved in person by doctors after appropriate treatment the other problem with study is source of omega 3 lack of omega six which is neccesary for the body to produce omega 9 and also type and solubility of the d supplement most market products today do not even break down as they should there just knock off something close because vitamins supplements like medicines and all other gimics, to find real is not easy nor based on price.
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I am always a little disappointed when articles like this one are published to guide Americans on an endless quest for health-enhancing nutraceuticals like omega-3 fatty acids or vitamin D that, taken as a capsule (as opposed to eating the right foods) will significantly improve an otherwise healthy or unhealthy diet.
If you are eating healthy, like a Mediterranean diet, you don't need fish oil supplements or vitamin D unless solid clinical data show benefits for specific diseases or genetic disorders.
If you are eating an unhealthy diet, no amount of dietary supplements will help you unless you are suffering from rickets or scurvy. Go with what science has already proven; the benefits of a healthy diet and regular exercise.
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@Emergence, I am not sure why this information would disappoint you, it makes exactly the same point as you do, namely eat a healthy diet and follow a healthy lifestyle, rather than seeking special benefits from supplements that for most people are a waste of money, and, in the case of fish oil, are greatly depleting the oceans of the planet of the base of the food chain.
Whether the information gained from the study supports or fails to support the use of a particular supplement, it is a valuable addition to medical knowledge, it was a carefully performed, prospective, double-blind, placebo-controlled trial, carried out over 5 years. We should all be happy that we now have this knowledge to help guide us in our dietary and lifestyle choices.
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