Taking fish oil or vitamin D? Great research gives long-awaited answers to who does and does not use these popular nutrients.
Fish oils taken by healthy people at many doses in food supplements did not demonstrate a clear ability to reduce cardiovascular or cancer risk. For the same vitamin D.
But larger amounts of purified, prescription fish oil were cut into heart problems and heart attacks for deaths in humans with high triglycerides, a blood lipid and other cardiovascular risks. Doctors picked up results and said they could propose a new treatment option for hundreds of thousands of patients like these.
Up to 10 percent of American adults take fish oil. Even more vitamin D is still, despite major studies that support many health claims presented to it.
"Those who sell it make it all the best," but in this final test, vitamin D did not show anything, "said Dr. James Stein, a specialist in Wisconsin-Madison University, who had no role in research or bundling.
The results were unveiled at the American Heart Association conference in Chicago and published at the New England Journal of Medicine.
These oils, also called omega-3 fatty acids, are found in salmon, tuna and certain other fish. They reduce triglycerides and inflammation and may have other effects. There are different types, such as EPA and DHA.
In one study, 4 grams of Amarin Corp.'s Vascepa concentrate on EPA was tested in over 8,000 patients with high triglyceride and higher risk of heart for a variety of reasons. Everyone had already used a statin such as Lipitor or Zocor to lower cholesterol. Half the spruce and the rest, mineral oil capsules for comparison.
After five years, about 17 percent of patients in Vascepa had suffered from one of these problems – heart attack, stroke, cardiac death or blocked arteries requiring medical treatment – compared to 22 percent of the other.
This succeeded in reducing the risk by 25%. Individually speaking, heart attacks, cardiac deaths and strokes all were lower with Vasconan. Only 21 people would need to take Vascepan five years to prevent one of the most important problems – cheap coefficients, Stein said.
Undesirable effects may be of concern: Vasconese hospital treatment for several people is irregular heart beat – 3% compared to 2% of the control group. Doctors say this is confusing because other studies show that fish oil lowers the risk.
The problem with heart rhythm is that it can increase the risk of stroke, but Vascepa's patients had fewer strokes, said Dr. Deepak Bhatt Brigham, a researcher at the Boston Women's Hospital.
Vascepa costs about $ 280 a month; many insurers cover it. Amar sponsors the research, and some study managers work or negotiate with the company.
In the second study, a lower daily dose of 1 grams of different fish oil – the EPA / DHA combination sold in the Lovaza or Omacor and in generic form – was tested for 26,000 people without previous heart disease or cancer.
About five years later, syndromes, stroke and other problems were similar to fish oil users and comparator groups. Reports and Deaths were also similar.
The fish oil group had fewer heart attacks – 145 against the control group 200. The research director, Dr JoAnn Manson in Brigham and Women, called "significant benefits", but several independent experts disagreed on how the study was set up to monitor this and certain other results.
"These findings are speculative and should be strengthened in a separate study," said Dr Cleveland Clinic Dr. Steven Nissen.
Both studies have the same problem: oils used for control groups, which may not have been properly located. Vascepan's study used mineral oil that disrupts statins, increases cholesterol, and lowers the comparator's price and makes Vassepan look better than it really was.
Another study used olive oil that could have helped the comparator better, possibly covering all the benefits of fish.
The leaders of both studies said that the effects of comparative oils are not enough to change the most important results and are agreed by independent experts. But Nissen, who leads a new fish oil research, uses the corn oil in comparison.
Manson's study also tested vitamin D, which the skin makes in sunlight. It is difficult to get enough food, such as milk, eggs and greasy fish, even though many foods are now being established. Some studies have shown that lower level D patients are more likely to develop cancer, but it is not known whether these risks would be supplemented.
The study involved 2,000 international units D-3 (the most active form of vitamin D, also known as cholecalciferol) or fake vitamin supplements for five years.
Vitamin D was unlikely to affect the heart attack or stroke or the development of cancer. After the first two years of use, researchers found fewer cancer deaths in 112 and 149 placebo groups.
"Cancer can take years to develop", so the difference may not be apparent right away, Manson said. "This looks promising," and people are being studied longer to see if the trend is rising, he said.
Several other experts said that these numbers only refer to potential benefits that need more research.
"These" positive "results have to be interpreted cautiously," Dr. Clifford Rosen of the Maine Medical Center Research Institute and Dr. John Keaney Jr. from the University of Massachusetts wrote in a medical journal.