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May 17, 2014 · 3:28 AM

Supplemental Omega-3 Fats’ Effect on Heart Disease, Stroke, Cancer, and Death: No Relationship In a General Population

Salmon is one the the cold-water fatty fish loaded with omega-3 fatty acids

I’ve been sitting on this research report a few years, waiting until I had time to dig into it. That time never came. The full report is free online (thanks, British Medical Journal!). I scanned the full paper to learn that nearly all the studies in this meta-analysis used fish oil supplements, not the cold-water fatty fish the I recommend my patients eat twice a week.

Here’s the abstract:

Objective: To review systematically the evidence for an effect of long chain and shorter chain omega 3 fatty acids on total mortality, cardiovascular events, and cancer.

Data sources: Electronic databases searched to February 2002; authors contacted and bibliographies of randomised controlled trials (RCTs) checked to locate studies.

Review methods Review of RCTs of omega 3 intake for 3 6 months in adults (with or without risk factors for cardiovascular disease) with data on a relevant outcome. Cohort studies that estimated omega 3 intake and related this to clinical outcome during at least 6 months were also included. Application of inclusion criteria, data extraction, and quality assessments were performed independently in duplicate.

Results: Of 15 159 titles and abstracts assessed, 48 RCTs (36 913 participants) and 41 cohort studies were analysed. The trial results were inconsistent. The pooled estimate showed no strong evidence of reduced risk of total mortality (relative risk 0.87, 95% confidence interval 0.73 to 1.03) or combined cardiovascular events (0.95, 0.82 to 1.12) in participants taking additional omega 3 fats. The few studies at low risk of bias were more consistent, but they showed no effect of omega 3 on total mortality (0.98, 0.70 to 1.36) or cardiovascular events (1.09, 0.87 to 1.37). When data from the subgroup of studies of long chain omega 3 fats were analysed separately, total mortality (0.86, 0.70 to 1.04; 138 events) and cardiovascular events (0.93, 0.79 to 1.11) were not clearly reduced. Neither RCTs nor cohort studies suggested increased risk of cancer with a higher intake of omega 3 (trials: 1.07, 0.88 to 1.30; cohort studies: 1.02, 0.87 to 1.19), but clinically important harm could not be excluded.

Conclusion: Long chain and shorter chain omega 3 fats do not have a clear effect on total mortality, combined cardiovascular events, or cancer.

Reference: Hooper, Lee et al. Risks and benefits of omega 3 fats for mortality, cardiovascular disease, and cancer: systematic review. BMJ 2006;332:752-760 (1 April), doi:10.1136/bmj.38755.366331.2F (published 24 March 2006).

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Filed under coronary heart disease, Diabetes Complications, Fat in Diet, Fish, Heart Disease, Longevity, Stroke

Tagged as cancer, cardiovascular disease, death, fish oil supplements, Lee Hooper, longevity, omega-3 fatty acid supplements, omega-3 fatty acids, stoke, systematic review

June 24, 2011 · 2:00 AM

Finally Settled: Alcohol Consumption Linked to Lower Rates of Death and Heart Attack

Canadian and U.S. researchers report that moderate alcohol consumption seems to reduce 1) the incidence of coronary heart disease, 2) deaths from coronary heart disease, and 3) deaths from all causes. Reduction of death from all causes is a good counter-argument to those who say alcohol is too dangerous because of deaths from drunk driving, alcoholic cirrhosis, and alcohol-related cancers such as many in the esophagus.

Remember, we’re talking here about low to moderate consumption: one drink a day or less for women, two drinks or less a day for men. That’s a max of 12.5 grams of alcohol for women, 25 g for men. No doubt, alcohol can be extremely dangerous, even lethal. I deal with that in my patients almost every day. Some people should never drink alcohol.

The recent meta-analysis in the British Medical Journal, which the authors say is the most comprehensive ever done, reviewed all pertinent studies done between 1950 and 2009, finally including 84 of the best studies on this issue. Thirty-one of these looked at deaths from all causes.

Compared with non-drinkers, drinkers had a 25% lower risk of developing coronary heart disease (CHD) and death from CHD. CHD is the leading cause of death in develop societies.

Stroke is also considered a cardiovascular disease. Overall, alcohol is not linked to stroke incidence or death from stroke. The researchers did see strong trends toward fewer ischemic strokes and more hemorrhagic strokes (bleeding in the brain) in the drinkers. So the net effect was zero.

Compared with non-drinkers, the lowest risk of death from any cause was seen in those consuming 2.5 to 14.9 g per day (one drink or less per day), whose risk was 17% lower. On the other hand, heavy drinkers (>60 g/day) had 30% higher risk of death.

In case you’re wondering, the authors didn’t try to compare the effects of beer versus wine versus distilled spirits.

On a related note, scientists at the Medical University of South Carolina found that middle-aged people who took up the alcohol habit had a lower risk of stroke and heart attack. Wine seemed to be more effective than other alcohol types. They found no differences in overall death rates between new drinkers persistent non-drinkers, perhaps because the study lasted only four years and they were following only 442 new drinkers.

This doesn’t prove that judicious alcohol consumption prevents heart attacks, cardiac deaths, and overall deaths. But it’s kinda lookin’ that way.

Steve Parker, M.D.

References: Ronksley, Paul, et al. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. British Medical Journal, 2011;342:d671 doi: 10.1136/bmj.d671