Some amusing medical news

One of the enduring myths among health freaks is the magical power of fish oil.  There has however always been a lot of doubts about that among medical researchers so there have been many studies looking into the matter.  The latest review of the medical literature knocks the whole thing on its head.  The article concerned is hidden behind a fierce paywall but I think it is too amusing to stay only there.  So I am reproducing the abstract below.  Reproducing abstracts is not generally considered a breach of copyright.  The abstract was in fact sent to me by JAMA so I infer that they want the findings to be known in professional circles

Fish Oil Supplements

Long-chain omega-3 polyunsaturated fatty acids (PUFAs), which are present in cold-water fish such as herring or salmon and are commercially available in capsules (over the counter and by prescription), can decrease fasting triglyceride concentrations 20-50% by reducing hepatic triglyceride production and increasing triglyceride clearance. 1 With long-term intake, they may increase HDL-C.

Efficacy

The results of recent studies do not offer any convincing evidence that fish oil supplements either prevent cardiovascular disease or improve outcomes in patients who already have it. 2 3

Lovaza (formerly Omacor), a combination of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), was the first omega-3 PUFA product to be approved by the FDA for treatment of severe hypertriglyceridemia (Table). Daily doses of 3-12 g can lower triglycerides by 20-50%, but have not been shown to prevent pancreatitis, which is a major concern in patients with very high triglycerides. Vascepa, the second FDA-approved omega-3 PUFA product for treatment of severe hypertriglyceridemia, is the ethyl ester of EPA. In controlled trials, it has reduced triglyceride levels by 22-33% compared to placebo. 4

Adverse Effects

DHA can increase LDL-C levels, but EPA apparently does not. Fish oil supplements are generally well tolerated. Adverse effects have included eructation, dyspepsia, and an unpleasant aftertaste. Worsening glycemic control has been reported in diabetic patients taking large doses. Fish oil in large doses can also inhibit platelet aggregation and increase bleeding time; whether it could cause clinically significant bleeding has not been established.

Conclusion

Omega-3 polyunsaturated fatty acids can lower high plasma triglycerides, but they have not been shown to decrease the risk of pancreatitis. The results of recent studies do not offer any convincing evidence that fish oil supplements prevent cardiovascular disease.

From The Medical Letter on Drugs and Therapeutics

JAMA. 2014;312(8):839-840. doi:10.1001/jama.2014.9758.  Adapted from "Drugs for Lipids." Treat. Guide Med. Lett. 2014;12(137):1-6.


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