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Many people routinely take nutritional supplements, such as vitamin D and fish oil, in the hope of preventing major killers such as cancer and heart disease.
However, evidence of the possible benefits of the additives is mixed.
Now, a long-awaited research funded by the government, it has provided some of the clearest evidence of the usefulness of taking supplements. And the results – published in two papers – are mostly disappointing.
"Both trials were negative," says Dr. Lavrence Fine, Head of the Clinical Program for the Application and Prevention of the National Institute of Heart, Lung and Blood, part of the National Institute of Health, which financed the studies.
"All in all, they have shown that neither fish oil nor vitamin D actually have reduced the incidence of heart disease or cancer," Fine says.
The results were presented at the American Association for Heart Association in Chicago and were published on Saturday in the journal New England Journal of Medicine. One article was focused on replenishing vitamin D and the other on fossil oil.
Nearly 26,000 healthy adults aged 50 years or more without a history of cancer or heart disease who participated in the VITAL research project took part in the trials. Twenty percent of participants were Afro-American.
Some of the participants took either 1 gram of fish oil – containing omega-3 fatty acids – plus 2,000 international vitamin D units per day. Others consumed the same dose of vitamin D plus placebo, while others consumed the same dose of fish oil plus placebo. The last group took two placebos. After more than five years, researchers were unable to find any general benefit.
While overall results were disappointing, it seems to be a positive effect when it comes to one aspect of heart disease and fish oil: heart attacks.
Secondary analysis has shown that taking fish oil reduces the risk of heart attack by about 28%, which is a "statistically significant" finding, says JoAnn Manson, Head of Preventive Medicine at Brigham and Boston Women's Hospital. She was investigating.
Those who seemed to have the most benefits were people who do not usually eat a lot of fish in everyday diet, as well as African Americans, says Manson.
African Americans in the study had a 77% lower risk of heart attack compared with taking placebo, a "dramatic reduction," says Manson. Further research is needed to confirm these findings, she added, but "in the meantime, it would be sensible for African Americans to talk to their healthcare professionals about whether they can be candidates for taking fish oil supplements."
In an editorial published in Nev England Journal of Medicine, John F. Keanei and Dr. Clifford J. Rosen take into account some of the studies in the study and write that positive findings on a heart attack and African Americans and people who do not eat a lot of fish should be treated with caution.
There were no serious side effects, such as bleeding, high blood calcium or gastrointestinal symptoms found with any supplements.
Manson and her colleagues plan to further analyze their data and look for possible links between vitamin D and fish oil and cognitive function, autoimmune diseases, respiratory infections and depression. Previous research suggests that add-ons can have some benefit for these conditions.
In the meantime, a NIH official Lavrence Fine says, do not throw your fish oil and vitamin D.
"At this point, if you're thinking about supplements, or omega-3s or vitamin D, talking to your doctor or healthcare professional is the next step," says Fine.
Fine and Manson stressed that vitamins D and omega-3 fatty acids found in fish oil are important nutrients, but that it's the best way to get them as part of a well-balanced diet. This involves feeding fatty fish such as sardines, tuna and salmon, and vitamin D-fortified cereals, milk and orange juice.
The second study presented at the same meeting examined whether a substance derived from a fish oil component, known as icosapent ethyl, can reduce unwanted events among people who already have cardiovascular risk factors, such as curing arteries, diabetes or high blood fats such as triglycerides.
All in all, this study found that a 25 percent reduction in risk for patients taking extract. These patients were less likely to die of heart disease, stroke, or stroke, hospitalized due to chest pains or necessary procedures such as angioplasty, stenting or bypass surgery, the researchers reported.
"We report an exceptional degree of risk reduction," says Dr. Deepak Bhatt, who led the study and a cardiologist at Brigham and Women's Hospital.
The study, which was also a random clinical trial, followed the participants for an average of five years. The volunteers took icosapent ethyl, sold under the brand of Vascepa and was developed by the Amarin Corporation which was funded by Bhatt's research.
The product is available by prescription only for patients with high triglycerides. But it is expected that the company will submit a request for FDA approval within the next year to expand the treatment and include all high-risk cardiovascular patients. [Copyright 2018 NPR]
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