
Popular fish oil study deeply flawed, new research says - fraqed
http://www.cbc.ca/news/canada/ottawa/popular-fish-oil-study-deeply-flawed-new-research-says-1.2637702?cmp=rss
======
dredmorbius
First, a headline relevancy rant: the headline here is both vague and
misleading. "Researcher: 1970s Inuit heart disease fish oil study flawed"
maintains the word count of CBC's article while conveying far more
information. The headline as chosen is akin to a headline in a Poughkeepsie,
NY, newspaper headline "3 killed in house fire" ... where the fire in question
turns out to have been in Osaka, Japan. A human tragedy, yes. Likely highly
relevant to most in Poughkeepsie? No. Would those with friends or relatives in
Osaka be better served by the more accurate headline? Yes. As given the
headline is linkbait -- it fails to provide sufficient context to determine
whether or not the article is worth reading.

Fish oil has been tied to multiple benefits, not just heart disease. Claiming
a blanket lack of efficacy for fish oil supplementation presumes that 1) there
is no heart disease benefit (all we know is that there are methodological
errors in the Inuit study) and that there are no other health reasons for
supplementing with fish oil. From the Wikipedia article, identified (all
specifically tied to studies).

• Cancer

• Cardiovascular

• Hypertension

• Mental health

• Alzheimer's disease

• Lupus

• Psoriasis

• Pregnancy

~~~
spikels
A study or even a few does not prove anything. There are just too many ways to
get it wrong. You need multiple high quality studies that all agree before you
can be sure. And even then a small chance will remain that it is a statistical
mirage that will be disproven by a future high quality study. Sorry to let you
down but that is the nature of medical research.

~~~
dredmorbius
My point isn't that the claims are all proven. I was pointing out that the
Wikipedia claims _are_ sourced to actual research papers, rather than some
random blog (or worse: some random supplement sales site).

What this addresses is TFA's claim that fish oil has no benefits based on an
analysis of _one_ study concerning _one_ claimed benefit. That claim is just
as unsubstantiated as it claims the Inuit study benefits are.

~~~
virtue3
the article focuses on the cardiovascular benefits... which appear to have
been self-propagated by some adhoc "because x study says it helps!" without
anyone doing critical thinking on their own part.

Unfortunately it isn't apparent that that is the the focus until you look at
where the article is hosted. So I'll vehemently agree with your initial
observation that the original title is link-bait at best.

There are many studied and documented benefits of fish oil. This hardly "puts
a nail in the coffin" for the supplement but hopefully it gets people thinking
and some more studies funded so we can get a better picture.

Of course if our food just had a better omega-3 :omega-6 ratio we'd be in a
situation where the supplement wouldn't be the necessary...

------
bcebulla
There is a 20,000 person 2x2 randomized controlled trial underway right now
looking at how useful fish oil is in preventing disease:
[http://www.vitalstudy.org](http://www.vitalstudy.org) Results will be out
around 2017-2020.

An observational study from the 1970s and a critique of an observational study
from the 1970s will carry little merit compared to a 20k RCT.

Knowing that we'll have better data in 5 years, the comment by the researcher
is nauseating: "They simply don't do anything for you. The people should know
that it doesn't help to prevent heart disease." Since we haven't quite reached
an apex in research in fish oil, the comment is short-sighted and is
overstating what we know about fish oil to date.

~~~
mikestew
Just because we might have better data sometime down the road does not make
the researcher's comment false. Assuming that the original study was flawed as
claimed, then we're left to conclude that fish oil is in fact snake oil until
we have evidence to the contrary.

~~~
bcebulla
The researcher's comment IS false based on the information we have available
to date. We do not know if fish oil is worthless or not. The researcher
implicitly states that he knows fish oil is worthless based on the evidence to
date, when the evidence to date is much more mixed.

The NEJM article in this thread is much better evidence -- a 13k RCT that
found no statistically significant benefit in 1g/day of omega 3s. On the other
hand, there was a large 11k trial in the 90s that did find benefit 1g/day of
omega 3s:
[http://www.ncbi.nlm.nih.gov/pubmed/10465168](http://www.ncbi.nlm.nih.gov/pubmed/10465168)

The VITAL study underway will be interesting. It's the largest trial to date
on fish oil and is looking at a healthy normal population, as opposed to those
with CVD or high-risk of CVD.

------
carbocation
There is a more recent popular fish oil study - a randomized, placebo-
controlled trial - showing that fish oil has no effect on CV mortality or
morbidity. It's in the New England Journal, no less.
[http://www.nejm.org/doi/full/10.1056/NEJMoa1205409](http://www.nejm.org/doi/full/10.1056/NEJMoa1205409)

~~~
digitalengineer
Fish oil or Snake oil? "One tiny brain-imaging study of fatty acids has been
used to endorse fish oil as education's magic pill"
[http://www.theguardian.com/commentisfree/2010/jun/05/bad-
sci...](http://www.theguardian.com/commentisfree/2010/jun/05/bad-science-
omega3-fish-oil)

Makes me think about people, science and the church. There is large decline in
the church and it's as though a "faith" in everything "science" has replaced
it.

~~~
bambax
Your comment is being unjustly downvoted.

It's not true that there's such a thing as "faith" in true science, since
science is the opposite of faith.

But I would agree that there's faith in "science" with quotes, ie science-
sounding pseudo-facts.

Food supplements can't be good; we should just eat real food that we cook
ourselves; everything else is going to do us harm.

~~~
1337biz
I was wondering what your thoughts are on
[http://slatestarcodex.com/2014/04/28/the-control-group-is-
ou...](http://slatestarcodex.com/2014/04/28/the-control-group-is-out-of-
control/) .

~~~
digitalengineer
Thank you for the interesting read. My first thoughts are of the Placebo
itself (as it's coming up in the first part). A bit off-topic, but the placebo
is often called sugar-pil _but its exact content is often not revealed_. It
can be full of harmful stuff and this causes the examined group to look much
better. "The control group experienced equal amounts of stomach aches" when
the placebo was laced with stomach ache inducing stuff!

About parapsychology as mentioned in your link: Personally, that stuff scears
the crap out of me. I just like to think there is more between heaven and
earth than we know...

------
zxcdw
> "The fish oil capsules I don't think will stand up to a critical review.
> They simply don't do anything for you," he said. "The people should know
> that it doesn't help to prevent heart disease."

This struck me. For example examine.com has[0] quite good coverage when it
comes to supplements like fish oil, and not surprisingly their round-up shows
multitude of benefits from fish oil.

Okay, perhaps the phrasing was altered to provoke and mislead the reader, but
still.

0:
[http://examine.com/supplements/Fish+Oil/](http://examine.com/supplements/Fish+Oil/)

~~~
spikels
You might want to look at the examine.com page more carefully. The only result
that is both significant (i.e. large effect) and robust (i.e. agreement in
lots of double blind studies) is a reduction of triglycerides. And that is an
indirect impact on health outcomes at best. The rest of the studies were
either for sub-groups (depressed people) or were insignificant, mixed
direction and/or not robust.

~~~
bdcs
The National Library of Medicine by the NIH makes it look pretty good. Them
saying "possibly effective for..." is quite the endorsement:
[http://www.nlm.nih.gov/medlineplus/druginfo/natural/993.html](http://www.nlm.nih.gov/medlineplus/druginfo/natural/993.html)

------
jblow
No surprise. Most "scientific" studies in the realm of medicine are bullshit.
Even many of the ones trying hard not to be bullshit still end up in that bin.
For a clear understanding of why, read this:

[http://slatestarcodex.com/2014/04/28/the-control-group-is-
ou...](http://slatestarcodex.com/2014/04/28/the-control-group-is-out-of-
control/)

~~~
md224
Do you think this attitude explains some of the epistemological issues behind
the anti-vaccine movement? I'm pro-vaccination, but I find it weird when
people mock others for not believing vaccines are safe and then go on to
criticize GMOs and the validity of nutritional studies. (Not saying you're
doing this at all, this is just a tangent.)

Of course, vaccine studies are probably way more rigorous and easier to
control than figuring out the complexities of nutrition, but it is a little
unsettling how easily doubt can metastasize. There's really no solution here
other than trying to spread scientific literacy and helping people understand
the rigorous testing of modern medicine, while also encouraging them to think
twice about the sensationalized studies they read.

~~~
chc
As far as I can tell, the epistemological origin of the antivax movement is
the human drive to find a reason for things that happen. There was never a
scientific basis. They latched onto one study that suggested a link between
vaccines and autism, but it's not like they had some sophisticated meta-
analysis that led them to believe that study was more reliable than others. It
just provided a narrative that gave them the answer they were seeking, while
the alternative did not.

There _could_ hypothetically have been a basis like the one you're talking
about, but it seems evident from the movement itself that this didn't happen
in our version of reality.

~~~
saurik
> There was never a scientific basis.

That's the point: that we have trained people to distrust science because most
of the "results" people are exposed to are bad popular articles reporting on
sketchy studies from Psychology and Medicine that tend to be "overthrown"
every few years: it is difficult to go to people and say "no, seriously:
vaccines work" when they can retort "that's what you said about red wine, and
just today I read an article about how that was all bunk... in another few
years everyone is going to be sorry they listened to you guys about these
vaccine things you all love so much". :(

~~~
eshvk
> That's the point: that we have trained people to distrust science

I am not sure science is an article of faith to be trusted or not. Science is
a continuous process of reviewing evidence and making hypothesis based on that
evidence. It is not a mathematical proof.

Sure, there are "bad popular articles" that describe causal relations
enthusiastically. However, the pipeline of bullshit flows backwards too. There
are enough research papers out there where results may not be fudged but over
enthusiastic language may be used that can to the layman's eye look like
magic.

~~~
saurik
Science is one part process and one part people: you first have to trust the
process to provide useful evidence, and you second have to trust the people to
tell you what they did honestly. Psychology and Medicine are "problem fields"
in both areas: the process itself runs into ethical challenges that result in
very few real "experiments" (leading to lots of correlations with difficult
hidden variables, nothing at all like "causal relations"), and the people
involved in the reporting process are also much more likely to blow things out
of proportion as these are areas of extremely broad interest.

The result is that when Geophysics says something important the general
populace doesn't believe them (hence why "trust" is the right word to be using
here) because their mental model of Science is built out of "scientists"
making lots of firm contradictory statements, and especially many situations
they remember where what was said just a few years ago was entirely
"overthrown" by the new research of the week. If you actually listen to the
people who refuse to believe in things like vaccines or climate change, they
seem to just think scientists are silly people who think they know more than
they actually do :(.

~~~
eshvk
> Science is one part process and one part people: you first have to trust the
> process to provide useful evidence, and you second have to trust the people
> to tell you what they did honestly.

I spent a few years in a heavy math PhD program before dropping out. The only
two things I learnt.

1\. Be skeptical of all statistics out there that you cannot personally
replicate.

2\. See 1.

The pressure to publish is real. The pressure to do something for the sake of
novelty is real. The process becomes shakier and shakier as we go down the
chain from Pure Math to Engineering and so on.

If there are Numerical Analysis papers with over 100 citations with basic
linear algebra errors (that was a fun fucking two weeks of head scratching),
why on earth would I trust the process somewhere downstream written by people
who took a few grad courses in statistics?

Note that I am not taking sides here. I have no interest in one or the other
part of the vaccine lobby. I just find it weird when people use terms best
left to religion like 'faith' when it comes to scientific research.

> If you actually listen to the people who refuse to believe in things like
> vaccines or climate change, they seem to just think scientists are silly
> people who think they know more than they actually do

I think the problem comes from misconceptions in the fundamental nature of
science. Scientists are not Gods who are bringing you truth from some mystical
truth well. It is a continuous process prone with errors that eventually
evolves into getting us closer to understanding processes. If people take that
as a sign that everything is junk instead of having a healthy skepticism and
reasoning for themselves, they have themselves to blame. Can't argue with
stupid.

~~~
md224
> It is a continuous process prone with errors that eventually evolves into
> getting us closer to understanding processes. If people take that as a sign
> that everything is junk instead of having a healthy skepticism and reasoning
> for themselves, they have themselves to blame. Can't argue with stupid.

A couple points:

1) The average person probably lacks the necessary background (knowledge of
statistics, methodological concerns, etc.) to independently evaluate
scientific research. So blaming them for not going and evaluating the research
themselves is a bit unreasonable.

2) You also have to realize that this is not an abstract question for new
mothers. When you're injecting something into the precious bundle of joy they
carried in their bodies for 9 months, asking them to trust the current
conclusions of a "continuous process prone with errors" is not going to be the
easiest thing. Accepting the scientific consensus, one which you yourself
admit is no magical source of truth, _is_ a leap of faith for these parents;
they're committing their child to a medical procedure based on that consensus.

And they _should_ take that leap of faith, in my opinion. But let's not
pretend like faith doesn't enter into the equation just because it's science.

~~~
eshvk
You make some fair points. I am not sure what the right answer then is. I
agree that the average lay person is probably not going to know how to reason
on these matters. However, if we are building faith as an abstraction, how do
we deal with the fact that the abstraction is leaky. There will be errors. How
do we communicate that the errors don't necessarily mean that the system as a
whole is broken but that it is the nature of the system, whilst maintaing this
abstraction of faith?

~~~
md224
It's definitely complex and may never be completely solved. The biggest thing
in my mind is learning how to talk to these people; if someone is trying to
make sense of competing opinions with no good standard to judge them by, going
up to them and saying "Fuck you idiot, clearly we're right and you're stupid
for thinking otherwise" is not productive (granted, this is a straw-man, but
some of the vitriol I've seen comes pretty close). You run the risk of
creating a serious blowback effect, where your condescension drives them
further away from accepting what you're trying to tell them.

It's like a Chinese finger trap: if you want to convince an anti-vaxer, you
can't treat them like they're crazy, even if you have an impulse to judge. You
have to be able to meet them halfway, and from that point get them to
understand the safety profile of vaccines. You don't have to throw numbers in
their face, but there has to be some way of speaking to them as a fellow human
being: "I know you're scared and you don't know if this is safe, but we don't
want your child being hurt either. We've done an incredible amount of testing
to make sure vaccines are safe, and we firmly believe they will keep your
child as healthy as possible, as well as improving the overall health of the
community."

Of course, this is just my opinion. But I really think that empathy will make
it much easier to mend these kinds of fissures in our beliefs.

~~~
eshvk
> if you want to convince an anti-vaxer, you can't treat them like they're
> crazy, even if you have an impulse to judge.

> You run the risk of creating a serious blowback effect, where your
> condescension drives them further away from accepting what you're trying to
> tell them.

This is exactly what I am coming from too. In my few years in the programming
community, one thing I have noticed is a large population of people who pursue
science as a religion. (I mentally tag them the r/atheism crowd.) When you
treat something as canon and go up on people's faces as to why they are stupid
and wrong, you are not creating a productive discussion.

------
timr
This is on top of mounting concerns that fish oil supplementation may actually
_increase_ a man's risk of aggressive prostate cancer:

[https://www.fhcrc.org/en/news/releases/2013/07/omega-
three-f...](https://www.fhcrc.org/en/news/releases/2013/07/omega-three-fatty-
acids-risk-prostate-cancer.html)

It's looking more and more like the prudent choice for men is to avoid fish
oil supplements.

~~~
niels_olson
The prudent course of action is to avoid anyone trying to sell you additional
calories. Fish oil being a prime example.

------
tpeng
Popular and consensus opinions in nutrition (including those ostensibly backed
by science) are overturned all the time. Just look at historical views on
saturated fat, GI, cholesterol, etc. etc. That's why the seemingly anti-
intellectual advice of "eat a variety of foods in moderation" is actually
quite good advice.

~~~
eshvk
> That's why the seemingly anti-intellectual advice of "eat a variety of foods
> in moderation" is actually quite good advice.

That is because it is vague, imprecise and can be defined whichever way you
want.

For example, how much protein should a person intake? 56 gms per day as per
the CDC. Other variant figures in the body building community include like
0.68 gms per kg to 2.5 gms per kg. So which figure does one use to establish
the definition of moderation? Genetic and cultural differences also come into
play. I have lived in cultures (Africa/Asia) where protein is expensive, eaten
less. If I went with that sociological perspective of moderation, I could very
easily eat less than the 56 gms of the CDC requirement. If I went with the
American concept of protein, which sub population do I go with? Do I go with
the traditional American eat a Burger + Mashed Potatoes erry day deal or go
all Keto and eat Bacon every day?

Personally, I believe that one should gradually evolve towards a lifestyle
that is suited to one's own needs.

~~~
tpeng
It's true that the concept of moderation doesn't prescribe specific targets.
It only excludes extreme targets.

The two rules that you really can bank on are that calorie intake is directly
linked to weight loss/gain, and you need a certain amount of protein and fat
to maintain or build muscle. That being said, protein needed for survival is
minimal. Other dietary parameters will affect long-term health, but laypersons
are so inundated with misinformation that it's better to eat a variety of
foods in moderation than to adopt extreme diets or novel nutritional theories.

Why are those "one weird trick" ads so profitable?

I have a hypothesis that people focus on magic pills (like fish oil) and
conspiracy theories (like sugar toxicity) because it is a welcome distraction
from an ugly truth: that in order to achieve their ideal body composition,
they just need to be extremely disciplined and hardworking in their dietary
and exercise habits, and for the sake of long-term health, they should lay off
the junk food. There's no "trick". People already generally know what they
have to do, but they pretend to themselves that they don't, because if they
know what they have to do and fail to do it, that's indicative of personal
weakness. It's cognitive dissonance.

------
0xdeadbeefbabe
The deeply flawed study that linked less heart disease to fish oil relied on
public health records and hearsay. That doesn't seem like such a deep flaw, at
least not for fish oil, in light of thousands of other studies that may
confirm the hearsay was right or right about something other than heart
disease.

~~~
makomk
It's a pretty deep flaw given that Inuits apparently didn't have the same
level of access to doctors as the groups they were comparing them to and
therefore heart disease amongst them simply wasn't being reported in public
health records, despite no actual underlying difference in the rate of heart
disease.

------
iopq
Fish oil contains EPA and DHA which are necessary for healthy brain function.
The heart benefits may be bullshit.

~~~
mehwoot
That doesn't mean that a normal person would necessarily see any benefit from
having more than they are already.

~~~
iopq
The normal person doesn't not eat fatty fish every week.

------
guelo
They already did meta-studies a couple years ago that found no link between
Omega-3s and heart diseases.

[http://jama.jamanetwork.com/article.aspx?articleid=1357266](http://jama.jamanetwork.com/article.aspx?articleid=1357266)
[http://archinte.jamanetwork.com/article.aspx?articleid=11514...](http://archinte.jamanetwork.com/article.aspx?articleid=1151420)

~~~
rosser
Almost all the studies used in the first meta-analysis, and all the studies in
the second, were investigating the _secondary_ preventative effects of Ω-3
supplementation on CVD. That means the people being studied _already_ had
heart disease. Supplementation didn't demonstrate a definitive impact on all-
cause mortality, or cardiovascular events (though in both cases, there appears
to have been a slight reduction in _cardiovascular deaths_ ) in that
population. That's hardly surprising, and proves nothing at all, except
perhaps something we already knew: people with heart disease have heart
attacks and die.

~~~
scott_s
"Proves" is a complicated word. What they did was provide evidence supporting
the hypothesis that Omega-3 supplementation does not make a significant
difference for people who already have heart disease.

While not ground-breaking, it's something. And if you gather enough meta-
studies showing "Supplementation of _x_ in _y_ circumstance had no significant
effect", then it starts to become reasonable to claim supplementing _x_ in
general is not worthwhile. (I'm not saying they _have_ done that, but I'm
pointing out that this is part of the corpus of data we need to test a
supplement in general.)

~~~
joe_the_user
_And if you gather enough meta-studies showing "Supplementation of x in y
circumstance had no significant effect", then it starts to become reasonable
to claim supplementing x in general is not worthwhile_

Woah, that's a horrible way to approach things.

As far as I know vitamin C only prevents exactly one ailment, scurvy. By that
token, you could test against a hundred other random conditions and claim
you'd proved it was worthless. Of course, you test substances for ailments you
have a reason to think they will prove effective against and any other tests
are beside the point.

Also, whatever the merit of the study mentioned, for its purse, the GP citing
here is kind of misleading or irrelevant. People don't take fish oil to cure
their existing heart disease, they take supplements to prevent heart disease
(which it may or may not do regardless of whether or not it does other
things).

~~~
scott_s
There is no evidence that vitamin C _supplementation_ has any benefit. I have
seen studies on this, and they don't show any benefit.

Please note the difference between supplementation and deficiency. I am using
"supplementation" in the same way that I understand the medical community uses
it: for strictly when you are supplementing a normal diet, and you are not
already deficient in that vitamin or compound. If you are deficient in vitamin
C because you are forced to eat foods without it for a long period, then you
should take vitamin C pills to prevent scurvy. But if you are _not_ deficient
in vitamin C, and you do get it from your normal diet, then no one has
established any benefit to its _supplementation_.

In that context, I think that the meta-study is relevant. People supplemented
their normal diet with omega-3s, and it didn't help. Yes, there are other
circumstances we have to test. We have not "proved" that omega-3
supplementation is not beneficial. But we need to amass a large corpus of
evidence to address the question, and that is part of it.

------
pmboyd
The America Heart Association's recommendation is based on multiple randomized
control studies
([http://circ.ahajournals.org/content/106/21/2747.full#sec-4](http://circ.ahajournals.org/content/106/21/2747.full#sec-4)),
none of which are the study in question.

~~~
mehwoot
Well, most of those studies deal specifically with people recovering from a
heart attack, not the general population. Those are two very different groups.

The largest study there (MARGARIN) showed pretty much no benifit for ordinary
people with no history of MI. There are many mixed results in that summary as
well...

 _Several randomized trials of fish oil were conducted over the past 10 years
to test the hypothesis that omega-3 fatty acids could prevent restenosis after
percutaneous transluminal coronary angioplasty. Although a meta-analysis of
seven early trials concluded that supplementation was beneficial,49 more
recent trials (with large study populations given 5 to 7 g /d of omega-3 fatty
acids) have not supported this conclusion.50,51 Most investigators have
concluded that further trials are not warranted._

 _The first study to explore the effects of omega-3 fatty acids on
angiographic progression rates provided 59 patients either 6 g /d of omega-3
fatty acids or olive oil for 2 years.46 No benefit was observed._

 _In contrast to the growing body of evidence supporting a protective effect
of omega-3 fatty acids in secondary prevention, a recent study reported no
effect of 3.5 g /d of DHA+EPA versus corn oil on cardiac events in post-MI
patients (n=300) after 1.5 years of intervention._

Far from conclusive.

------
knodi
I take 1800mg of DHA a day and on those days my joins don't hurt. I do martial
arts and that takes a toll on my knees but when i take fish oil they feel
better.

Placebo? Maybe, but it works for me.

~~~
seanmcdirmid
Placebos work in general as long as the problems are psychological. The whole
field Chinese Medicine depends on that.

~~~
Semaphor
> Placebos work in general as long as the problems are psychological.

There was a study [0] about the placebo effect in heart failure patients: "In
a 1999 Swedish Study, doctors implanted an active pacemaker into 40 heart
failure patients. Another 40 patients underwent the same surgery, believing
they were receiving active pacemakers. But their pacemakers were never turned
on: they were, in essence, placebo pacemakers." \- [1]

Now as a disclaimer, I did not complete read or understand this study nor do I
know if there are counter studies, but it's my favorite bit of information
about the placebo effect.

[0]
[http://www.ncbi.nlm.nih.gov/pubmed/10190407](http://www.ncbi.nlm.nih.gov/pubmed/10190407)

[1] [http://blog.placeboeffect.com/reverse-heart-
disease/](http://blog.placeboeffect.com/reverse-heart-disease/) (laymen
conclusion)

------
nazgulnarsil
Eating fish is much more robustly tied to health outcomes. This is all the
result of people absolutely refusing to follow health advice more complex than
popping a pill.

------
chris_mahan
The more I know about science, the more I understand that there's so much we
don't know that there's very little we can say we know for sure, if any.

~~~
jmnicolas
This is not science, it's marketing masquerading as science.

------
josephjrobison
This turns my whole world upside down, next they're going to come out and say
snake oil won't cure my rheumatism.[1]

[1][http://www.csicop.org/sb/show/peddling_snake_oil/](http://www.csicop.org/sb/show/peddling_snake_oil/)

~~~
dredmorbius
The original snake oil -- from the Chinese water snake -- may in fact have
been effective, in part due to its high Omega-3 oil content. The pejorative
sense came from a mix of hucksterism and cargo-culting: concoctions from other
sources (including other animal oils or petroleum-based oils) which lacked the
specific constituents of the Chinese remedy:

 _Well, hucksters that sold patent or proprietary medicine caught wind of the
miraculous muscle-soothing powers of snake oil. Naturally, they decided to
sell their own versions of snake oil—but it was just much easier to forgo
using actual snakes._

(From the Collectors Weekly reference below.)

[https://en.wikipedia.org/wiki/Snake_oil](https://en.wikipedia.org/wiki/Snake_oil)

[https://en.wikipedia.org/wiki/Chinese_Water_Snake](https://en.wikipedia.org/wiki/Chinese_Water_Snake)

[http://www.collectorsweekly.com/articles/how-snake-oil-
got-a...](http://www.collectorsweekly.com/articles/how-snake-oil-got-a-bad-
rap/)

------
sev
Coming soon:

"Popular debunking study of popular fish oil study deeply flawed, new research
says."

~~~
dfc
I do not think this comment was very beneficial to the community here at HN.
It seems this same sentiment can be found in other comments on this story.
Furthermore, regardless of the novelty of the idea expressed, these slapstick
humor, childish one liners do not invite debate or lead to lively discussions.
What was the point of your comment?

~~~
sev
Though I agree it was slapstick humor, in my eyes it was the fastest way to
convey the simple idea that science research findings often alternate from
saying something is good for you, to something is bad for you. You really are
never sure of anything.

------
jebblue
Red wine, extra virgin olive oil and nuts are supremely good for you. Do not
believe the disparaging stories showing up on HN today.

------
Cowicide
Are the newer studies factoring in perhaps that their diets may have changed
since the older studies? Do they eat less fish, etc. nowadays and eat more
junk food? Consume more alcohol? Other drugs? More sedentary? If that's the
case, the new study is deeply flawed.

~~~
spikels
Those are just a tiny fraction of the reasons why medical research is so
difficult. Others include statistical issues, genetic variation, high costs,
long timeframes, ethical constraints, publishing bias, bias of researchers,
various kinds of fraud.

~~~
Cowicide
Ok, but how does that diminish my point?

------
spikels
More evidence that vitamins and supplements are bullshit. While people with
specific conditions may benefit AFAIK there is no pill you can take that has
actually been proven to improve the health outcomes on otherwise healthy
people.

All this confusion is the natural result of the combination of profit seeking
and the difficulty of medical research. Maybe someday they will find that
magic pill just not yet.

NY Times had a bunch of good article on the subject at the end of last year
such as this one:

[http://mobile.nytimes.com/blogs/well/2013/12/16/a-challenge-...](http://mobile.nytimes.com/blogs/well/2013/12/16/a-challenge-
to-vitamins/)

~~~
dredmorbius
The problem with your comment IMO is that, while there's a fair bit of
foundation to both questions of efficacy of vitamin supplements in general
(it's a _very_ incestuous industry with a history of collusion and abuse), and
to megadosing in particular (most micronutrients are generally considered to
be limiting only when lacking from a diet -- consuming more than limiting
factors tends not to be associated with benefits and can be associated with
harm, such as where overconsumption of one nutrient blocks uptake of another,
or has toxic effects of its own).

But to claim that _all_ supplements, _and_ vitamins, are bullshit, without
substantiation, is simply not justified. There are in fact clear cases where
supplementation _has_ proven beneficial _where a deficiency exists_ (vitamins
C, D, and B-complex vitamins in particular).

And it seems HN are calling you on that.

I do generally agree that eating a balanced and nutritious diet is your best
insurance.

~~~
spikels
Yes - if you have a known vitaamin deficiency, you should (and your doctor
would recommend) be taking vitamins to correct it. I hope this is not
controversial.

However if you are healthy (i.e. have no known condition requiring treatment
with vitamins), then there is no solid evidence that vitamins or supplements
improve health outcome. If you disagree the burden of proof is on you: Point
to multiple double blind studies by reputable researchers showing consistent
and significant (practically not statistically) positive results. This may
happen but AFAIK has not happened to date.

~~~
eurleif
About 77% of the population is deficient in vitamin D.[0] You can't say
"vitamins are bullshit" because only deficient people need them when a huge
majority of the population IS deficient.

[0] [http://www.scientificamerican.com/article/vitamin-d-
deficien...](http://www.scientificamerican.com/article/vitamin-d-deficiency-
united-states/)

~~~
spikels
Sensible theory so then you need to run experiments to see if supplementing
Vitamin D in "healthy" people actually improves their health outcomes. There
are many reasons the theory might be wrong (ex. Natural variation of "normal"
vitamin D levels). Unfortunately so far these studies have been mixed - even
some negative outcomes.

[http://mobile.nytimes.com/blogs/well/2013/12/11/limits-of-
vi...](http://mobile.nytimes.com/blogs/well/2013/12/11/limits-of-vitamin-d-
supplements/)

~~~
eshvk
From what I understand, the paper did a survey of Vitamin D related
statistical studies. Then, went ahead and said that there existed a reverse
causal link (Depression -> Stay Inside -> Low Vitamin D) as to why certain
correlations existed. I am not going to make any judgements as to the causal
conclusions they make. However, can you please clarify where you got the
"negative outcomes"? There is no such thing mentioned in the NYT article,
neither in the abstract of the Lancet paper.

~~~
spikels
The negative outcomes are not in those short summaries but the are easy to
find. However just as a few positve studies don't prove Vitamin D is good for
you a few negative studies don't prove it is bad. However negative studies do
add to balance of evidence against use.

There is also the risk of overdose in any widely used supplement. Thankfully
few of the 60,000 cases of vitamin toxicity in the US annually are Vitamin D
(Iron is the riskyist).

A short walk in the sunlight is the best source of Vitamin D because your body
naturally regulates it's production to near the optimum amount! I often wonder
if the extreme avoidance of sunlight by some people is actually unhealthy...

Cancer:
[http://www.medpagetoday.com/PrimaryCare/GeneralPrimaryCare/3...](http://www.medpagetoday.com/PrimaryCare/GeneralPrimaryCare/32369)

Heart Disease:
[http://www.ncbi.nlm.nih.gov/pubmed/21505219](http://www.ncbi.nlm.nih.gov/pubmed/21505219)
[http://www.news-medical.net/news/20111117/Vitamin-D-and-
its-...](http://www.news-medical.net/news/20111117/Vitamin-D-and-its-good-and-
bad-effects-on-the-heart.aspx)

------
Theodores
As a vegetarian I am pleased to hear that those fish oil supplements are not
all that they are cracked up to be.

As a child I was made to feel that _as a vegetarian_ , if I did not take these
fish oil supplements, then I would probably die. No TV advert or doctor told
me that, just ambient peer pressure from good, well-meaning friends and their
mothers that indulged in these fish oil things. The fear of god is one thing,
scientific evidence from the back of the packet is something else. Looking
back it is a miracle that I did not give in to the peer pressure.

I am part of the self-selected control group of vegetarians. We exist so any
normal people (i.e. in the meat-eating cult) can see if you really need fish,
meat or some scientifically proven meat/fish dietary supplement thing. As it
happens the vegetarian control group, even if some of them do wear leather
shoes, tends to outlive those that are tied to their beliefs about things like
eating their fish oils, getting tonnes of protein from beef, eating things
because those vitamins can only be found in pigs not celery and so on.

Hence I can quietly keep my feelings of "told you so" to myself on this one,
rather than go round my friend's mum's house and tell her how wrong she was to
try and force feed me that fish oil stuff.

~~~
mikestew
> Hence I can quietly keep my feelings of "told you so" to myself on this one

Yes, quietly post to an international forum of thousands of users how you're
keeping those feelings to yourself.

As a vegetarian myself, I would suggest that you'll hold an audience longer by
dialing the "smug" knob down a notch. People like their meat, and someone
waiting since childhood to say "I told you so" isn't likely to change their
mind.

On the other hand, calm and reasonable explanations aren't likely to change
their minds, either. Because, damn, bacon sure tastes good.

