
Long-Awaited Study Results on Vitamin D and Fish Oil Supplements - nradov
https://www.npr.org/sections/health-shots/2018/11/10/666545527/vitamin-d-and-fish-oil-supplements-disappoint-in-long-awaited-study-results
======
koboll
"Fine and Manson stressed that vitamin D and the omega-3 fatty acids found in
fish oil are important nutrients, but the best way to get them is as part of a
well-balanced diet. That includes eating fatty fish like sardines, tuna and
salmon, and vitamin-D fortified cereals, milk, and orange juice."

Ah, okay. So instead of taking supplemental Vitamin D, you should get it from
natural sources, such as..... foods that have been artificially fortified with
supplemental Vitamin D.

~~~
sametmax
It's espacially weird given that D vitamins can be produced easily in the
human body as long as you expose the skin to the sun. It's in no way required
to be provided from external sources.

A daily 15 minutes of exposure for the face and forarms is enough, and it
contributes to recalibrate the mood and circadian rythm as well. It's free,
healthy, and simple. Why would anyone recommand a supplement to people that
have access to the sun is beyong me.

Omega 3 is harder, but still.

~~~
oe
It’s not free or simple if the sun doesn’t shine where you live.

~~~
glun
And even when it does shine the critical UVB spectrum may not pierce the
athmosphere at a strong enough intensity for the body to produce vitamin D.

------
devonEnlis
Study linked was not the biggest cardiovascular health news of today--

This was:
[https://www.nejm.org/doi/full/10.1056/NEJMoa1812792](https://www.nejm.org/doi/full/10.1056/NEJMoa1812792)

A single purified component of fish oil - EPA, did lead to a 25% relative risk
reduction on top of statin treatment. This is a huge result with off the
charts p values.

~~~
dmix
Importantly the results were only positive for those:

> Among patients with elevated triglyceride levels

Much like low dose aspirin its possible this is a bad idea for the average
person unless you are already showing signs of heart disease.

~~~
agsdfgsd
How is low dose aspirin bad for the average person? It is an anti-
inflammatory, and inflammation is a leading theory of potential disease
causation for a number of diseases. Daily low dose aspirin is associated with
a significantly lower all-cause mortality in average people.

~~~
loeg
> How is low dose aspirin bad for the average person?

There's a small dollar cost, and there's this whole section:
[https://en.wikipedia.org/wiki/Aspirin#Adverse_effects](https://en.wikipedia.org/wiki/Aspirin#Adverse_effects)

~~~
agsdfgsd
Nothing there suggests it is bad for the average person. The average person
will lower their chances of dying by taking daily low dose aspirin. The
average person does not have a sensitivity to aspirin, and the side effects of
high dose aspirin don't apply.

------
JumpCrisscross
Dark-skinned office-working New Yorker here. Neglected blood tests for years.
Took a significant other to realise that, every winter, I’d start eating
tinned sardines by the caseload. Once I began supplementing, on doctor’s
orders after a blood test, the cravings stopped. Guess what’s super-rich in
Vitamin D?

~~~
INTPenis
Yeah I came here to say this. I'm sure people do take vitamin D to stave off
heart disease and cancer but that was never my intention.

I live in scandinavia so every autumn I start taking one vitamin D pill a day
to keep my spirits up during the long darkness.

I believe it helps and I have no illusions of preventing any diseases with it,
except winter depression.

~~~
te_chris
Came to say this. I’ve lived in London for 3.5 years and first winter got
really depressed - originally from NZ and we have more light. Tried meditation
and exercise and it kind of worked, but still not great. Next one and all
since just took vit D everyday and the change in mood through winter has been
remarkable.

~~~
gns24
What dosage did you take?

~~~
ccozan
I take for example a 5000mg poll every two days. But in winter I take it every
day.

~~~
insertnickname
You probably mean 5000 IU, which is equivalent to 125 micrograms (of vitamin
D).

~~~
mrhappyunhappy
I don’t remember where I read this but I heard 2000 IU is the minimum to be
effective.

------
SubiculumCode
[https://www.nejm.org/doi/full/10.1056/NEJMoa1809944](https://www.nejm.org/doi/full/10.1056/NEJMoa1809944)

Abstract: 'It is unclear whether supplementation with vitamin D reduces the
risk of cancer or cardiovascular disease, and data from randomized trials are
limited. Methods

We conducted a nationwide, randomized, placebo-controlled trial, with a two-
by-two factorial design, of vitamin D3 (cholecalciferol) at a dose of 2000 IU
per day and marine n−3 (also called omega-3) fatty acids at a dose of 1 g per
day for the prevention of cancer and cardiovascular disease among men 50 years
of age or older and women 55 years of age or older in the United States.
Primary end points were invasive cancer of any type and major cardiovascular
events (a composite of myocardial infarction, stroke, or death from
cardiovascular causes). Secondary end points included site-specific cancers,
death from cancer, and additional cardiovascular events. This article reports
the results of the comparison of vitamin D with placebo. Results

A total of 25,871 participants, including 5106 black participants, underwent
randomization. Supplementation with vitamin D was not associated with a lower
risk of either of the primary end points. During a median follow-up of 5.3
years, cancer was diagnosed in 1617 participants (793 in the vitamin D group
and 824 in the placebo group; hazard ratio, 0.96; 95% confidence interval
[CI], 0.88 to 1.06; P=0.47). A major cardiovascular event occurred in 805
participants (396 in the vitamin D group and 409 in the placebo group; hazard
ratio, 0.97; 95% CI, 0.85 to 1.12; P=0.69). In the analyses of secondary end
points, the hazard ratios were as follows: for death from cancer (341 deaths),
0.83 (95% CI, 0.67 to 1.02); for breast cancer, 1.02 (95% CI, 0.79 to 1.31);
for prostate cancer, 0.88 (95% CI, 0.72 to 1.07); for colorectal cancer, 1.09
(95% CI, 0.73 to 1.62); for the expanded composite end point of major
cardiovascular events plus coronary revascularization, 0.96 (95% CI, 0.86 to
1.08); for myocardial infarction, 0.96 (95% CI, 0.78 to 1.19); for stroke,
0.95 (95% CI, 0.76 to 1.20); and for death from cardiovascular causes, 1.11
(95% CI, 0.88 to 1.40). In the analysis of death from any cause (978 deaths),
the hazard ratio was 0.99 (95% CI, 0.87 to 1.12). No excess risks of
hypercalcemia or other adverse events were identified. Conclusions

Supplementation with vitamin D did not result in a lower incidence of invasive
cancer or cardiovascular events than placebo. (Funded by the National
Institutes of Health and others; VITAL ClinicalTrials.gov number,
NCT01169259.)'

~~~
SubiculumCode
I'm curious as to whether 2000 IU per day is considered a large dose by the HN
community. I've a bottle of 5,000 IU.

~~~
thomasfedb
This was in otherwise generally healthy people, so the dosage is going to be
less than you'd give to a person with a deficiency.

A person with a moderate deficiency would probably get 5,000 IU. Doses up to
10,000 IU are fairly well tolerated.

So, no it's not a large dose. It's a modest dose.

------
freedomben
In my opinion, the best benefit of fish oil and Omega threes and vitamin D are
in combating depression. This article did not touch on that. There is pretty
good evidence that fish oil is one of the best supplements for combating
depression because it is used directly in construction of neurotransmitter
pathways.

I highly recommend reading Dr Mark Hyman's book the Ultramind Solution. It's
loaded with great info regarding nutrition and how it affects your brain. It
is truly life changing information. He also had a podcast called Broken Brain
that is worth checking out.

Julia Ross' the Mood Cure is good too, the not as detailed (tho that can be
good if you are feeling overwhelmed).

~~~
thomasfedb
Fairly recent Cochrane review concludes:

> ... we do not have sufficient high quality evidence to determine the effects
> of [omega-3] as a treatment for [major depression]. Our primary analyses
> suggest a small-to-modest, non-clinically beneficial effect ... compared to
> placebo; however the estimate is imprecise, and we judged the quality of the
> evidence on which this result is based to be low/very low.

[https://www.cochrane.org/CD004692/DEPRESSN_omega-3-fatty-
aci...](https://www.cochrane.org/CD004692/DEPRESSN_omega-3-fatty-acids-
depression-adults)

Also, I'd be careful with Mark Hyman. He's controversial at best and
associated with some fairly quacky organisations. I'm also automatically wary
because his bibliography is wonder-fix followed by magic-cure - and medicine
is never that simple.

I'm a student doctor. If the answer was easy we'd have found it, and we'd tell
you about it.

~~~
alan_wade
Can you recommend any books similar to Ultramind Solution but with more
helpful info, in your opinion?

~~~
adetrest
From the amazon page about ultramind: "Three-time New York Timesbestselling
author Dr. Mark Hyman unveils his groundbreaking program that shows how we can
fix our broken brains by healing our bodies first. Based on the emerging field
of Functional Medicine, Dr. Hyman presents a simple six-week plan to restore
health and gain an UltraMind, one that's highly focused, able to pay attention
at will, has a strong memory, and leaves us feeling calm, confident, in
control, and in good spirits."

That sounds like a bookful of BS and pseudo science.

~~~
diydsp
without knowing anything about the book, i believe it is possible based on
many videos by dr. gregor of NutritionFacts.org. Many nutritional changes,
such as eating berries and other antioxidants and cutting saturated fat and
cholesterol, and adding whole grains and beans have measurable improvements om
the hourly and day scale increasing serotonin and decreasing anxiety. Add a
few forms of exercise, fasting and supplements and your mind can be very clear
and powerful.

------
kingkawn
2000 iu per day is well under the recommended dose per this 2014 study
published in the journal Nutrients:

[http://dx.doi.org/10.3390/nu6104472](http://dx.doi.org/10.3390/nu6104472)

~~~
cies
Indeed. If supplementing D3, at least respect the threshold value.

------
toomuchtodo
Except as fish oil supplements relate to heart attacks (headline is misleading
IMHO):

> While the overall results were disappointing, there appeared to be a
> beneficial effect when it came to one aspect of heart disease and fish oil:
> heart attacks.

> Taking fish oil lowered the risk of heart attack by about 28 percent, which
> is a "statistically significant" finding, says Dr. JoAnn Manson, who is
> chief of the division of preventive medicine at the Brigham and Women's
> Hospital in Boston. She led the research.

> Those who appeared to benefit the most were people who didn't ordinarily eat
> much fish in their day-to-day diet, as well as African Americans, Manson
> says.

> African-Americans in the study experienced a 77 percent lower risk of heart
> attack when compared to placebo, which is a "dramatic reduction," Manson
> says. Further research is needed to confirm these findings, she adds, but,
> "in the meantime it would be reasonable for African Americans to talk with
> their health care providers about whether they may be candidates for taking
> fish oil supplements."

~~~
SlowRobotAhead
Likewise a Vitamin-D deficiency can make your tongue swell a bit. Is it a long
term health issue? No. But, is it annoying af to bite your tongue and mess
words up, yes it is.

Edit: LOL downvotes for a straight up medical fact :D

~~~
Chyzwar
[https://en.wikipedia.org/wiki/Vitamin_D_deficiency](https://en.wikipedia.org/wiki/Vitamin_D_deficiency)

Osteoporosis among other symptoms. Swelling tongue is not on the list.

~~~
SlowRobotAhead
Because Wikipedia is a medical reference.

~~~
Chyzwar
Because Wikipedia is more reliable than a random guy from the internet.

------
jryan49
So wait, what is disappointing about this:

"Taking fish oil lowered the risk of heart attack by about 28 percent, which
is a "statistically significant" finding, says Dr. JoAnn Manson, who is chief
of the division of preventive medicine at the Brigham and Women's Hospital in
Boston. She led the research."

and

"African-Americans in the study experienced a 77 percent lower risk of heart
attack when compared to placebo, which is a "dramatic reduction,"

~~~
dmix
The fact fish oil and vitamin d have been touted for couple decades as helping
prevent cancer?

I remember both my parents taking both regularly growing up in the 90s and
they both separately mentioned cancer prevention as the big reasons.

~~~
marktangotango
I’m a big believer in fish oil. In my late 30s I experienced a consistent
feeling of unwell ness and what I describe as “brain fog” so badly and
consistently I went to the dr about it. Turned I had high blood pressure and
high cholesterol. Dr wanted me to modify my diet and if it didn’t improve he
wanted to put me on statins(!)

Fish has never been part of my diet. Started using fish oil, eating Cheerios,
vitamins and some excercise. Started makeung a point to include seafood 2
times a week. Long story short, 6 months later all my numbers were in line.

The most striking thing I recalled from this was the fish oil, brain fog went
away, I felt a great deal more mental acuity.

Fast forward to today; that was all 8 years ago, in the interim I stopped all
that and the brain fog and unwell ness are back. I started fish oil again, and
the effect was immediate. I even remarked to my wife how much better I felt.

That’s all anecdotal, and probably placebo effect anyway, ymmv.

~~~
phkahler
As for the statins... Doc said we had to treat my high cholesterol and
triglycerides. I was very reluctant to take statins so she said "OK try red
yeast rice for 3 months but if it doesn't improve you're gonna have to take
statins". OK. My cholesterol 320->220\. My triglycerides 300+ -> 115\. It
turns out that lovastatin was identified as _one of_ the key molecules in the
ancient Chinese remedy.

So that's my one data point, and the only one relevant _to me_ regarding
statins.

~~~
codewiz
It's not at all surprising that red yeast rice would be as effective as a
prescription drug in lowering triglycerides. In fact, "Some red yeast rice
products contain large amounts of monacolin K, which is chemically identical
to the active ingredient in the cholesterol-lowering drug lovastatin." (from
[https://nccih.nih.gov/health/redyeastrice](https://nccih.nih.gov/health/redyeastrice))

It seems statins have serious side effects such as nerve damage, so perhaps
you should go with the exact dosage prescribed by a doctor instead of taking
an unknown quantity of the same drug from natural sources.

~~~
phkahler
I got the muscle aches that can come from statins. Lowered my dose and they
went away. Thing is, the doc never saw anyone achieve the results I did with
the prescription stuff. No need to support a broken patent system and get a
doctor and pharma company involved.

------
raspasov
Sooooooo... I did a little bit of digging here.

3 studies:

\-------------------

1st study about Vitamin D
[https://clinicaltrials.gov/ct2/show/NCT01169259](https://clinicaltrials.gov/ct2/show/NCT01169259)

2nd study about fish oil with a low dose, 1 gram
[https://clinicaltrials.gov/ct2/show/NCT01169259](https://clinicaltrials.gov/ct2/show/NCT01169259)

3rd study about a PROPRIETARY PRESCRIPTION variation of fish oil with a HIGH
DOSE
[https://clinicaltrials.gov/ct2/show/record/NCT01492361](https://clinicaltrials.gov/ct2/show/record/NCT01492361)

Results:

\---------------------

1st study - no effect.

2nd study - no effect.

3rd study - "REMARKABLE degree of risk reduction".

The researchers are different but the HOSPITAL that conducted them is the
same.

The HOSPITAL posted about BOTH studies at the same time (today):
[https://www.brighamandwomens.org/about-bwh/newsroom/press-
re...](https://www.brighamandwomens.org/about-bwh/newsroom/press-releases-
detail?id=3189) [https://www.brighamandwomens.org/about-bwh/newsroom/press-
re...](https://www.brighamandwomens.org/about-bwh/newsroom/press-releases-
detail?id=3190)

IMHO, something smells a little bit ... FISHY in here LOL.

Amarin is a one-product medical "startup" trying to show that their fish oil
variation works. Oh, they are also publicly traded. Their stock went up after
this announcement. It has also 10x-ed this year. They are also trying to
convince the FDA that it "works".

My opinion? Total fraudsters.

~~~
albedoa
It is unclear what your suspicions are. You capitalized a bunch of words and
concluded with "Total fraudsters". Can you tell us your specific issues with
the studies?

~~~
raspasov
See my other comments in the thread, the Forbes article quoting a few other
cardiologists from other major universities.

Google around about the company and their drug Vascepa. Many people are
skeptical about it and IMHO they have a point. Vascepa an extract from fish
oil but is... prescription? Why? So they can extract hundreds of dollars from
programs like Medicare when your doctor writes you a prescription about it.
Vascepa does not seem to be any better than regular over-the-counter fish oil.

------
mirekrusin
Why came up with this title?

""We are reporting a remarkable degree of risk reduction," says Dr. Deepak
Bhatt, who headed the study and is a cardiologist at Brigham and Women's
Hospital."

"Taking fish oil lowered the risk of heart attack by about 28 percent, which
is a "statistically significant" finding".

"African-Americans in the study experienced a 77 percent lower risk of heart
attack when compared to placebo, which is a "dramatic reduction," Manson
says".

"Overall, that study found there was a 25 percent risk reduction for patients
taking the extract. These patients were less likely to die from heart disease,
have a heart attack or stroke, be hospitalized for chest pain or need
procedures such as angioplasty, stenting or bypass surgery, researchers
reported."

~~~
koboll
Yeah, it's very stupid. "Fish oil slashes heart attack risk by a huge
percentage--but it's not a Wonder Drug that cures all ailments.
Disappointing!"

------
AltruisticGap
I can't say I noticed a change in mood when taking D3.

However fish oil undeniably reduces dryness in the EYES, with and without
contact lenses.

They do sell in pharmacy supplements for eye health, I think targeted at older
people, and the dosage of EPA /DHA is very low. I didn't try those so I can't
say how much is needed.

I took eg. Life Extension 700/500 epa/dha and for me the effect was 100%
reproducible. On a day I took it, my eyes supported the contacts much better
in the evening. Without supplements I could feel the difference.

I wish I could say as much about D3. I keep hearing how it's good for winter
etc, but even though I am healing TRAUMA and have suffered anxiety for 20+
years before starting therapy.. i never noticed any obvious changes in mood
when supplementing with D3 (which was averaging 3000-ish IU per day). I wish!
(edit: and, I spend a ton of time indoors, and working on a PC.. so if they
did anything I should have noticed?)

~~~
p0nce
Hello,

I didn't noticed a lot of changes with 2000 IU but at 5000 IU the effect on
mood is dramatic and quite noticeable. Being liposoluble the effect has quite
a latency over several days.

It's basically the "summer vacation" feeling.

(Be carefult to take pure D3 not something mixed with calcium though:
effective dosage of vit D. would bring into calcium overdosage.)

~~~
c0nducktr
I've noticed my mood improves at higher Vitamin D dosages as well. I've
currently been taking Solaray brand Vitamin D3+K2, which is 5000IU D-3, 50mcg
K-2, 110mg Calcium, 84mg Phosphorus.

Since this contains calcium, is it harmful to take everyday? Should I try to
find a different supplement?

~~~
p0nce
No comment was about supplements that are 500IU + 110mg Calcium. If you 10x
this does you will have too much calcium.

Vitamin D supplements can sometimes be underdosed.

------
eagsalazar2
Man I am so confused. How is 28% reduction in heart attacks and 77% for
african american men "negative" for both cancer and heart disease??? Am I
missing something? Those results seem _HUGE_. Right?

------
cavisne
"At this point, if one is thinking about supplementation, either omega-3s or
vitamin D, talking to your physician or healthcare provider is the next step"
Does anyone actually talk to their doctor before taking a vitamin? What
information could they possibly provide

~~~
peterxpark
I have a terrific new naturopathic doctor who actually cares about my health
and will run blood panels frequently and let me know what lifestyle changes
and supplements would help me. I never knew before that I was deficient in
zinc. Before her though, most of my doctors were of the bland "if you aren't
in extreme pain then it's not a problem" camp.

~~~
hashbig
I would much rather have a "if you aren't in extreme pain then it's not a
problem" doctor, than one who would over diagnose every minor issue.

~~~
rjplatte
I'd rather have a competent doctor than either of those.

~~~
ianai
And them listening to their patient is a necessary condition! A doctor who
doesn’t listen to his/her patient is a red flag.

------
jryan49
We should also note that the studies were only done on people _over 50 years
old_ :

"... among men 50 years of age or older and women 55 years of age or older in
the United States"

Maybe by then it's too late?

------
mark_l_watson
I admit to some confusion: my wife and I take omega-3 supplements, eat fatty
fish, and take vitamins D supplements because of the purported increase in
brain health.

Still, a 25% decrease in heart decease for African Americans and people who
don’t eat fatty fish is a good result.

Also, re: “That includes eating fatty fish like sardines, tuna and salmon, and
vitamin-D fortified cereals, milk, and orange juice.” I don’t like breakfast
cereals, to many carbs, I prefer my morning carbs from steamed cauliflower,
broccoli, etc. I decided to cut out dairy partly for health reasons and partly
because of animal cruelty. I hate drinking commercially packaged orange juice,
tastes like sugar. A fresh orange is tasty but does does not have artificially
added vitamin D - so take vitamin D pills.

I am in my mid 60s and felt tired and low energy earlier this year. My doctor
tested vitamin D levels, put me on vitamin D pills, and I literally felt good
again within a week.

------
foxhop
In my opinion the biggest issue with meds, supplements, and health studies in
general is that it's an n+1 issue. All humans are unique individual cases.

What works great for one person might not work for the majority. This doesn't
mean a particular remedy or supplement should be cast aside.

Here is an example of where I wish the "health industry" would move:

[https://leapsmag.com/how-bacteria-killing-viruses-may-
save-u...](https://leapsmag.com/how-bacteria-killing-viruses-may-save-us-from-
antibiotic-resistance/)

[https://phagesdb.org/](https://phagesdb.org/)

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

------
daniel_iversen
Isn’t fish oil also good for your joints?

EDIT: here’s some information - [https://arthritisaustralia.com.au/managing-
arthritis/living-...](https://arthritisaustralia.com.au/managing-
arthritis/living-with-arthritis/complementary-treatments-and-therapies/fish-
oils/) \- and without doing much research I’ve been taking it to prevent joint
strains from running - not sure if that’s worthwhile or not

------
BadassFractal
Been taking 10k IU of D3 for a few months now, managed to get my measurement
from the teens or 20s into the 90s of whatever unit that's in. I believe 100
is the max of the healthy range. Can't tell the difference, but allegedly
you're going to feel "worse" if you're low on this stuff.

It would be amusing to find out that it actually makes no difference at all
and it's all placebo.

~~~
avinium
Yeah, I've tried the same (my theory was it would help mitigate the effects of
SAD through the long, dark winter).

I've noticed no difference (though to be fair, it was hardly an empirical
approach). I have a pretty well-rounded diet, so I assume I'm not deficient.

I do think that fish oil makes a difference, at least in terms of exercise.

~~~
baccheion
Do you also take magnesium? Have you verified serum levels via blood work?

~~~
avinium
As I said, I have to admit it wasn't empirical, so no blood work.

I wasn't aware of magnesium supplements - what's the science behind it?

------
jab777
If anyone is wondering why the study results are being framed as
"disappointing" to major media outlets, take a look at the disclosed financial
conflicts of interest document. Lots of mysterious "consultant" fees paid out
by major pharmaceutical companies who have an obvious incentive to bash any
natural alternative to their drugs.

Also, the "placebo" used here was mineral oil, which has many known health
benefits. Why not use some type of sugar pill? Talk about tipping the scale in
favor of big pharma's desired results from the beginning. Past similar studies
on fish oil (funded by big pharma) have even used an olive oil "placebo",
which skews p-values even further. Imagine a weight loss study that told the
placebo group to start running a mile everyday and eating healthier food....

------
baccheion
Exposing the scrotum/testicles to direct sunlight for 20 minutes/day increases
testosterone significantly. I wonder if a sun/S.A.D. lamp would have a similar
effect?

~~~
ddalex
Citation needed

------
nirv
Fellow Europeans under the GDPR, FTFY:
[https://text.npr.org/s.php?sId=666545527](https://text.npr.org/s.php?sId=666545527)

~~~
yholio
That's a forced consent design if I ever saw one.

------
Angostura
Interesting. In the UK, the NHS suggests most people should routinely take
vitaminD between November and March, but I wasn’t aware that heart attacks
were the main issue with vitamin D deficiency.

Also, though the studies are dubbed ‘disappointing’ in the second paragraph

> African-Americans in the study experienced a 77 percent lower risk of heart
> attack when compared to placebo,

Isn’t exactly chicken feed.

------
Leary
Given these studies. I will stop taking fish oil. However, in light of further
evidence by gwern as presented below, I will continue to take Vitamin D, even
though my confidence in it is lessened.

[https://www.gwern.net/Longevity](https://www.gwern.net/Longevity)

~~~
lhl
I have my doubts on omega-3 supplementation as the amounts typically are not
enough to change the omega-3:omega-6 ratios, which has been shown to have a
big effect on hazard ratios for CVD. It looks like this study was for 1g of
fish oil and there were no controls on dietary intake, so IMO the results
aren't surprising.

I'd recommend that anyone interested in the health benefits of eating
healthier... look into eating healthier. I really dig Marty Kendall's work on
[https://nutrientoptimiser.com/](https://nutrientoptimiser.com/)

~~~
WalterSear
Algae and Fish oil bypass the preferential omega-6 metabolism - EPA & DHA are
downstream metabolites, so there is no barrier.

Flax seed oil is still healthy but only for the lignans - only marine oils can
effectively provide DHA and EPA. Though most commercially available products
are DHA heavy, which no longer seems to be the beneficial conjugate.

------
pliftkl
I'm a little surprised by the combination of a study on low dose (1 g) of fish
oil coupled with the recommendation to get fish oil from diet. When I eat a
tin of sardines, I'm certainly getting more than a gram of fish oil. Am I
missing something?

------
raverbashing
Well, first, the study looked at cancers and heart disease. The conclusion is:

> there appeared to be a beneficial effect when it came to one aspect of heart
> disease and fish oil: heart attacks.

> Taking fish oil lowered the risk of heart attack by about 28 percent,

------
rjplatte
This reminds me of the study showing that a component of coconut oil can delay
alzheimer's onset by years. There need to be more studies done with
traditional remedies.

------
dagoat
It’s been known for a while that supplemental omega 3s are probably best
avoided until there’s more data out there.

[https://www.health.harvard.edu/blog/fish-oil-friend-or-
foe-2...](https://www.health.harvard.edu/blog/fish-oil-friend-or-
foe-201307126467)

Vitamin C, E, and many other supplements have similarly questionable benefits
with possible harsh side effects.

I wouldn’t reach for almost any supplement unless a doctor + blood tests + my
own research suggested I should. And even then I believe diet and lifestyle
modifications could be attempted beforehand.

~~~
copperx
Just to highlight one of the points in the linked page: There was a recent
study that correlated high levels of serum DHA with aggressive prostate
cancer. It is not known whether the elevation in DHA from the subjects was due
to fish oil supplementation or some other biochemical process.

Everything has side effects.

------
yread
> "statistically significant"

Why the quotes?! If the author doesn't understand what that means why report
on science at all?

~~~
agsdfgsd
Because those two words were a quote.

------
maxerickson
Glad to see this thread about scientific research didn't immediately devolve
into speculation about nutritionology.

------
yborg
It always seemed unlikely to me that any single substance that can be ingested
as a supplement would have any significant effect on general malignancies.
There are probably thousands of paths by which these can occur, one magic pill
that would address them all is improbable to say the least.

------
Breadmaker
text.npr.org
[https://text.npr.org/s.php?sId=666545527&rid=1001](https://text.npr.org/s.php?sId=666545527&rid=1001)

------
sytelus
TLDR; Overall, they showed that neither fish oil nor vitamin D actually
lowered the incidence of heart disease or cancer. However aspect of heard
disease that benefits is heart attack. Taking fish oil lowered the risk of
heart attack by about 28 percent.

It is important to remember though D3 has other proven benefits.

~~~
cblum
I hadn’t even heard of it being potentially beneficial to prevent heart
disease and cancer.

I take vitamin D because it makes a massive difference to my mood during the
gloomy months in Seattle.

------
starpilot
The broader significance is that fish oil was considered one of the most well
supported supplements out there. Others like turmeric are less evidenced but
maybe promising, and there's stuff like colloidal silver which is homeopathy
nonsense. If fish oil does nothing for large swaths of the population, what do
we really know about the efficacy of any supplements?

------
choot
Quite a large population in the the world lives at place where fishes aren't
available.

So is it possible some people don't really need fish oil for well-being?
Evolution might have rendered eating fish useless for these people.

~~~
lustysocietyorg
Yes, absolutely. Fish oil is not needed at all. The EPA and DHA in fish was
initially produced by algae anyway.

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

The 2 essential fatty acids are:

\- alpha-linolenic acid (ALA, an omega-3 fatty acid).
[https://en.wikipedia.org/wiki/Alpha-
Linolenic_acid](https://en.wikipedia.org/wiki/Alpha-Linolenic_acid)

\- linoleic acid (LA, an omega-6 fatty acid).
[https://en.wikipedia.org/wiki/Linoleic_acid](https://en.wikipedia.org/wiki/Linoleic_acid)

Linseed oil (flaxseed oil) is a good provider of essential fatty acids.
[https://en.wikipedia.org/wiki/Linseed_oil](https://en.wikipedia.org/wiki/Linseed_oil)

EPA (eicosapentaenoic acid) or DHA (docosahexaenoic acid) are conditionally
essential fatty acids.

[https://en.wikipedia.org/wiki/Essential_fatty_acid#Condition...](https://en.wikipedia.org/wiki/Essential_fatty_acid#Conditionally_essential)

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

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

Experts recommend a vegan diet against heart disease and cancer.

E.g.

[http://www.who.int/features/qa/cancer-red-
meat/en/](http://www.who.int/features/qa/cancer-red-meat/en/)

[https://www.ncbi.nlm.nih.gov/m/pubmed/19562864/?i=2&from=/27...](https://www.ncbi.nlm.nih.gov/m/pubmed/19562864/?i=2&from=/27886704/related)

[https://www.eatright.org/food/nutrition/vegetarian-and-
speci...](https://www.eatright.org/food/nutrition/vegetarian-and-special-
diets/feeding-vegetarian-and-vegan-infants-and-toddlers)

[https://lustysociety.org/diet.html](https://lustysociety.org/diet.html)

~~~
agsdfgsd
>Fish oil is not needed at all. The EPA and DHA in fish was initially produced
by algae anyway

People who lived in areas without fish also lived in areas without algae.

>The 2 essential fatty acids are

It is worth noting that there is basically no evidence that those 2 fatty
acids are actually essential. A single study done in the 1930s is the basis
for that belief. A study in which rats fed no fat got symptoms we now would
consider indicative of vitamin B6 deficiency. This study was done prior to the
discovery of vitamin B6. Although adding "essential" omega 6 fatty acids
alleviated the rat's symptoms, later studies were able to alleviate the
symptoms using vitamin B6 while the rats continued to receive absolutely no
fats.

>Linseed oil (flaxseed oil) is a good provider of essential fatty acids

And linseed oil consumption is correlated with an increase in all cause
mortality.

>Experts recommend a vegan diet against heart disease and cancer.

Experts recommend all sorts of things that contradict evidence. Like taking
statins even though they increase mortality. Or switching from perfectly safe
saturated fats to "heart healthy" trans fats even though it increases
mortality. Or once trans fats were too obviously bad they simply changed their
recommendation to "polyunsaturated fats" which are also correlated with
increased mortality.

~~~
lustysocietyorg
> People who lived in areas without fish also lived in areas without algae.

The point is that EPA and DHA is not made by fish. EPA and DHA can be bought
in vegan form. EPA and DHA are not even considered as essential fatty acids.
Unlike ALA and LA.

I have not seen any study what shows that ALA and LA are not essential. If you
have one, please link it. I would like to know.

> And linseed oil consumption is correlated with an increase in all cause
> mortality.

Link please.

> Or switching from perfectly safe saturated fats to "heart healthy" trans
> fats even though it increases mortality.

What are you talking about ? Are yout talking about margerine and butter ?

But I agree that many so called experts are not experts.

Many organizations and in particular government organizations (e.g. EPA and
FDA in the USA) affected by politicians are very prone to corruption and
pleasing corrupting lobby groups like the food industry and the military
industry and the fossil fuel industry.

But some truth is known in 2018.

[https://livinontheveg.com/omnivore-or-
herbivore/](https://livinontheveg.com/omnivore-or-herbivore/)

[https://www.youtube.com/watch?v=xl8zNztsoGg](https://www.youtube.com/watch?v=xl8zNztsoGg)

[https://www.youtube.com/watch?v=ZCMWctmCCqU&t=432](https://www.youtube.com/watch?v=ZCMWctmCCqU&t=432)

[https://www.youtube.com/playlist?list=PLLrSGiXTX6Im72KTZRDln...](https://www.youtube.com/playlist?list=PLLrSGiXTX6Im72KTZRDlnwypJFfMYH8Vm)

~~~
agsdfgsd
>The point is that EPA and DHA is not made by fish

But that point is not relevant to the post you replied to, which was wondering
aloud about human adaptation to the availability of fish. The availability of
algae is the same as the availability of fish.

>I have not seen any study what shows that ALA and LA are not essential.

Have you seen one that shows it is? Because there are none.

>Link please.

I can't find the original study, just people talking about it. They gave up on
the original premise as the linseed oil was killing people instead of making
them healthy, so they ended up reporting on smoking and blood pressure.

[https://tidsskriftet.no/en/2012/01/life-expectancy-and-
cause...](https://tidsskriftet.no/en/2012/01/life-expectancy-and-cause-death-
men-examined-medical-check-ups-1964#reference-6)

>But some truth is known in 2018.

But people with agendas lying on their blogs or youtube isn't truth.
Pretending carnivores are omnivores and then saying "look we're not like
omnivores" is just deliberate dishonesty. We are not like carnivores. We are,
100% without any question, omnivores. Read literally any text on mammology,
there is no debate, no controversy, no ambiguity. Poor studies like the
adventist study vegan advocates like to cite may show benefits when they don't
control for anything else. But properly defined and conducted trials show
veganism is not associated with lower mortality:
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4691673/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4691673/)

~~~
lustysocietyorg
> But that point is not relevant to the post you replied to

Yes it is. Remember:

>>> So is it possible some people don't really need fish oil for well-being?
Evolution might have rendered eating fish useless for these people.

> But people with agendas lying on their blogs or youtube isn't truth.
> Pretending carnivores are omnivores and then saying "look we're not like
> omnivores" is just deliberate dishonesty.

Yes we can it fresh meat and digest it. Even cows can digest milk and meat to
some degree; remember the mad cow disease.

The human body works best with vegan food as main food or only vegan food in
2018 with modern vitamin supplements. This is a fact.

Regarding vitamin B12:
[https://www.youtube.com/watch?v=cavI_FnIrh4](https://www.youtube.com/watch?v=cavI_FnIrh4)
and [https://www.youtube.com/playlist?list=PL5TLzNi5fYd-
Tyz9vI6Q2...](https://www.youtube.com/playlist?list=PL5TLzNi5fYd-
Tyz9vI6Q2QLxyFtMUjltf)

I am sure you have not watched the videos because otherwise your would reply
differently.

Again, human physiology that you can not deny or call a lie:

[https://livinontheveg.com/omnivore-or-
herbivore/](https://livinontheveg.com/omnivore-or-herbivore/)

[https://www.youtube.com/watch?v=sXj76A9hI-o](https://www.youtube.com/watch?v=sXj76A9hI-o)

By far most humans do not like and do not eat raw meat.

Most humans do not even like predigested meat in the form of cooked meat or
grilled meat without further additions like salt and spices and other plant
based food for the taste.

~~~
agsdfgsd
>Yes it is.

No it is not, read the context you intentionally cut out: "Quite a large
population in the the world lives at place where fishes aren't available".

>The human body works best with vegan food as main food or only vegan food in
2018 with modern vitamin supplements

There is no evidence to support your assertion. The fact that vitamin
supplements are required in order to avoid dying is incontrovertible evidence
that humans are not herbivores. Our digestive tract, dentition, and enzyme
production are those of an omnivore. We have absolutely no characteristics of
herbivores.

>Even cows can digest milk and meat to some degree

All mammals can digest milk, that is why all mammals produce milk. That has
nothing to do with your claim. Meat fed to cattle is pre-digested in order to
allow them to get some energy value from it. They can not digest it normally.

>Again, human physiology that you can not deny or call a lie:

It is a bunch of lies and deliberate nonsense. Claws do not define diet, that
is a completely irrelevant characteristic to focus on. Dogs are not omnivores
they are carnivores. Our closest primate relatives are omnivores just like us,
not herbivores. Notice how you keep referencing vegan activists spouting
nonsense on blogs and videos? That is not evidence. There is a reason every
biologist in the US has read this book rather than watch vegan youtube videos:
[https://www.amazon.ca/Mammalogy-Adaptation-Diversity-
George-...](https://www.amazon.ca/Mammalogy-Adaptation-Diversity-George-
Feldhamer/dp/0801886953)

>Most humans do not even like predigested meat in the form of cooked meat or
grilled meat without further additions like salt and spices and other plant
based food for the taste.

And your basis for this claim is that the vast majority of the population of
earth consumes meat all the time? If lots of people choose to add additional
flavorings to something they eat, then that means it isn't part of their
natural diet? By that definition, the natural diet of humans is absolutely
nothing, not even water.

~~~
lustysocietyorg
I will not further defend the points that I have made and still make. You just
call it lies and link a book that I will not buy. Probably because you can not
find valid information against my standpoint on the internet.

Wolves are presented as typical carnivores in the linked video.

The web page puts dogs in the category of omnivores like many experts do or
did.

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

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

[http://www.vetstreet.com/our-pet-experts/are-dogs-
carnivores...](http://www.vetstreet.com/our-pet-experts/are-dogs-carnivores-
heres-what-new-research-says)

I link these "vegan activists" because they were active to create the good
videos that I can link.

I live in West-Europe and from primary school to university, the
recommendation for food has always been less meat and less cheese and less fat
and less candy and more vegetables including fruits and more fiber.

The benefits of a plant based or vegan diet have become only more
scientifically validated and more accepted in the population. Also because of
a growing acceptance that actions against climate warming and pollution and
unsustainable and horrible animal farming are needed.

[https://xkcd.com/1338/](https://xkcd.com/1338/)

[http://www.who.int/features/qa/cancer-red-
meat/en/](http://www.who.int/features/qa/cancer-red-meat/en/)

[https://www.ncbi.nlm.nih.gov/m/pubmed/19562864/](https://www.ncbi.nlm.nih.gov/m/pubmed/19562864/)

[https://www.ncbi.nlm.nih.gov/m/pubmed/27886704/](https://www.ncbi.nlm.nih.gov/m/pubmed/27886704/)

[https://www.ncbi.nlm.nih.gov/m/pubmed/21139125/](https://www.ncbi.nlm.nih.gov/m/pubmed/21139125/)

[https://www.eatright.org/food/nutrition/vegetarian-and-
speci...](https://www.eatright.org/food/nutrition/vegetarian-and-special-
diets/feeding-vegetarian-and-vegan-infants-and-toddlers)

~~~
agsdfgsd
>You just call it lies

You are literally linking to youtube videos by an infamous crank.

>link a book that I will not buy

You don't need to buy it. The point is, biology text books contradict your
advocate fraud. Which is more credible?

>The web page puts dogs in the category of omnivores like many experts do or
did.

Dogs are the same species as wolves.

>I live in West-Europe and from primary school to university, the
recommendation for food has always been less meat and less cheese and less fat
and less candy and more vegetables including fruits and more fiber.

And health problems have gotten worse. Funny how that works huh? Myocardial
infarctions literally did not exist prior to the 1900s when "vegetable oil"
was introduced to our diets. We consume far less animal fat than Victorians
did, yet have far worse health. Hmmm.

>The benefits of a plant based or vegan diet have become only more
scientifically validated and more accepted in the population.

There is no evidence to support that belief.

>Also because of a growing acceptance that actions against climate warming and
pollution and unsustainable and horrible animal farming are needed.

That has nothing to do with veganism, it is a red herring vegans use to push
their agenda on the back of environmentalism which people are more receptive
to.

------
resters
This headline is quite misleading (and arguably very biased toward white
readers). It describes a marked improvement in outcomes for African American
study participants.

So perhaps NPR views this as "disappointing" but the headline suggests broadly
that everyone should stop taking those supplements, when in fact the results
are far more nuanced.

HN's absurd title policy is using a clickbait (and misleading) title chosen by
NPR and amplifying it.

~~~
dang
HN's policy is just the opposite. It would be good to know what the guidelines
are before calling them absurd!

" _Please use the original title, unless it is misleading or linkbait_."

[https://news.ycombinator.com/newsguidelines.html](https://news.ycombinator.com/newsguidelines.html)

~~~
koboll
This is absolutely a clickbait title.

A better one would be something like "Landmark Study On Fish Oil and Vitamin D
Shows Fish Oil Reduces Heart Attacks, But Few Other Benefits"

~~~
Fnoord
Orig title was: "Vitamin D And Fish Oil Supplements Disappoint In Long-Awaited
Study Results"

Current title is: "Long-Awaited Study Results on Vitamin D and Fish Oil
Supplements"

The current title doesn't contain the conclusion which is much more neutral
and invites for more reading. The current title is not clickbait.

~~~
resters
It was fixed after my comment.

------
dawhizkid
Why do we keep looking for some magic pill and ignore diet and exercise,
especially when we talk about cancer and cardiovascular disease? Expecting a
pill to counteract a sedentary lifestyle and a diet high in sugar and carbs is
lunacy.

~~~
Leary
Show me a randomized control study of healthy people with lower all cause
mortality from either diet or exercise, and I'll gladly change my ways.

~~~
lhl
One of the largest observational studies done, the PURE study (large,
epidemiological cohort study of individuals aged 35-70 years (enrolled between
Jan 1, 2003, and March 31, 2013) in 18 countries with a median follow-up of
7·4 years (IQR 5·3-9·3). Dietary intake of 135 335 individuals was recorded
using validated food frequency questionnaires) includes statistically
significant all-cause mortality data and is the best controlled for study yet.

Here are the abstract results: Higher carbohydrate intake was associated with
an increased risk of total mortality (highest [quintile 5] vs lowest quintile
[quintile 1] category, HR 1·28 [95% CI 1·12-1·46], ptrend=0·0001) but not with
the risk of cardiovascular disease or cardiovascular disease mortality. Intake
of total fat and each type of fat was associated with lower risk of total
mortality (quintile 5 vs quintile 1, total fat: HR 0·77 [95% CI 0·67-0·87],
ptrend<0·0001; saturated fat, HR 0·86 [0·76-0·99], ptrend=0·0088;
monounsaturated fat: HR 0·81 [0·71-0·92], ptrend<0·0001; and polyunsaturated
fat: HR 0·80 [0·71-0·89], ptrend<0·0001). Higher saturated fat intake was
associated with lower risk of stroke (quintile 5 vs quintile 1, HR 0·79 [95%
CI 0·64-0·98], ptrend=0·0498). Total fat and saturated and unsaturated fats
were not significantly associated with risk of myocardial infarction or
cardiovascular disease mortality. INTERPRETATION: High carbohydrate intake was
associated with higher risk of total mortality, whereas total fat and
individual types of fat were related to lower total mortality. Total fat and
types of fat were not associated with cardiovascular disease, myocardial
infarction, or cardiovascular disease mortality, whereas saturated fat had an
inverse association with stroke. Global dietary guidelines should be
reconsidered in light of these findings.

doi: 10.1016/S0140-6736(17)32252-3

See also: 10.1016/S0140-6736(18)31812-9

If your primary interest is in longevity, IMO your best bet is to eat less
often:

10.1016/j.cmet.2014.02.006

10.1111/j.1474-9726.2012.00798.x

10.1126/science.1172539

10.1016/j.cell.2015.02.020

10.1111/acel.12338

10.1097/MCO.0000000000000239

10.1016/j.arr.2006.04.002

Also, exercise isn't bad either:

10.1371/journal.pone.0000465

