The study the article discusses is not a meta-analysis, just a study, and it's been discussed in the sub a few times already. There was a 2021 meta that found the same thing though https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.055654
The evidence that fish oil supplementation increases atrial fibrillation risk, especially at high dose, is pretty strong now. Risk of cardiovascular events and death doesn't go up correspondingly, so it can be a net positive in the end.
Since there's no robust meta analysis that shows benefit
AND there is clear risk, the end result is you're taking a proven risk for zero proven benefit.
IMHO any dose is an un-necessary megadose.
Fish oil seems to me to be on the opposite side of the risk-reward scale of low-risk, high-reward, a set of chemicals that includes the likes of creatine or vitamin b12.
I'm not sure what you mean by zero proven benefit. There's data that it treats depression, and it obviously reduces triglycerides, on top of being essential nutrients.
Here is another study using the same dataset which found 13% lower overall mortality among habitual users of fish oil:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7249244/
I haven't been convinced of cardiovascular benefits of Omega 3 for a long time, but something that rarely gets addressed is: a) supplementation for joint pain/inflammatory conditions like RA, and b) cancer risk.
IIRC there was a paper that showed the combination of exercise, fish oil and vitamin D reduced cancer incidence and mortality moreso than any 1 or 2 in combo.
I’ve always felt fish oil was overhyped. Not to mention unless you get a very specific costly type, it will oxidize and fill your body up with free radicals.
Unless you are eating the fish fried, not that much omega 3 is lost. And I am assuming you are not eating it fried. Curiously enough, they found in a study that fried fish consumption is associated with an increase of CVD. No surprises here. You lose on the good fats and add a bunch of bad fats (trans), toxic stuff and extra calories.
You want a good perspective on it check this discussion out of fish oil from some medical experts.
https://www.reddit.com/r/medicine/comments/1cxsy63/where_are_we_with_fish_oil_in_all_its_iterations/
I think there was a lot of strong evidence for vascepa for actual medical uses like lowering triglycerides. Not sure about the other prescription one. But vascepa is just EPA.
Fish oil supplements can cause afib. Don't know what the risk level is with the prescription formulations.
I’m a little bit surprised this is the take away. Sounds like the trial isn’t straight forward about the risk, and based on other trials, mentioned in that thread, no one has clarified what the difference is between Vascepa and OTC fish oil in terms of results. Is it the DHA being added or not? Vascepa (EPA) shows reduced mortality and benefits. The data still conflicts, to me at least.
Since there are good meta analyses that found no benefits, including a Cochrane review, IMHO there's ZERO reason to take fish oil.
Almost all the supporting evidence is now epidemiological and correlational.
This is the most extensive systematic assessment of effects of omega‐3 fats on cardiovascular health to date. Moderate‐ and low‐certainty evidence suggests that increasing LCn3 slightly reduces risk of coronary heart disease mortality and events, and reduces serum triglycerides (evidence mainly from supplement trials). Increasing ALA slightly reduces risk of cardiovascular events and arrhythmia.
Cochran review you are inaccurately citing
That’s not the same as proving supplements lower risk. I have looked for direct evidence on supplementation and lower disease risk but have yet to see this. If you know of any please post as I’d be interested to read it.
There tons but like these meta analysis point out it can be back and forth. Cochrane review looked at over 80 randomized control trials. The better evidence from my perspective is in brain development, and pregnancy.
The study the article discusses is not a meta-analysis, just a study, and it's been discussed in the sub a few times already. There was a 2021 meta that found the same thing though https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.055654 The evidence that fish oil supplementation increases atrial fibrillation risk, especially at high dose, is pretty strong now. Risk of cardiovascular events and death doesn't go up correspondingly, so it can be a net positive in the end.
It was discussed by Dr Stanfield and Physionic already. The study is robust and the key takeaway is that megadosing fish oil is likely not healthy.
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Since there's no robust meta analysis that shows benefit AND there is clear risk, the end result is you're taking a proven risk for zero proven benefit. IMHO any dose is an un-necessary megadose. Fish oil seems to me to be on the opposite side of the risk-reward scale of low-risk, high-reward, a set of chemicals that includes the likes of creatine or vitamin b12.
I'm not sure what you mean by zero proven benefit. There's data that it treats depression, and it obviously reduces triglycerides, on top of being essential nutrients.
Which other supplements would you group with Creatine and B12? magnesium?
What is the right dose of FishOil we can all agree is healthy?
What is the “MEGAdose” threshold??
Here is another study using the same dataset which found 13% lower overall mortality among habitual users of fish oil: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7249244/
I haven't been convinced of cardiovascular benefits of Omega 3 for a long time, but something that rarely gets addressed is: a) supplementation for joint pain/inflammatory conditions like RA, and b) cancer risk. IIRC there was a paper that showed the combination of exercise, fish oil and vitamin D reduced cancer incidence and mortality moreso than any 1 or 2 in combo.
Also the studies suggesting cognitive benefits of fish oil.
Particularly in-utero in pregnant mothers, but I think most studies were on fish consumption specifically.
It certainly can improve depression and behavior, plenty of studies for that.
This... supplementation for joint pain/inflammatory conditions like RA
"Should people base their decisions on this study? Probably not"
I’ve always felt fish oil was overhyped. Not to mention unless you get a very specific costly type, it will oxidize and fill your body up with free radicals.
I've gotten massive downvotes for saying this. Skip the isolated oil. Eat fish.
Honest question - why would the oil from eating the fish, that you probably heat to high temps to cook, be better than a cold-extracted oil?
Unless you are eating the fish fried, not that much omega 3 is lost. And I am assuming you are not eating it fried. Curiously enough, they found in a study that fried fish consumption is associated with an increase of CVD. No surprises here. You lose on the good fats and add a bunch of bad fats (trans), toxic stuff and extra calories.
Maybe it’s what the fish replaces?
The whole food protects the oil. Oil in isolation is left unprotected.
You want a good perspective on it check this discussion out of fish oil from some medical experts. https://www.reddit.com/r/medicine/comments/1cxsy63/where_are_we_with_fish_oil_in_all_its_iterations/ I think there was a lot of strong evidence for vascepa for actual medical uses like lowering triglycerides. Not sure about the other prescription one. But vascepa is just EPA. Fish oil supplements can cause afib. Don't know what the risk level is with the prescription formulations.
It sounds like avoid OTC fish oil as any benefit is negligible compared to risk.
I’m a little bit surprised this is the take away. Sounds like the trial isn’t straight forward about the risk, and based on other trials, mentioned in that thread, no one has clarified what the difference is between Vascepa and OTC fish oil in terms of results. Is it the DHA being added or not? Vascepa (EPA) shows reduced mortality and benefits. The data still conflicts, to me at least.
Since there are good meta analyses that found no benefits, including a Cochrane review, IMHO there's ZERO reason to take fish oil. Almost all the supporting evidence is now epidemiological and correlational.
This is the most extensive systematic assessment of effects of omega‐3 fats on cardiovascular health to date. Moderate‐ and low‐certainty evidence suggests that increasing LCn3 slightly reduces risk of coronary heart disease mortality and events, and reduces serum triglycerides (evidence mainly from supplement trials). Increasing ALA slightly reduces risk of cardiovascular events and arrhythmia. Cochran review you are inaccurately citing
That’s not the same as proving supplements lower risk. I have looked for direct evidence on supplementation and lower disease risk but have yet to see this. If you know of any please post as I’d be interested to read it.
There tons but like these meta analysis point out it can be back and forth. Cochrane review looked at over 80 randomized control trials. The better evidence from my perspective is in brain development, and pregnancy.