In 2008, I wrote two posts related to the Wake Forest University School of Medicine study that questioned the place of tilapia in a heart healthy diet. The issue of concern was the ratio of Omega 3 to Omega 6 fatty acids. Some health care professionals and researchers suggested that because the ratio of 3 to 6 was low, tilapia could actually cause inflammation instead of reduce it (like omega 3 fatty acids in salmon are said to do).
I noted in those posts 4 years ago that tilapia was a popular fish that was mild in taste, low in calories, saturated fat, and mercury and high in protein. In other words, it was a really great food. Right before starting this post, I had tilapia for dinner! (with roasted Brussels sprouts and baby corn).
In a special section of this month's Nutrition Action Health Letter several myths, scams and claims are challenged. The tilapia "caution" is one of them. The WFU study was summarized and the tilapia naysayer was identified as Dr. Andrew Weil. I have found him to be a little extreme with his nutrition advice at other times as well. This article doesn't say that tilapia has a higher ratio than was suggested by the WFU researchers, it just clarifies that the low ratio has NOT been conclusively linked to any adverse health outcome.
The American Heart Association considers tilapia to be a good choice and since we are talking about inflammation and its relation to heart disease, that is a good enough endorsement for me. To be clear - salmon is the better fish for heart health.
Showing posts with label omega 3. Show all posts
Showing posts with label omega 3. Show all posts
Wednesday, November 7, 2012
Wednesday, September 12, 2012
Plate or Pill? Fish Oil Revisited.
I feel a personal responsibility to respond on the results from the omega 3 fatty acids study that is published this week in the peer reviewed journal of the American Medical Association or JAMA.
You may have already heard the 'news' that there is a lack of evidence to suggest a health benefit from the use of fish oil supplements. That would be an accurate headline that does align with the study results.
My need to address the study here comes from my post in 2009 after I returned from an truly enjoyable and educational week at the Cooper Institute in Dallas Texas. Dr. Kenneth Cooper is a strong advocate for fish oil supplementation and after hearing him speak, and share research, I was convinced of the positive effect. If you are familiar with my blog you know that I strongly and emphatically endorse nutrient intake in the form of food not pills. It was a departure for me to share his recommendation on supplementation.
So what happened to change the consensus? Past research did show a positive benefit from fish oil. (and Dr. Cooper made his assessment based on the research that was available at the time) Some of the studies used fish oil capsules, others tracked dietary omega 3s, and a few studied fish oil supplementation in animals.
The current research is a review. It began with a screening of over 3600 study records. Of those, the scientists used only 20 which met strict inclusion criteria. The ones included were considered sound research studies. They had to be randomized and include control groups. People who were different only by random chance and not in any systematic way were given pills or not given pills. The studies that were included had to last more than one year. Most of them were blinded - people did not know what they were being given in order to reduce the chance of a placebo effect. The scientists considered the design of the study, the actual robustness of the data collected and how the data was analyzed. All of this is spelled out in their research article allowing other scientists to challenge or confirm their conclusions. The outcomes that were studied include, death from any cause, sudden death, cardiac mortality, heart attack and stroke.
Of these 20 studies, two of them were a comparison of dietary intake not pills. Those 2 studies cancelled themselves out and were not discussed further in the article.
On a separate note, the Mediterranean diet has been the subject of much research and eating fish has been associated with positive health outcomes. It was this association that led to supplementation in the first place.
The authors conclude that there is no evidence to support the use of fish oil supplements in clinical practice. In other words, doctors should not prescribe it to prevent first heart attacks or to treat heart disease.
The pills are very expensive and this is a sad dollar day for the supplement industry. The pills are out, but the salmon benefit is still very real.
At the end of the day, in my role as public health professional, that leaves one nutrient/vitamin to consider for supplementation - Vitamin D. There just isn't any way to get sunshine onto a plate and the best source of Vitamin D is the sun. Talk to your doctor before starting on any medications or supplements.
The study abstract is available:
You may have already heard the 'news' that there is a lack of evidence to suggest a health benefit from the use of fish oil supplements. That would be an accurate headline that does align with the study results.
My need to address the study here comes from my post in 2009 after I returned from an truly enjoyable and educational week at the Cooper Institute in Dallas Texas. Dr. Kenneth Cooper is a strong advocate for fish oil supplementation and after hearing him speak, and share research, I was convinced of the positive effect. If you are familiar with my blog you know that I strongly and emphatically endorse nutrient intake in the form of food not pills. It was a departure for me to share his recommendation on supplementation.
So what happened to change the consensus? Past research did show a positive benefit from fish oil. (and Dr. Cooper made his assessment based on the research that was available at the time) Some of the studies used fish oil capsules, others tracked dietary omega 3s, and a few studied fish oil supplementation in animals.
The current research is a review. It began with a screening of over 3600 study records. Of those, the scientists used only 20 which met strict inclusion criteria. The ones included were considered sound research studies. They had to be randomized and include control groups. People who were different only by random chance and not in any systematic way were given pills or not given pills. The studies that were included had to last more than one year. Most of them were blinded - people did not know what they were being given in order to reduce the chance of a placebo effect. The scientists considered the design of the study, the actual robustness of the data collected and how the data was analyzed. All of this is spelled out in their research article allowing other scientists to challenge or confirm their conclusions. The outcomes that were studied include, death from any cause, sudden death, cardiac mortality, heart attack and stroke.
Of these 20 studies, two of them were a comparison of dietary intake not pills. Those 2 studies cancelled themselves out and were not discussed further in the article.
On a separate note, the Mediterranean diet has been the subject of much research and eating fish has been associated with positive health outcomes. It was this association that led to supplementation in the first place.
The authors conclude that there is no evidence to support the use of fish oil supplements in clinical practice. In other words, doctors should not prescribe it to prevent first heart attacks or to treat heart disease.
The pills are very expensive and this is a sad dollar day for the supplement industry. The pills are out, but the salmon benefit is still very real.
At the end of the day, in my role as public health professional, that leaves one nutrient/vitamin to consider for supplementation - Vitamin D. There just isn't any way to get sunshine onto a plate and the best source of Vitamin D is the sun. Talk to your doctor before starting on any medications or supplements.
The study abstract is available:
Saturday, May 23, 2009
wellness weekly
Okay back to the regular news and a video meal:
The News:
Prescription Drugs: I believe that anyone who has read at least three of my blog entrees, even ones from the early 00s, knows that I have a very strong inclination against prescription drugs. It is also true that when a disease can be controlled or cured and quality life years added, I support pharmacotherapy. That is my little disclaimer I guess. I don’t want people to think that I never advocate for meds. I am not doing so today however. This past week has been a disturbing one in several ways. One big pharma is reported to have paid less taxes than one would expect due to a certain way that they closed a deal, and another kept worrisome clinical trial results hidden from people taking a certain antipsychotic drug. By the way, this is NOT the first case like that. Another company is in trouble for over charging Medicaid. All are being investigated. I also spoke to a man this week who listed six or seven prescription meds he has to take, though he couldn’t name any chronic disease that he had. Another woman told me that the doctor keeps putting her adult daughter on more and more meds and is stymied because she isn’t losing weight. The mother said to me, “He doesn’t understand. She eats like a pig.” Another woman told me how when she was first diagnosed with emphysema, she continued to smoke and could not make her inhaler last for the whole month. On a positive note, she told me that she has quit smoking and hardly needs to use the inhaler. That is EXACTLY why it is never too late to quit smoking. If you have a disease and are in treatment for it, that treatment will be more effective if you stop the activity that is causing the disease. I know, I am so smart. Back to the drug companies, one of them markets an inhaler for COPD in TV commercials and actually says during the commercial that the medicine can be used by current smokers. WHAT?!?!?! Too many meds, too many side effects, and too little personal responsibility. Remember, at least four of the ten leading causes of death and disability CAN and should be prevented.
Omega 3s: I want to say more about this today. First I advise that you read a little more from a trusted source, i.e, a non profit volunteer agency that does not also sell supplements! The American Heart Association. Here is a direct link: Fish and Omega-3 Fatty Acids. I want to revisit this for two reasons. First, last week I reported that Dr. K Cooper said in his lecture that everyone needs to take Omega 3s in supplement form and that the dose is 1g per day. I know he said 1 gram and that it should be 60% DHA/EPA, both of those statements are supported in other literature but the AHA has different dosage recommendations based on an individuals health. According to the AHA for example, I do not need to take the supplement but someone wanting to reduce their LDL or with existing heart disease should. Also they recommend even higher doses for some people, with physician supervision. You must make your own educated decisions. But here is the second thing I want to emphasize. The amount and type of Omega 3 that these companies are adding to your bread, eggs, milk and whatnot, are both WRONG. I checked out a milk carton today that very boastfully claimed 36 mg of Omega 3, well, great, where are you going to get the other 964 mg you need to get 1 GRAM. One place is in salmon, but oh my gosh, there is another awesome link on the AHA, it lists mercury content in one column and omega 3 in the other (by gram). This is wonderful and the kind of info I need to bring out to the community. Fish, Levels of Mercury and Omega-3 Fatty Acids
Device Recall Hits ‘em Where it Hurts: Drugs and devices, both types of companies can get seedy with their direct to consumer advertising and their doctor pandering. More reason to eat your fish and not your chips! We have had recalls of pacemaker batteries, wires that misfire, defibrillators, stents that reclog and more, but this time Medtronic got in trouble with a bone graft device that doctors recommended and used for off label conditions. They can do that, but the concern is that they may have been paid consulting or speaking fees and indirectly marketed the device for a treatment for which it was not FDA approved. Things have gotten bad because a lot of adverse health outcomes were reported for the off label use. Seriously, the FDA didn’t seem that keen on the device for the regular use either. This off label stuff is serious business, I myself had to sign a disclaimer before talking to docs about tobacco addiction treatment. Anyway, according to the WSJ this week, there has been a near 70% profit drop for Medtronic and jobs are being cut.
Fitness: Just a short bit to remind you that physical fitness is measured by muscle strength and endurance as well as flexibility and cardiovascular conditioning. It is important and imperative to good health to exercise your heart. Cardiovascular activity, what we often think of as aerobic, includes activities that get your heart rate up. A weight bearing exercise is not necessarily cardio and cardio is not necessarily weight bearing. What does weight bearing have to do with it? Weigh bearing exercises help men and women prevent bone loss. So running is an example of both cardio and weight bearing while swimming and cycling are just cardio. Of course walking can really get your heart rate up and you can cycle without increasing your heart rate much. Effort counts! Weight training for fitness is not the same as weight training for a competition. Ladies, relax, really, you won’t bulk up unless you spend hours and hours and hours in the gym weekly. Flexibility can be gained through simple stretches, yoga, pilates, etc. Whatever You are willing to do. You can work your core also without doing crunches, by doing the plank for example.
Okay then what are you doing? Don’t just sit there you have diseases to prevent…
Live Well
Deirdre
the following video is a dinner I put together after work one day. enjoy
The News:
Prescription Drugs: I believe that anyone who has read at least three of my blog entrees, even ones from the early 00s, knows that I have a very strong inclination against prescription drugs. It is also true that when a disease can be controlled or cured and quality life years added, I support pharmacotherapy. That is my little disclaimer I guess. I don’t want people to think that I never advocate for meds. I am not doing so today however. This past week has been a disturbing one in several ways. One big pharma is reported to have paid less taxes than one would expect due to a certain way that they closed a deal, and another kept worrisome clinical trial results hidden from people taking a certain antipsychotic drug. By the way, this is NOT the first case like that. Another company is in trouble for over charging Medicaid. All are being investigated. I also spoke to a man this week who listed six or seven prescription meds he has to take, though he couldn’t name any chronic disease that he had. Another woman told me that the doctor keeps putting her adult daughter on more and more meds and is stymied because she isn’t losing weight. The mother said to me, “He doesn’t understand. She eats like a pig.” Another woman told me how when she was first diagnosed with emphysema, she continued to smoke and could not make her inhaler last for the whole month. On a positive note, she told me that she has quit smoking and hardly needs to use the inhaler. That is EXACTLY why it is never too late to quit smoking. If you have a disease and are in treatment for it, that treatment will be more effective if you stop the activity that is causing the disease. I know, I am so smart. Back to the drug companies, one of them markets an inhaler for COPD in TV commercials and actually says during the commercial that the medicine can be used by current smokers. WHAT?!?!?! Too many meds, too many side effects, and too little personal responsibility. Remember, at least four of the ten leading causes of death and disability CAN and should be prevented.
Omega 3s: I want to say more about this today. First I advise that you read a little more from a trusted source, i.e, a non profit volunteer agency that does not also sell supplements! The American Heart Association. Here is a direct link: Fish and Omega-3 Fatty Acids. I want to revisit this for two reasons. First, last week I reported that Dr. K Cooper said in his lecture that everyone needs to take Omega 3s in supplement form and that the dose is 1g per day. I know he said 1 gram and that it should be 60% DHA/EPA, both of those statements are supported in other literature but the AHA has different dosage recommendations based on an individuals health. According to the AHA for example, I do not need to take the supplement but someone wanting to reduce their LDL or with existing heart disease should. Also they recommend even higher doses for some people, with physician supervision. You must make your own educated decisions. But here is the second thing I want to emphasize. The amount and type of Omega 3 that these companies are adding to your bread, eggs, milk and whatnot, are both WRONG. I checked out a milk carton today that very boastfully claimed 36 mg of Omega 3, well, great, where are you going to get the other 964 mg you need to get 1 GRAM. One place is in salmon, but oh my gosh, there is another awesome link on the AHA, it lists mercury content in one column and omega 3 in the other (by gram). This is wonderful and the kind of info I need to bring out to the community. Fish, Levels of Mercury and Omega-3 Fatty Acids
Device Recall Hits ‘em Where it Hurts: Drugs and devices, both types of companies can get seedy with their direct to consumer advertising and their doctor pandering. More reason to eat your fish and not your chips! We have had recalls of pacemaker batteries, wires that misfire, defibrillators, stents that reclog and more, but this time Medtronic got in trouble with a bone graft device that doctors recommended and used for off label conditions. They can do that, but the concern is that they may have been paid consulting or speaking fees and indirectly marketed the device for a treatment for which it was not FDA approved. Things have gotten bad because a lot of adverse health outcomes were reported for the off label use. Seriously, the FDA didn’t seem that keen on the device for the regular use either. This off label stuff is serious business, I myself had to sign a disclaimer before talking to docs about tobacco addiction treatment. Anyway, according to the WSJ this week, there has been a near 70% profit drop for Medtronic and jobs are being cut.
Fitness: Just a short bit to remind you that physical fitness is measured by muscle strength and endurance as well as flexibility and cardiovascular conditioning. It is important and imperative to good health to exercise your heart. Cardiovascular activity, what we often think of as aerobic, includes activities that get your heart rate up. A weight bearing exercise is not necessarily cardio and cardio is not necessarily weight bearing. What does weight bearing have to do with it? Weigh bearing exercises help men and women prevent bone loss. So running is an example of both cardio and weight bearing while swimming and cycling are just cardio. Of course walking can really get your heart rate up and you can cycle without increasing your heart rate much. Effort counts! Weight training for fitness is not the same as weight training for a competition. Ladies, relax, really, you won’t bulk up unless you spend hours and hours and hours in the gym weekly. Flexibility can be gained through simple stretches, yoga, pilates, etc. Whatever You are willing to do. You can work your core also without doing crunches, by doing the plank for example.
Okay then what are you doing? Don’t just sit there you have diseases to prevent…
Live Well
Deirdre
the following video is a dinner I put together after work one day. enjoy
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