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In the largest-scale study of its kind to date, researchers tracked the health outcomes of nearly half a million middle-aged participants in the U.K.
March 10, 2020
By: Mike Montemarano
A study published on March 4 in the BMJ Medical Journal yielded evidence that habitual fish oil supplementation significantly reduces the risk of all-cause mortality, cardiovascular disease (CVD) mortality, and mortality from CVD incident events. Fish oil, a rich source of the long-chain omega-3 fatty acids EPA and DHA, has been attached to several large-scale randomized controlled trials, in an attempt to prove that it significantly reduces the risk of CVD and related health incidents. Some studies have previously found statistically significant evidence suggesting the positive health claim, while others have yielded correlations too small to be considered significant. Of the UK Biobank participants who were evaluated, 31.2% of the participants reported habitual use of fish oil supplements. Using multivariable adjusted hazard ratios for the habitual users versus non-users of fish oil, the researchers found that those who took fish oil saw a 13% reduction in all-cause mortality rates, a 16% reduction in cardiovascular disease mortality rates, and a 7% reduction in incident CVD events compared to the majority of the group which didn’t use the supplement. “Habitual use of fish oil seems to be associated with a lower risk of all cause and CBD mortality and to provide a marginal benefit against CVD events among the general population,” the researchers concluded. “The protective association of fish oil use against CVD events was somewhat stronger in those with prevalent hypertension.” Further research is required to determine what function fish oil serves in relation to clinical outcomes. “Several mechanisms could explain the benefits for clinical outcome derived from fish oil supplementation,” researchers said. “Firstly, the results of several studies have indicated that supplementation with omega 3 fatty acids has beneficial effects on blood pressure, plasma triglycerides, and heart rate, all of which would exert a protective effects against the development of CVD. Secondly, several trials have shown that omega 3 fatty acids can improve flow mediated arterial dilation, which is a measure of endothelial function and health. Thirdly, omega 3 fatty acids have been shown to possess antiarrhythmic properties that could be clinically beneficial. Finally, studies have reported that fish oil can reduce thrombosis.” The BMJ cohort study, likely the largest-scale study of its kind to date, tracked the health outcomes of 427,678 men and women aged between 40 and 69 who had no CVD or cancer at baseline, who enrolled in the study between 2006 and 2010 and were followed up with at the end of 2018. While the study possessed strengths which included a population-based cohort of nearly a half-million participants to show fish oil’s effectiveness in a real-life setting, including detailed information on individual factors, some limits included the detailed information on supplementation itself. Researchers did not elicit detailed information on supplement use itself, such as the dose, formulation, and duration of use. “The lack of such information precluded us from evaluating dose-response associations between fish oil supplementation and outcomes, the independent effects and best ratio of the individual components of fish oil supplements, and the optimal duration of fish oil supplementation,” the study authors wrote. It is also difficult to comment on the dose of fish oil supplements needed to achieve a clinically meaningful effect.” Participants completed a questionnaire, a face-to-face interview, and provided biological samples and physical measurements to researchers. Participants with incomplete data on the use of fish oil (declined to say “yes” or “no” when asked if they habitually use fish oil), those with CVD or cancer at baseline, or those who subsequently withdrew from the study were excluded from the analysis by researchers. At the end of the study, participants’ health outcomes had been monitored for a median of nine years. Researchers also used the questionnaire to identify several possible counfounding variables to minimize inferential bias and adjust accordingly, including demographic factors, socioeconomic status, lifestyle habits, body mass index, physical activity, dietary intake, drug use, and other dietary supplementations.
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