By Sarah A LoBisco, ND
My homepage blog discusses the power of belief on health outcomes. This placebo effect that acts as a control in medical research is strong. It is the standard of measurement on if an intervention has an effect and determining what is the benefits-to-risk ratio.
Below are some top trials in nutrient supplements and lifestyle factors that have been shown to have an outstanding and empowering effect on our bodies (emphasis mine)!
What is More Powerful than Placebo?
CoQ10 and Heart Power
The current study, which thus far has only been presented at a conference, albeit a prestigious one, and not yet published in full in the peer-reviewed literature, appears to be a game-changer. The trial was conducted in nine countries, enrolled hundreds of patients, and followed them for two years. It had all the right bells and whistles, too: It was randomized, double-blinded, and placebo-controlled.
The punch line was refreshingly straightforward: The CoQ10 group had half the mortality rate, and half as many adverse cardiac events, as the placebo group. Both findings were of clear statistical significance. That they were of stunning clinical significance is all but self-evident, but it embellishes the case to note that a drug to lower mortality in congestive heart failure has not been identified in over a decade.
What makes this study truly astonishing, and causes it to reverberate through modern medicine far beyond the topics of either CoQ10 or heart failure, is that the very possibility of such an effect was overtly dismissed that same decade ago.
Source: Katz, D. CoQ &A. The Huffington Post (huffingtonpost.com). May 31, 2013. http://www.huffingtonpost.com/david-katz-md/coenzyme-q10-heart-failure_b_3365355.html
Fish Oil and a Stressed Heart
“In today’s fast-paced society, stress is as certain as death and taxes,” study researcher Jason Carter, a researcher at the university, said in a statement. “Moreover, our eating habits have deteriorated. This study reinforces that fish oils may be beneficial for cardiovascular health, particularly when we are exposed to stressful conditions.”
The study, published in the American Journal of Physiology: Regulatory, Integrative, and Comparative Physiology, included 67 people without hypertension who were assigned to take either 9 grams of a fish oil supplement for eight weeks, or a placebo of olive oil for eight weeks. Before starting the supplements and at the end of the study period, all the participants underwent blood pressure, heart rate and other testing.
At the end of the study, researchers had the study participants do an arithmetic test, during which their stress responses were measured. They found that the participants who took the fish oil supplements had blunted the reactivity of the muscle sympathetic nerve activity, as well as the effects of mental stress on heart rate. However, fish oil did not seem to have an impact on the reactivity of blood pressure to mental stress.
Note: This study did not use a true placebo, but more of a comparison. Olive oil has been shown to have positive effects on heart health which might explain why a stronger difference was not found!
Source: Huffington Post. Fish Oil Could Blunt Effects Of Mental Stress On Heart, Small Study Suggests. Lifestyle. 6/18/13. http://www.huffingtonpost.com/2013/06/18/fish-oil- mental-stress-heart-rate-_n_3437113.html?ref=topbar
Negative Attention on Fish Oils-Is it Warranted?
Many studies have reported powerful effects from fish oil for many factors. Recent negative attention on one large trial may not be warranted. Craig Wetherby did a wonderful summary of the trials’ shortcomings:
Most media coverage of a large new clinical trial claims that fish oil didn’t live up to its heart-healthy reputation. The five-year trial involved 12,513 people who showed evidence of atherosclerosis or had multiple cardiovascular risk factors … but who’d not suffered a heart attack. Although the results were disappointing in some regards, they were positive in other ways, and the negative outcomes were both unsurprising and explicable.
The Italian trial tested the ability of omega-3 fish oil to do either of two things:
Reduce death rates from cardiovascular causes.
Reduce hospital admissions related to cardiovascular health.
After five years, there was no drop in death rates, or reduction in overall hospital admissions related to cardiovascular health, overall.
The results seemed disappointing, compared with those of some prior trials … but there are reasons why we added the qualifier, “overall”.
In fact, the trial results showed these significant benefits … a fact overlooked by most media reports:
HDL (“good”) cholesterol rose slightly.
Women were 18 percent less likely to die from heart-related causes.
Triglyceride levels dropped 28 percent more than in the control group.
Hospital admissions for heart failure dropped by 34 percent among men and women.
Prior, positive clinical trials …
Both GISSI trials found that fish oil supplements reduced the risk of sudden cardiac death, which is usually caused by a risky irregular heart rhythm (ventricular arrhythmia).
…The JELIS trial showed that adding EPA to statin therapy cut major coronary events (heart attack, stroke, death) by 19 percent, compared with the no-EPA control group, which took only statins and other cardiac drugs.
Not every subsequent trial has shown the benefits seen in the GSSI and JELIS trials … but many suffered from limitations or confounding factors that muddied the waters:
Trial was small or short.
Omega-3 doses were low.
Participants were very sick.
Participants were taking cardiac drugs (e.g., statins) proven to reduce heart risks.
Sources:
Weatherby, C. Does Fish Oil Really Help Hearts? VitalChoice Newsletter. 5/9/2013.
Yokoyama M, Origasa H; JELIS Investigators. Effects of eicosapentaenoic acid on cardiovascular events in Japanese patients with hypercholesterolemia: rationale, design, and baseline characteristics of the Japan EPA Lipid Intervention Study (JELIS) (abstract). Am Heart J. 2003 Oct;146(4):613-20.
Yokoyama M. [Japan EPA Lipid Intervention Study (JELIS). Randomized clinical trial involving primary and secondary prevention of cardiovascular events with EPA in hypercholesterolemia] Nihon Ronen Igakkai Zasshi. 2009 Jan;46(1):22-5. Japanese.
More Evidence of Fish Oil Efficacy
Another scientific measure for effectiveness of an intervention is the use of comparison trials. These experiments use two different populations or comparing levels in the blood of an intervention on outcomes.
The following support the heart benefits of fish oil:
Fish Oil and Stress on the Heart
Conclusion: Short-term fish-oil supplementation may favorably influence the frequency domain of heart rate variability, as indicated by an enhanced vagal tone, which may be an important mechanism underlying the antiarrhythmic and other clinical effects of fish oil.
Source: Wei Xin,Wei Wei, and Xiao-Ying Li. Short-term effects of fish-oil supplementation on heart rate variability in humans: a meta-analysis of randomized controlled trials (abstract). Am J Clin Nutr May 2013 ajcn.049833. http://ajcn.nutrition.org/content/early/2013/03/19/ajcn.112.049833.abstract
Levels of Omega Fish Oil and Death
BOSTON — The highest levels of plasma phospholipid omega-3 polyunsaturated fatty acids (PUFA), as measured in >2500 older adults initially without coronary heart disease or a history of stroke, predicted the lowest mortality in the observational, prospective Cardiovascular Health Study (CHS)[1].
In comparisons of the highest quintile of omega-3 PUFA levels vs the lowest quintile, all-cause mortality fell by 27%, with most of the benefit due to a reduction in cardiovascular death. The rate of arrhythmic death, in particular, fell by nearly one-half.
Source: Stiles, S. Omega-3 PUFA as Biomarkers: Plasma Levels Predict Mortality, CV Events in CHS Analysis. Heartwire. April 3, 2013. http://www.medscape.com/viewarticle/781894? src=wnl_edit_specol&uac=146852BY
My final thought:
Studies have shown so many benefits of fish oil. Due to the fact that most people are not eating healthy fats to fuel their cardiac muscles, I tend to suggest supplementation of high quality fish oil for most of my clients.
