When the reports came out, screaming in the headlines, my husband got a little nervous. He asked me to take a gander. We both have risk factors, conditions, that heighten our risks for cardiovascular problems. I got to reading... I felt extremely comfortable reassuring him that we were safe continuing our fish oil therapy.
@@BradSchoenfailed no.. because humans were eating fish for millions of years and if there was anything wrong with fish we would have been long gone by extinction.
DUDE - CORRELATION!! I'm a statistics-based engineer. 'Baseline' just means 'haven't had a heart issue yet'. Common sense would say that people who get a blood test showing elevated levels of LDL are statistically more likely to take fish oil, as a natural way of improving this value. This statement, if accepted, means that the baseline fish oil population generally has higher LDL (or non-HDL cholesterol) than the population who doesn't feel the need to supplement with fish oil. This would be difficult to tease out from the data, but would explain the 1.13 hazard ratio from baseline vs the lower ratio in other cohorts, due to a slight protective effect at all ranges.
That's a pretty quick shortcut you're taking here. People taking fish oil don't necessarily take it based on their LDL (or any other specific risk factor). You could reasonably argue the exact opposite that people taking fish oil (or supplementing with anything at all) are actually healthier at baseline with lower risk of CVD because they're more health conscious, more likely to exercise, eat a better diet and consume other supplements. I agree that the big issue with all these nutrition and supplementation studies is that there are just too many factors to control for, not to mention that "controlling" for a factor through data analysis after the fact is a very poor control with questionable biological relevance, even if it's the best we can do for something as complex as nutrition. Not only that, but the relative risk are ultimately quite small and almost certainly clinically irrelevant (5-15% increased or decreased risk of something that's very rare in the first place and has very good outcomes even when it happens (you usually don't die from attrial fibrilation). After all, this very same study shows there's zero impact on death.
@childofaether8733 I find atrial fibrillation to be an odd endpoint to choose in the first place, considering the primary benefits of fish oils are purported to be related to inflammation and atherosclerosis. My understanding is that a-fib is either generally benign and transient as you mentioned (and related to electrolyte/neuro/hormonal issues) or caused hy structural heart disease, which is a very weak proxy for atherosclerosis.
@@childofaether8733 furthermore to group differences: those "health conscious" people taking fish oils are more likely to fuck their electrolytes after a marathon, or exercise at very high cardiac outputs, lift very heavy, and/or take steroids: all of which are risk factors for types of structural heart disease and a-fib (to lay people reading this please note this doesn't contextualize all the other benefits of intense exercise - nothing in life has zero risk and please don't drastically alter your lifestyle based off the comment section)
I wasn't a believer when my doctor recommended it to lower my tryglicries, but about 5 blood tests later, my HDL went up, and tryglicries went really down. No study is going to convince me different.
Thanks for the screenshots of the paper discussed as well as the further references to explore. It’s great to have a weekly source of con-ed and to practice reading/evaluating research
@@Joseph1NJ Work in Longevity / Concierge Medicine. Just had to basically had to reassure people that their specific program with fish oil was fine, not to over react.
I am not a cardiologist, but my understanding is that atrial fibrillation is an electrical disease, whereas myocardial infarction is a vascular disease. It's not necessarily a progression from one to another, they're separate causes.
In a nutshell, coronary artery disease (what you are likely referring to as vascular disease) can overtime result in structural remodeling of heart tissue. There are a variety of reasons why this may occur (ischemic scar tissue, dilated atria, etc.), but subsequent to these maladaptive changes, electrical conduction abnormalities such as atrial fibrillation frequently arise. Important to note that it is not always the cause of afib, but a common source as people age. Atrial fibrillation is caused by failure of conduction/disorganized activity by pacemaker cells in the sinoatrial node, leading to “quivering” of the atria, rather than contraction. So to answer your question more succinctly: the two conditions may be, but are not always, related, as you can have afib w/o CAD and vice versa.
Physionic explains it better and in more detail. Basically above a certain dose of 1g, afib increases possibly due to changes in the sodium potassium pump in the heart.
The atoms involved there is potassium, sodium and calsium with magnesium. So the omega 3(DPA/EPA ALA must decrease or increase this, or create an unballance. Hmm hard to belive! I don't think so, but they have to make topic's. Use your own head first! Just a tip
Take your fish oil if you do it…. This is pretty good at showing what relative risk really means. You look at the odds/hazard ratio and the percent deviation up or down from 1.00 is either an increase or decrease in relative risk from 1.00. The original risk is completely separate. Meaning you might have a 5% risk of a stroke in the next ten years. A significant odds ratio of 1.38 means that you have an increased risk of stroke by doing “x behavior” of .38 or 38%. It’s not additive, meaning your risk of stroke is 5% plus 38% = 43% risk of stroke in the next ten years. It means 38% of 5% added onto the 5%. So the new risk is 5% + 1.9% (38% of 5) = 6.9% risk. So the news media often reports “OMG!!! If you smoke, you increase your risk of lung cancer by 50%!!!!” But it’s built into the original risk. So if that risk was 10% without smoking, your risk of lung cancer when smoking goes up to 15%. I'm making up the smoking statistics but just wanted to give an example.
The other thing that seems to increase risk of a fib while decreasing risk of everything else is lots of endurance exercise. So this phenomenon is not without precedent, and the parallel is fascinating.
If there’s been proven problems with fish oils it’s more likely the poor quality and hexanes found in them. Purity is hard to find. Just eat oily fish twice a week
I don’t remember the exact number but it was a lot of the most well known brands that they tested the product was rancid. It was a crazy high percentage of products. Very disturbing.
@@Zoe.TheBody360Xtend life has the world best fish oil distilled on molecular levels on site fresh no rancidy toxic heavy metals and bacteria 🦠🧫 Third party tested and in house too . For 20 years I was taking it
Thank you so much Dr Norton for shedding some light on this. I just recently heard about this study and was a bit nervous. I was hoping Sr Norton would post a video on this. Dr Norton is the man !
Cardiovascular Research 54 (2002) 183-190 Excerpt...... In this randomized controlled double-blind trial, patients with CAD received dietary supplementation with 1.65 g of Omega-3-PUFA per day (EPA plus DHA) or placebo, for 2 years, in addition to standard treatment. Active treatment did not slow progression of carotid atherosclerosis
Could it be that people nearing the edge of baseline are more likely to be recommended a fish oil supplement by a doctor than those that aren’t, so you get a bias in that only those that are on their way to a progressed disease state are the ones taking the supplement?
Layne, the fish oils are protective after afib because of blood thinning effect. People with afib get blood pooling in the left atrium. The sitting blood forms clots, which then can cause stroke, MI, and death. We know fish oil thins the blood. Thus, the fish oil is protective in the population with afib because it likely is decreasing clot burden and the associated mechanisms of poor outcomes from afib specifically. It wouldn't confer this benefit in people without afib.
How about the experimental trials we have on fish oil and its role in improving inflammation? Mood? Brain? Triglycerides? Skin? Eyes? As always, there's a cost/benefit ratio, which is typical with every. single. compound. in. the. world. Getting scared off of a substance due to one minor effect it can have on you means you'll be scared off of everything. There's nothing in this world without potential cons. Half of the fat in the brain is comprised of Omega 3. You absolutely need to intake Omega 3 somehow. Given that most of the world doesn't consume enough omega 3 rich foods, I'd argue there's a very strong rationale for taking fish oil. Not only is it a highly bioavailable form of EPA and DHA, but it comes with less harmful ingredients as well (like heavy metals) since reputable fish oil companies test for that stuff. I got nothing against actual fish though either to be fair (in most cases).
When this came out I looked into it; this is not the first study that shows cardiovascular harm from fish oil, including a meta analysis (Gencer. 2021.) Fish oil is expensive, so I’ve discontinued it.
Another study conducted using the UK Biobank data by Li et al. found that those taking fish oil supplements had a 13% decreased risk of all-cause mortality 16% decreased risk of cardiovascular mortality 20% decreased risk of death from heart attack 7% decreased risk of cardiovascular event 8% decreased risk of heart attack 10% decreased risk of stroke
I been using fish oil for years , with no Problems . No study on people who work out , and keep in shape . Maybe the people with heart problems do not take of themselves .
Correlation and causation are completely different. Like. During the summer, ice cream and swimming increases with shark attacks. Ice cream has nothing do do with it. More people out there in the water is what increases the rick of shark encounter/attack.
Why didn't he mention the p values on majority of these findings, anything p>= 0.05 is pretty garbage statistically. Almost certainly doesn't disprove the null hypothesis.
Is it possible that diet has more to do with the development of heart conditions than the actual fish oil supplement? It seems to me that this type of study did not control for diet, physical activity, or the type, quantity, and quality of the fish oil supplements taken by those individuals. It is very difficult for me to understand how they could arrive at this conclusion without having monitored all patients closely regarding diet, exercise, and the supplements taken.
Why can’t the answer be that this study isn’t to be taken too seriously because it’s a correlation study over a long period of time with a lack of controls? They didn’t even check if the participants had continued to take fish oil after the initial interview
This isn’t the first signal of omega-3 supplementation increasing the risk of atrial fibrillation. But the aggregate data is consistent with that risk only beginning once one achieves around 1000 mg of long chain fatty acids (DHA/EPA) per day. There is a consumer labs evaluated omega-3 from Spring Valley brand, which I take that has about 800 mg of long chain omega-3 per 1000 mg capsule. I’m not going to stop taking it just because I’m “healthy“.
The lifelong risk of atrial fibrillation is 20-40% depending on the lifestyle. I don't see a 10% increase in this risk as a game changer given all the other benefits of EPA/DHA supplementation. And the atrial fibrillation risk can be mitigated via other lifestyle choices.
@@EVanDoren that is well put and with most Americans there is some room to maneuver to improve risk of atrial fibrillation otherwise. For me, though, I simply keep the dose to where fairly confident it would still help with dementia risk production if committed to taking over a lifetime, which I amstill remaining below the threshold of notable a trial fibrillation risk which seems to be above the 1000 mg EPA/DHA threshold
@@DrTomMDWhat about 1000mg of omega 3 a day which some supplements come in? Should one worry? Or is it best to have below 1000mg? I take a premium excellent brand with 700mg DHA and 300mg EPA... Now I'm concerned about this study that confuses scientists even 😆
@@theancientsancients1769 obviously my recommendation has to be that you should discuss this with your license primary care provider. Now, if you’re asking if it was me, would I stop at 1000 mg? No, I would not. I would not go above 1000 mg either, though. And I tend to skip my supplementfor a couple days I have good fatty fish like trout, sardines or salmon. But that’s just me :-)
keep it simple stu! and runny eggs. eat these everyday, first and foremost, and you win the Darwin Award for staying alive and.....wait for it..... for reproducing for a longer period of time. now, who's your daddy? Almost forgot. And Himalayan salt. I just discovered how many micro nutrients is in that stuff. it's a one a day vitamin almost!
I tried eating fish regularly (canned because of the cost) and just couldn't make myself do it. Fish oil capsules I can do. It's what you can do that's sustainable
Yes! I started taking 1000 mg of Fish Oil and my AFIB came back. I previously had AFIB and had an Ablation which stopped my AFIB. I finally figured it was the Fish Oil. If you take 1000 mg or more you are at risk of AFIB. Thankfully after I stopped the Fish Oil my AFIB cleared up. I didn't take Fish OIl for my heart, I took it to try and relieve soreness and stiffness in my neck ligaments and tendons.
Thank you for your straight down the middle approach. it's good to know you have a voice to trust. I would like to know what your thoughts on stains are. Information seems to be all over the place. Keep up the good work.
How I read this study: there are so many objectives that it looks like p-hack. With that many variables and conditions being followed a few would be significant. To be trustworthy, most outcomes should be in the same direction. The fact that there is heterogeneity points out that fish oil likely have NO effect on outcomes.
The other thing to consider is that once people have atrial fibrillation the intervention to keep their hearts healthy is likely higher. They are now much more likely under a cardiologist care, and on on cholesterol medication. Which may explain why the transition to A-fib does not lead to worse outcomes.
@@Brandon-dg9lu certainly possible. A portion of afib is “paroxysmal” meaning that it occurs infrequently and a fib does not always cause symptoms like palpitations so many people can have a low burden of afib activity and not realize it.
What the report seems to say is stage 1 of desease increases while all subsequent stages remains constant or decrease. Is it possible that stage 1 is a net positive it is just that all the advanced stage improvements land in that bucket hiding that fact? It's math. The later stage counts had to land somewhere.
I'm not surprised, since I found out that companies like "Seven Seas cod liver fish oil max strength" has vegetable and seed oils now included in its ingredients. I questioned their customer service line about it, they said they would cal me back. No response
Maybe people that figured they were at higher risk, decided to use fish oil to offset that perceived risk? So if you think you are a higher risk of heart disease due to some life style factors, perhaps you are more likely to add something like a fish oil to compensate? As far as I understood, these people were not randomized so self decided to take the fish oil or not, so that could be one possible reason for the correlation even if taking the fish oil would be slightly protective against even early stages of heart disease.
Isn’t it possible that people start taking fish oil, frequently, when they have reason that they are concerned for their health, and that THIS is the source of the correlation? Seems at least plausible, if I understood what was being said.
Maybe healthy people already have a healthy Omega 3 to Omega 6 ratio and supplementing with it tips the scales in a negative direction. I know it’s not a very scientific statement and I don’t understand a lot about this topic, but, from what I understand, there should be a balance here.
Fair point about the ratio, though why would you see a protective effect at more advanced stages of the disease. As in, if higher O6/O3 ratio can take you to the disease, why would it then protect you from it.
@@CharlieFader yeah but didn't they account for this variable in the study? So if what you observed was generally true, people in this study would have consumed loads of O3 to nullify a protective effect of O6 supplementation, but only until the first stages of the disease appeared, and then stop the O3 to a point where a protective effect of O6 can now be observed.
@@PepitoSbezzeguti that’s not what I meant. I was responding to the other comment, that was proposing that maybe healthy people already have a healthy ratio, before supplementing with ω3s. At least when it comes to the ω3 index, it seems that most people that are in the healthy range (of said index) do supplement or eat fish on a regular basis.
@@PepitoSbezzeguti What I have seen more recently was that the whole ratio is irrelevant, and what actually was relevant was getting enough Omega-3 in absolute terms. People that had poor ratio, also had poor absolute intake of Omega-3 so people mistakenly though that the ratio was somehow meaningless when it wasn't.
The question I'd ask is what are the factors that determine whether a person decides to take fish oil or not. Is it possible that healthy individuals from families with known higher risk of developing cardiovascular disease are much more likely to take fish oil than healthy people from families without cardiovascular disease? And that fish oil has no effect on the first progression but does on later progression?
I don't think the study did more than ask at the start if they took fish oil. Who knows what they did after that. This is more psychology of why people suppliment with fish oil.
one confounding variable that is probably not accounted for in this study is the amount of omega-3 in their diet. Supplementing with something you already get plenty of is likely to have zero to negative benefit. It may be that different transitional groups had different levels of Omega 3 in their diet, so for some groups supplementing showed a benefit, but not for others.
I started taking fish oil and I’m pretty sure it give me Afib (I was diagnosed with Afib from the docs and had it for 3 months!) because when I stopped taking it it went away. I’m too scared to go back on it …….
Great video! I don't see the Human Randomized Control Trial t-shirt anywhere on the BioLayne store, though. Latest t-shirt is "You Are Never Out of the Fight." Is it only visible for US customers right now?
I believe the authors speculated, and I think it makes a lot of sense, that people consume higher quality fish oil supplements as their heart disease progresses. Which potentially means that the lowest grade fish oil supplements contain impurities that are causing the small baseline-afib jump, which is later counteracted by more pure supplementation when people get more serious about dealing with their heart health.
Or people that think they are at higher risk because of life style or their family genetics simply are more eager to use fish oil compared to people that have no heart disease in their family and live otherwise healthy. Would explain the correlation, it would simply be reverse causality where higher heart disease risk causes higher fish oil consumption when the people self try to compensate for that higher perceived risk.
@@cyberfunk3793Eh I would imagine more likely a healthy user effect of just about any supplement compared to people thinking they can band aid their health with supplements. There’s a lot of information out there telling people it doesn’t work like that, and the unhealthy are probably happy to save money.
Feels like there’s another confounder in here. E.g., did they take out people who started taking fish oil because relatives had heart attacks or because they have bad lipid profiles (albeit no diagnosed heart disease)?
What about getting a hangover from alcohol but then drinking more to get over it? Is that a good analogy for the contradictions in the study? Instead of "hair of the dog" it's "oil of the fish".😄
I have decided to never again eat anything as it is all harmful. I will probably die in a short time because of this decision. Then again I might just have a big mac later on.
If we assume that among the group who use/consume fish oil there are more people who know that they are at a higher risk of getting cardiovascular events due to gentics or lifestyle. Why ? Because they start using fish oil as a preventative measure. Then you may get a higher incidence of AF due to group selection. And then since the fish oil has a preventative effect it produces a lower RR for further disease progression.
I can see they looked at how much red meat both user group and non-user group consumed, but at the individual level, it's plausible that those who eat oily fish on a regular basis (at least two times a week) would be less inclined to take fish oil supplements, and that those who don't eat oily fish on a regular basis (at least two times a week) would be more included to take fish oil supplements. And it's also plausible that the latter individuals would more likely to have consumed more red meat. Now, if you consume more red meat along with fish oil supplements, the supplements might not be able to stop you from getting atrial fibrillation, but they might be able to stop you from getting worse than that.
@@hallandrewe "We were able to show that adherence to the Mediterranean diet, and especially the intake of plant-based foods such as nuts, vegetables, and fruits, and also preference for white meat over red meat, was less frequently reported by AF patients." Mediterranean Diet and Atrial Fibrillation: Lessons Learned from the AFHRI Case-Control Study (2022)
@@jadedk9916 Yes and there's also studies that show that most people that eat red meat are eating it with bread and french fries and other things, The study you cited is extremely flawed just like most nutritional studies, I love vegetables and I eat them myself but there has been studies of an all meat diet and it literally clears up heart disease. The Mediterranean diet is great, The standard American diet is not.
@@jadedk9916 there's also studies that say that there is microplastics and heavy metals in almost all fish so eating a high fish diet has other drawbacks. Eating a clean diet that includes red meat, vegetables, fish and organic fruits in moderation does not cause heart disease.
Question, I’m currently on Rivaroxaban (blood thinner) for my Antiphospholipid syndrome and cerebral venous sinus thrombosis. I’ve stopped taking fish oil supplements after this paper came out, is it safe to consume? Of course I will consult with my doctor but I am curious
If you are already taking Xarelto, then you are essentially receiving treatment for atrial fibrillation. Since the main thing that we worry about with any degree of a fib is thrombosis. I would say it is safe to continue taking fish oil in your case, but I don’t know exactly what you were taking so definitely consult with your doctor. Disclaimer: I am a physician, but I am not your physician 😂
What this data tells me is 10% of 10% is 1% and that is an insignificant statistic that can easily explained by other random factors. The most obvious being that older people with health problems are more likely to be taking supplements to improve heart function compared to younger healthy adults.
I wonder if the researchers who conduct and publish these studies get frustrated--or even angry--when the media baldly oversimplifies the findings, ignores the data and study design and ultimately distorts the conclusions to such a degree that they're virtually unrecognizable relative to what the studies actually state. Ya kinda wanna give the scientists a hug and tell 'em that ya still love them...
This sounds like there is some sort of self-selection in using fish oil when healthy i.e. sicker people but that don’t present heart disease yet take fish oil. While when you are already sick, i.e. heart disease that self-selection effect is gone and the positive effect on heart health is better identified.
Layne> Could it be a possibility, that the patients who got afib, also got started on preventive drugs and this treatment resulted in the outcome of delay of death? 🤔 Details are very important, when interpreting study data! 😉
Still, the data shows an increased risk of AF in healthy populations. Other papers show it too. Perhaps it's the DHA from what I've seen so far. If you get AF you very likely have to go on blood thinning medication, which definitely has it's own risks.
Thank you for discussing the difference between relative risk reduction and absolute risk reduction. Relative risk reduction is a scam and should never be used. For example, when doctors are shown the relative risk reduction of statins, they overwhelmingly advocate their use. When shown absolute risk reduction -- which is statistically insignificant -- they oppose the use of statins overwhelmingly.
I've seen a lot of doctors on social media make this mistake because it's easy to look at the numbers and make that conclusion. But it's because they don't factor in the time of exposure to the risk. Trying to think of an example then smoking 10 cigarettes a day poses a certain risk if done for 2 years and then stopping. In comparison then there's a much larger risk in smoking 10 cigarettes a day for a decade and then stopping. So statins have a low relative risk reduction over a two year HRCT but a much larger relative risk reduction over decades. I'm hoping that's a bit clearer now.
@@WilliamRoscoe First of all, I didn't say statins have a low relative risk reduction. They actually have a high relative risk reduction. What I said was, they have a very low absolute risk reduction. And if you have evidence that the absolute risk reduction of statins is significant over many decades, can you please link me to the evidence? Because the meta studies track statin studies that average about 5 years. Further, has anyone ever demonstrated the side effect risk of statins when taken over decades as compared to any reduction in CVD risk?
@@WilliamRoscoe How could I possibly agree with a premise that has never been demonstrated? Without long-term testing, we have no idea what the long-term efficacy of statins is, or whether the long-term risks outweigh any benefits. All we know is that, over and over again, statins fail to reduce absolute risk to any statistical significance. And when doctors are actually shown this statistic and not relative risk reduction, they overwhelmingly oppose the use of statins.
@@cdprince768 I'm starting from first principles so we're both on the same page.. Do you agree that the absolute risk of dying from smoking related disease increases over the time that you smoke? Say 1 pack for 1 day vs 1 pack every day for a decade. Ignore statins for the moment.
The populations with a high omega 3 index aren't taking supplements, they are just eating fish. Maybe it might be better to just eat food rather than to use supplements. Who knows if those fish oil supplements are oxidized.
Its selection bias. Each individual chose when to start or stop the supplements. If they had a suspicion that they were developing a heart problem, pre diagnosis, then they are more likely to begin taking fish oil. Once they were diagnosed with problems then there was likely a saturation in the number of people taking it.
Layne, two comments. First you need to do a "Journal Club" podcast with Peter Attia, like he does with Huberman. This paper would have been perfect for that. Second, there will be a special place in hell for our friends in the media who engage in this flagrant misrepresentation. No journalist should graduate from J school unless they can explain the difference between relative risk and absolute risk. That relative risk is presented is THE risk in the media is one of the most shameful and disgusting practices in today's journalism, and there is a LOT of competition in that "award" category.
Wishing i took fish oil before my stroke. BUT i am now... just incase it helps which i am sure is worth at this point. My therapist recommended it for anxiety also.
When the reports came out, screaming in the headlines, my husband got a little nervous. He asked me to take a gander. We both have risk factors, conditions, that heighten our risks for cardiovascular problems.
I got to reading...
I felt extremely comfortable reassuring him that we were safe continuing our fish oil therapy.
Only diet proven to prevent and reverse heart disease is a low fat, whole food, plant based diet.
Because Layne Norton said so ? lol
@@BradSchoenfailed 😐
@@BradSchoenfailed no.. because humans were eating fish for millions of years and if there was anything wrong with fish we would have been long gone by extinction.
@@ravichandra3210but this study is not about eating fish, this study is about supplementing fish oil.
I'm watching this while gulping down 2 fish oil capsules
Are you still alive?
this sounds fishy
"Yes, that was him officer."
Well done 😂
Oh, mega fishy...
Fish puns now? Oh cod...
🤣🤣🤣
DUDE - CORRELATION!! I'm a statistics-based engineer.
'Baseline' just means 'haven't had a heart issue yet'. Common sense would say that people who get a blood test showing elevated levels of LDL are statistically more likely to take fish oil, as a natural way of improving this value. This statement, if accepted, means that the baseline fish oil population generally has higher LDL (or non-HDL cholesterol) than the population who doesn't feel the need to supplement with fish oil. This would be difficult to tease out from the data, but would explain the 1.13 hazard ratio from baseline vs the lower ratio in other cohorts, due to a slight protective effect at all ranges.
That's a pretty quick shortcut you're taking here. People taking fish oil don't necessarily take it based on their LDL (or any other specific risk factor). You could reasonably argue the exact opposite that people taking fish oil (or supplementing with anything at all) are actually healthier at baseline with lower risk of CVD because they're more health conscious, more likely to exercise, eat a better diet and consume other supplements.
I agree that the big issue with all these nutrition and supplementation studies is that there are just too many factors to control for, not to mention that "controlling" for a factor through data analysis after the fact is a very poor control with questionable biological relevance, even if it's the best we can do for something as complex as nutrition. Not only that, but the relative risk are ultimately quite small and almost certainly clinically irrelevant (5-15% increased or decreased risk of something that's very rare in the first place and has very good outcomes even when it happens (you usually don't die from attrial fibrilation). After all, this very same study shows there's zero impact on death.
Fish oil reduces TRG and increases HDL, and increases LDL a little.
@childofaether8733 I find atrial fibrillation to be an odd endpoint to choose in the first place, considering the primary benefits of fish oils are purported to be related to inflammation and atherosclerosis.
My understanding is that a-fib is either generally benign and transient as you mentioned (and related to electrolyte/neuro/hormonal issues) or caused hy structural heart disease, which is a very weak proxy for atherosclerosis.
@@childofaether8733 furthermore to group differences: those "health conscious" people taking fish oils are more likely to fuck their electrolytes after a marathon, or exercise at very high cardiac outputs, lift very heavy, and/or take steroids: all of which are risk factors for types of structural heart disease and a-fib (to lay people reading this please note this doesn't contextualize all the other benefits of intense exercise - nothing in life has zero risk and please don't drastically alter your lifestyle based off the comment section)
Is this the study funded by Gates? If so keep your eyes wide open.
I wasn't a believer when my doctor recommended it to lower my tryglicries, but about 5 blood tests later, my HDL went up, and tryglicries went really down. No study is going to convince me different.
Which brand do you take?
I agree. If you listen to all these guys you end up sick. What should you take???
Will stick to my sardines and wild caught salmon. Normally have 2-3 servings a week of fish
Thanks for the screenshots of the paper discussed as well as the further references to explore. It’s great to have a weekly source of con-ed and to practice reading/evaluating research
Had to cover this with many patients and clients....had to calm many of them down.
What services to you provide, and what was your advice? Thank you.
@@Joseph1NJ Work in Longevity / Concierge Medicine. Just had to basically had to reassure people that their specific program with fish oil was fine, not to over react.
Fish contains mercury though
@@seamussullivan2218 Thank you for the response.
I always worry about this, i take an algae omega 3 supplement.. i figure less polution @@leonardodavinci7425
I am not a cardiologist, but my understanding is that atrial fibrillation is an electrical disease, whereas myocardial infarction is a vascular disease. It's not necessarily a progression from one to another, they're separate causes.
Oh man, u know nothing
In a nutshell, coronary artery disease (what you are likely referring to as vascular disease) can overtime result in structural remodeling of heart tissue. There are a variety of reasons why this may occur (ischemic scar tissue, dilated atria, etc.), but subsequent to these maladaptive changes, electrical conduction abnormalities such as atrial fibrillation frequently arise. Important to note that it is not always the cause of afib, but a common source as people age. Atrial fibrillation is caused by failure of conduction/disorganized activity by pacemaker cells in the sinoatrial node, leading to “quivering” of the atria, rather than contraction.
So to answer your question more succinctly: the two conditions may be, but are not always, related, as you can have afib w/o CAD and vice versa.
As soon as I was told about this I was hoping you'd release a video talking about it. Great stuff as always!
Physionic explains it better and in more detail. Basically above a certain dose of 1g, afib increases possibly due to changes in the sodium potassium pump in the heart.
The atoms involved there is potassium, sodium and calsium with magnesium. So the omega 3(DPA/EPA ALA must decrease or increase this, or create an unballance. Hmm hard to belive! I don't think so, but they have to make topic's. Use your own head first! Just a tip
@@Kjuken69I'm at risk of Heart disease I can't make up my mind
I've been taking it for years
Do you think I should keep taking it
Thanking you.
Take your fish oil if you do it…. This is pretty good at showing what relative risk really means. You look at the odds/hazard ratio and the percent deviation up or down from 1.00 is either an increase or decrease in relative risk from 1.00. The original risk is completely separate. Meaning you might have a 5% risk of a stroke in the next ten years. A significant odds ratio of 1.38 means that you have an increased risk of stroke by doing “x behavior” of .38 or 38%. It’s not additive, meaning your risk of stroke is 5% plus 38% = 43% risk of stroke in the next ten years. It means 38% of 5% added onto the 5%. So the new risk is 5% + 1.9% (38% of 5) = 6.9% risk. So the news media often reports “OMG!!! If you smoke, you increase your risk of lung cancer by 50%!!!!” But it’s built into the original risk. So if that risk was 10% without smoking, your risk of lung cancer when smoking goes up to 15%. I'm making up the smoking statistics but just wanted to give an example.
Yes suck down that rancid oil, your body will thank you
The other thing that seems to increase risk of a fib while decreasing risk of everything else is lots of endurance exercise. So this phenomenon is not without precedent, and the parallel is fascinating.
I was going to make this exact comment! 😃
YES RUNNING MARATHONS OR ANYTHING OVER 2 MILES , WILL STRESS THE HEART OUT
No proof of this
@@MeIn321 Few things in science are "proven," but many, like this, are supported by abundant evidence.
Thank you for this. I’ll add this to the many many reasons I can safely ignore the media about health messaging.
Isn’t this media?
If there’s been proven problems with fish oils it’s more likely the poor quality and hexanes found in them. Purity is hard to find. Just eat oily fish twice a week
I don’t remember the exact number but it was a lot of the most well known brands that they tested the product was rancid. It was a crazy high percentage of products. Very disturbing.
@@ATFstein absolutely. Unregulated supplements. It’s a big problem generally.
Yes pack in that mercury and microplastics! Yum!
@@Zoe.TheBody360Xtend life has the world best fish oil distilled on molecular levels on site fresh no rancidy toxic heavy metals and bacteria 🦠🧫 Third party tested and in house too . For 20 years I was taking it
Either way there's still heavy metals and high Vitamin A in seafood. But it's your body so eat what you choose
Thank you so much Dr Norton for shedding some light on this. I just recently heard about this study and was a bit nervous. I was hoping Sr Norton would post a video on this.
Dr Norton is the man !
Cardiovascular Research 54 (2002) 183-190
Excerpt......
In this randomized controlled double-blind trial, patients with CAD received dietary supplementation with 1.65 g of Omega-3-PUFA per day (EPA plus DHA) or placebo, for 2 years, in addition to standard treatment. Active treatment did not slow progression of carotid atherosclerosis
Could it be that people nearing the edge of baseline are more likely to be recommended a fish oil supplement by a doctor than those that aren’t, so you get a bias in that only those that are on their way to a progressed disease state are the ones taking the supplement?
For Al Gore's Rhythm 👍
Layne, the fish oils are protective after afib because of blood thinning effect. People with afib get blood pooling in the left atrium. The sitting blood forms clots, which then can cause stroke, MI, and death. We know fish oil thins the blood. Thus, the fish oil is protective in the population with afib because it likely is decreasing clot burden and the associated mechanisms of poor outcomes from afib specifically. It wouldn't confer this benefit in people without afib.
How about the experimental trials we have on fish oil and its role in improving inflammation? Mood? Brain? Triglycerides? Skin? Eyes? As always, there's a cost/benefit ratio, which is typical with every. single. compound. in. the. world. Getting scared off of a substance due to one minor effect it can have on you means you'll be scared off of everything. There's nothing in this world without potential cons.
Half of the fat in the brain is comprised of Omega 3. You absolutely need to intake Omega 3 somehow. Given that most of the world doesn't consume enough omega 3 rich foods, I'd argue there's a very strong rationale for taking fish oil. Not only is it a highly bioavailable form of EPA and DHA, but it comes with less harmful ingredients as well (like heavy metals) since reputable fish oil companies test for that stuff. I got nothing against actual fish though either to be fair (in most cases).
When this came out I looked into it; this is not the first study that shows cardiovascular harm from fish oil, including a meta analysis (Gencer. 2021.) Fish oil is expensive, so I’ve discontinued it.
Another study conducted using the UK Biobank data by Li et al. found that those taking fish oil supplements had a
13% decreased risk of all-cause mortality
16% decreased risk of cardiovascular mortality
20% decreased risk of death from heart attack
7% decreased risk of cardiovascular event
8% decreased risk of heart attack
10% decreased risk of stroke
I been using fish oil for years , with no
Problems . No study on people who work out , and keep in shape . Maybe the people with heart problems do not take of themselves .
Eggs, flaxseed, walnuts, mackerel all contain Omega 3 DHA and EPA.
Correlation and causation are completely different. Like. During the summer, ice cream and swimming increases with shark attacks. Ice cream has nothing do do with it. More people out there in the water is what increases the rick of shark encounter/attack.
Correct. So why take fish oil pills?
Why didn't he mention the p values on majority of these findings, anything p>= 0.05 is pretty garbage statistically. Almost certainly doesn't disprove the null hypothesis.
Is it possible that diet has more to do with the development of heart conditions than the actual fish oil supplement? It seems to me that this type of study did not control for diet, physical activity, or the type, quantity, and quality of the fish oil supplements taken by those individuals. It is very difficult for me to understand how they could arrive at this conclusion without having monitored all patients closely regarding diet, exercise, and the supplements taken.
Why can’t the answer be that this study isn’t to be taken too seriously because it’s a correlation study over a long period of time with a lack of controls? They didn’t even check if the participants had continued to take fish oil after the initial interview
This isn’t the first signal of omega-3 supplementation increasing the risk of atrial fibrillation. But the aggregate data is consistent with that risk only beginning once one achieves around 1000 mg of long chain fatty acids (DHA/EPA) per day.
There is a consumer labs evaluated omega-3 from Spring Valley brand, which I take that has about 800 mg of long chain omega-3 per 1000 mg capsule. I’m not going to stop taking it just because I’m “healthy“.
The lifelong risk of atrial fibrillation is 20-40% depending on the lifestyle. I don't see a 10% increase in this risk as a game changer given all the other benefits of EPA/DHA supplementation. And the atrial fibrillation risk can be mitigated via other lifestyle choices.
@@EVanDoren that is well put and with most Americans there is some room to maneuver to improve risk of atrial fibrillation otherwise. For me, though, I simply keep the dose to where fairly confident it would still help with dementia risk production if committed to taking over a lifetime, which I amstill remaining below the threshold of notable a trial fibrillation risk which seems to be above the 1000 mg EPA/DHA threshold
@@DrTomMDWhat about 1000mg of omega 3 a day which some supplements come in? Should one worry? Or is it best to have below 1000mg? I take a premium excellent brand with 700mg DHA and 300mg EPA... Now I'm concerned about this study that confuses scientists even 😆
@@theancientsancients1769 see my original comment. It addressed your question re 1000mg
@@theancientsancients1769 obviously my recommendation has to be that you should discuss this with your license primary care provider. Now, if you’re asking if it was me, would I stop at 1000 mg? No, I would not. I would not go above 1000 mg either, though. And I tend to skip my supplementfor a couple days I have good fatty fish like trout, sardines or salmon. But that’s just me :-)
This is the problem with cross sectional correlational studies. The model specification dictates the results to a large degree.
Think I'll just keep eatin my sardines.
keep it simple stu! and runny eggs. eat these everyday, first and foremost, and you win the Darwin Award for staying alive and.....wait for it..... for reproducing for a longer period of time. now, who's your daddy? Almost forgot. And Himalayan salt. I just discovered how many micro nutrients is in that stuff. it's a one a day vitamin almost!
I eat my sardines too, but not too often due to the urid acid implications and all the diseases associated with high urid acid levels.
Just don't eat too many at one sitting. Sardines have arsenic in them.
@@uuzoo really? never heard that before
Eggs and sardines everyday, your gas will smell awesome
I tried eating fish regularly (canned because of the cost) and just couldn't make myself do it. Fish oil capsules I can do. It's what you can do that's sustainable
Just make sure the oil in the capsule isn't rancid. You'll need to open each capsule before taking it to make sure
Yes! I started taking 1000 mg of Fish Oil and my AFIB came back. I previously had AFIB and had an Ablation which stopped my AFIB. I finally figured it was the Fish Oil. If you take 1000 mg or more you are at risk of AFIB. Thankfully after I stopped the Fish Oil my AFIB cleared up. I didn't take Fish OIl for my heart, I took it to try and relieve soreness and stiffness in my neck ligaments and tendons.
layne ive been watching you for years, please bro treat the room you record in i bet your views will increase
Thank you for your straight down the middle approach. it's good to know you have a voice to trust. I would like to know what your thoughts on stains are. Information seems to be all over the place. Keep up the good work.
How I read this study: there are so many objectives that it looks like p-hack. With that many variables and conditions being followed a few would be significant. To be trustworthy, most outcomes should be in the same direction. The fact that there is heterogeneity points out that fish oil likely have NO effect on outcomes.
The other thing to consider is that once people have atrial fibrillation the intervention to keep their hearts healthy is likely higher. They are now much more likely under a cardiologist care, and on on cholesterol medication. Which may explain why the transition to A-fib does not lead to worse outcomes.
@@Brandon-dg9lu certainly possible. A portion of afib is “paroxysmal” meaning that it occurs infrequently and a fib does not always cause symptoms like palpitations so many people can have a low burden of afib activity and not realize it.
What the report seems to say is stage 1 of desease increases while all subsequent stages remains constant or decrease. Is it possible that stage 1 is a net positive it is just that all the advanced stage improvements land in that bucket hiding that fact? It's math. The later stage counts had to land somewhere.
As someone who takes fish oil, thanks for breaking it down. I'm going to keep taking it.
Did they take into account what channel blockers many of these people would have been on?
T-shirt ordered🙏❤️
I'm not surprised, since I found out that companies like "Seven Seas cod liver fish oil max strength" has vegetable and seed oils now included in its ingredients. I questioned their customer service line about it, they said they would cal me back. No response
Thank you so much for covering this stuff not all of us can or or has time to read and dif into these kinds of nuances thank you so much again.
Maybe people that figured they were at higher risk, decided to use fish oil to offset that perceived risk? So if you think you are a higher risk of heart disease due to some life style factors, perhaps you are more likely to add something like a fish oil to compensate? As far as I understood, these people were not randomized so self decided to take the fish oil or not, so that could be one possible reason for the correlation even if taking the fish oil would be slightly protective against even early stages of heart disease.
My thought exactly! People with high LDL, high triglycerides, smokers, or diabetic maybe more likely to take fish oil at baseline.
Atrial fibrillation has a high chance of stroke development from blood clots.
Also, what was the dosage? Were they mega-doses of fish oil?
Thank you sir, highly appreciate your efforts in exposing out the shinnanigans ..👍💯
eat fish at the weekends. exercise every day. quit carbs.
Isn’t it possible that people start taking fish oil, frequently, when they have reason that they are concerned for their health, and that THIS is the source of the correlation?
Seems at least plausible, if I understood what was being said.
Maybe healthy people already have a healthy Omega 3 to Omega 6 ratio and supplementing with it tips the scales in a negative direction.
I know it’s not a very scientific statement and I don’t understand a lot about this topic, but, from what I understand, there should be a balance here.
Fair point about the ratio, though why would you see a protective effect at more advanced stages of the disease. As in, if higher O6/O3 ratio can take you to the disease, why would it then protect you from it.
From what I’ve seen, most people that don’t take ω3 supplement and don’t regularly eat fish, don’t have good ω6/ω3 ratio. So…
@@CharlieFader yeah but didn't they account for this variable in the study? So if what you observed was generally true, people in this study would have consumed loads of O3 to nullify a protective effect of O6 supplementation, but only until the first stages of the disease appeared, and then stop the O3 to a point where a protective effect of O6 can now be observed.
@@PepitoSbezzeguti that’s not what I meant. I was responding to the other comment, that was proposing that maybe healthy people already have a healthy ratio, before supplementing with ω3s. At least when it comes to the ω3 index, it seems that most people that are in the healthy range (of said index) do supplement or eat fish on a regular basis.
@@PepitoSbezzeguti What I have seen more recently was that the whole ratio is irrelevant, and what actually was relevant was getting enough Omega-3 in absolute terms. People that had poor ratio, also had poor absolute intake of Omega-3 so people mistakenly though that the ratio was somehow meaningless when it wasn't.
Appreciate the clarification 🤙
The question I'd ask is what are the factors that determine whether a person decides to take fish oil or not. Is it possible that healthy individuals from families with known higher risk of developing cardiovascular disease are much more likely to take fish oil than healthy people from families without cardiovascular disease? And that fish oil has no effect on the first progression but does on later progression?
just keep any oil out of direct sunlight, cause then it will
i once saw a store that sold supplements with fish oil in the window display
I'm sceptical of any food in window displays, that area can get way hotter than recommended storage temperature.
How many were vaccinated during this study?
I don't think the study did more than ask at the start if they took fish oil. Who knows what they did after that.
This is more psychology of why people suppliment with fish oil.
Great clarification
one confounding variable that is probably not accounted for in this study is the amount of omega-3 in their diet. Supplementing with something you already get plenty of is likely to have zero to negative benefit. It may be that different transitional groups had different levels of Omega 3 in their diet, so for some groups supplementing showed a benefit, but not for others.
I started taking fish oil and I’m pretty sure it give me Afib (I was diagnosed with Afib from the docs and had it for 3 months!) because when I stopped taking it it went away. I’m too scared to go back on it …….
Thank you for summing this up. You are a GOD!
Great video! I don't see the Human Randomized Control Trial t-shirt anywhere on the BioLayne store, though. Latest t-shirt is "You Are Never Out of the Fight." Is it only visible for US customers right now?
I never knew of Eskimos with heart problems
How many Eskimos do you know?
@@GordonAnderson-c6m I know many, every year I spend holidays with them
Is it okay to simply not supplement and instead do an hour of cardio each day and also not be fat?
People did fine before fish oil tablets. They didn’t have cardiovascular disease either. Of course you don’t need supplements.
I guess the conclusion must be: the dosage makes the antidote.
I believe the authors speculated, and I think it makes a lot of sense, that people consume higher quality fish oil supplements as their heart disease progresses. Which potentially means that the lowest grade fish oil supplements contain impurities that are causing the small baseline-afib jump, which is later counteracted by more pure supplementation when people get more serious about dealing with their heart health.
Or people that think they are at higher risk because of life style or their family genetics simply are more eager to use fish oil compared to people that have no heart disease in their family and live otherwise healthy. Would explain the correlation, it would simply be reverse causality where higher heart disease risk causes higher fish oil consumption when the people self try to compensate for that higher perceived risk.
@@cyberfunk3793Eh I would imagine more likely a healthy user effect of just about any supplement compared to people thinking they can band aid their health with supplements. There’s a lot of information out there telling people it doesn’t work like that, and the unhealthy are probably happy to save money.
Feels like there’s another confounder in here. E.g., did they take out people who started taking fish oil because relatives had heart attacks or because they have bad lipid profiles (albeit no diagnosed heart disease)?
What about getting a hangover from alcohol but then drinking more to get over it? Is that a good analogy for the contradictions in the study? Instead of "hair of the dog" it's "oil of the fish".😄
it's not that complicated actually. omega 3 decreases the trombocyte levels which makes your blood thinner. this can cause atrial fibrillation.
I have decided to never again eat anything as it is all harmful. I will probably die in a short time because of this decision. Then again I might just have a big mac later on.
If we assume that among the group who use/consume fish oil there are more people who know that they are at a higher risk of getting cardiovascular events due to gentics or lifestyle. Why ? Because they start using fish oil as a preventative measure. Then you may get a higher incidence of AF due to group selection. And then since the fish oil has a preventative effect it produces a lower RR for further disease progression.
I'm just recovering from a haddock tack.
Fantastic and rational analysis. 🎉
So another case of, "Sheep go BAAAAHHHHHHHH"? Sounds about right.
Really good assessment
This was a great breakdown
Do you take Fish Oil @Dr. Layne Norton?
H e won't answer you? Next week you see all of them trying to ask you to buy it.
I can see they looked at how much red meat both user group and non-user group consumed, but at the individual level, it's plausible that those who eat oily fish on a regular basis (at least two times a week) would be less inclined to take fish oil supplements, and that those who don't eat oily fish on a regular basis (at least two times a week) would be more included to take fish oil supplements. And it's also plausible that the latter individuals would more likely to have consumed more red meat.
Now, if you consume more red meat along with fish oil supplements, the supplements might not be able to stop you from getting atrial fibrillation, but they might be able to stop you from getting worse than that.
Red meat does not cause AFib.
@@hallandrewe "We were able to show that adherence to the Mediterranean diet, and especially the intake of plant-based foods such as nuts, vegetables, and fruits, and also preference for white meat over red meat, was less frequently reported by AF patients."
Mediterranean Diet and Atrial Fibrillation: Lessons Learned from the AFHRI Case-Control Study (2022)
@@jadedk9916 Yes and there's also studies that show that most people that eat red meat are eating it with bread and french fries and other things, The study you cited is extremely flawed just like most nutritional studies, I love vegetables and I eat them myself but there has been studies of an all meat diet and it literally clears up heart disease. The Mediterranean diet is great, The standard American diet is not.
@@jadedk9916 there's also studies that say that there is microplastics and heavy metals in almost all fish so eating a high fish diet has other drawbacks. Eating a clean diet that includes red meat, vegetables, fish and organic fruits in moderation does not cause heart disease.
Question, I’m currently on Rivaroxaban (blood thinner) for my Antiphospholipid syndrome and cerebral venous sinus thrombosis. I’ve stopped taking fish oil supplements after this paper came out, is it safe to consume? Of course I will consult with my doctor but I am curious
If you are already taking Xarelto, then you are essentially receiving treatment for atrial fibrillation. Since the main thing that we worry about with any degree of a fib is thrombosis. I would say it is safe to continue taking fish oil in your case, but I don’t know exactly what you were taking so definitely consult with your doctor. Disclaimer: I am a physician, but I am not your physician 😂
I was a pharmaceutical rep for VAScepa. I know this couldn’t be further from the truth. Pure EPA actually removes plaque from the heart.
What this data tells me is 10% of 10% is 1% and that is an insignificant statistic that can easily explained by other random factors. The most obvious being that older people with health problems are more likely to be taking supplements to improve heart function compared to younger healthy adults.
Relative percentages mean squat , no matter what study
Digging in it seems like high dosage could be it, since people weren’t asked about dosage in this study
Did they do proper false discovery rate statistical analysis, like Bonferonni corrections?
the vigor of the "for the algorithm" mantra is definitely on the downslide.
I wonder if the researchers who conduct and publish these studies get frustrated--or even angry--when the media baldly oversimplifies the findings, ignores the data and study design and ultimately distorts the conclusions to such a degree that they're virtually unrecognizable relative to what the studies actually state. Ya kinda wanna give the scientists a hug and tell 'em that ya still love them...
This sounds like there is some sort of self-selection in using fish oil when healthy i.e. sicker people but that don’t present heart disease yet take fish oil. While when you are already sick, i.e. heart disease that self-selection effect is gone and the positive effect on heart health is better identified.
What quality/purity/toxin-load fish oil did they use? There is a wide range if fish oil quality.
Fish Oil tablets give me A Fib . I tested 3 times . Every time resulted in an onset of A Fib . Fish oil from eating fish I have no problems .
Layne> Could it be a possibility, that the patients who got afib, also got started on preventive drugs and this treatment resulted in the outcome of delay of death? 🤔
Details are very important, when interpreting study data! 😉
Still, the data shows an increased risk of AF in healthy populations. Other papers show it too. Perhaps it's the DHA from what I've seen so far. If you get AF you very likely have to go on blood thinning medication, which definitely has it's own risks.
Thank you for discussing the difference between relative risk reduction and absolute risk reduction. Relative risk reduction is a scam and should never be used. For example, when doctors are shown the relative risk reduction of statins, they overwhelmingly advocate their use. When shown absolute risk reduction -- which is statistically insignificant -- they oppose the use of statins overwhelmingly.
I've seen a lot of doctors on social media make this mistake because it's easy to look at the numbers and make that conclusion.
But it's because they don't factor in the time of exposure to the risk.
Trying to think of an example then smoking 10 cigarettes a day poses a certain risk if done for 2 years and then stopping.
In comparison then there's a much larger risk in smoking 10 cigarettes a day for a decade and then stopping.
So statins have a low relative risk reduction over a two year HRCT but a much larger relative risk reduction over decades.
I'm hoping that's a bit clearer now.
@@WilliamRoscoe First of all, I didn't say statins have a low relative risk reduction. They actually have a high relative risk reduction. What I said was, they have a very low absolute risk reduction. And if you have evidence that the absolute risk reduction of statins is significant over many decades, can you please link me to the evidence? Because the meta studies track statin studies that average about 5 years. Further, has anyone ever demonstrated the side effect risk of statins when taken over decades as compared to any reduction in CVD risk?
@@cdprince768 Do you agree that absolute risk is going to increase with exposure to that risk over time?
@@WilliamRoscoe How could I possibly agree with a premise that has never been demonstrated? Without long-term testing, we have no idea what the long-term efficacy of statins is, or whether the long-term risks outweigh any benefits. All we know is that, over and over again, statins fail to reduce absolute risk to any statistical significance. And when doctors are actually shown this statistic and not relative risk reduction, they overwhelmingly oppose the use of statins.
@@cdprince768 I'm starting from first principles so we're both on the same page..
Do you agree that the absolute risk of dying from smoking related disease increases over the time that you smoke?
Say 1 pack for 1 day vs 1 pack every day for a decade.
Ignore statins for the moment.
Very helpful. Thank you.
This sounds Mediterranean 🤔
The populations with a high omega 3 index aren't taking supplements, they are just eating fish. Maybe it might be better to just eat food rather than to use supplements. Who knows if those fish oil supplements are oxidized.
Honestly sometimes the best data is just self experimentation with time
Its selection bias. Each individual chose when to start or stop the supplements. If they had a suspicion that they were developing a heart problem, pre diagnosis, then they are more likely to begin taking fish oil. Once they were diagnosed with problems then there was likely a saturation in the number of people taking it.
They looked at a whole lot of variables… do you know if they made the Bonferroni correction for all of the looks at the data?
Layne, two comments. First you need to do a "Journal Club" podcast with Peter Attia, like he does with Huberman. This paper would have been perfect for that. Second, there will be a special place in hell for our friends in the media who engage in this flagrant misrepresentation. No journalist should graduate from J school unless they can explain the difference between relative risk and absolute risk. That relative risk is presented is THE risk in the media is one of the most shameful and disgusting practices in today's journalism, and there is a LOT of competition in that "award" category.
Did they not discuss side effects of fish oil supplementation such as bleeding?
I'm getting several of those shirts. Some for the gym and some for the bar
Wishing i took fish oil before my stroke. BUT i am now... just incase it helps which i am sure is worth at this point. My therapist recommended it for anxiety also.