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Vitamin D And Fish Oil Supplements Disappoint In Long-Awaited Study Results

cesanon
cesanon
23 Replies

"The trials involved nearly 26,000 healthy adults age 50 and older with no history of cancer or heart disease who took part in the VITAL research project. Twenty percent of the participants were African-American."

Vitamin D And Fish Oil Supplements Disappoint In Long-Awaited Study Results

Https://www.npr.org/sections/health-shots/2018/11/10/666545527/vitamin-d-and-fish-oil-supplements-disappoint-in-long-awaited-study-results

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arete1105

It wasn't all a bust. I found 2 benefits- mainly for cardio conditions:

1-Taking fish oil lowered the risk of heart attack by about 28 percent, which is a "statistically significant" finding, says Dr. JoAnn Manson, who is chief of the division of preventive medicine at the Brigham and Women's Hospital in Boston. She led the research.

2- Another study presented at the same meeting examined whether a substance derived from a component of fish oil, known as icosapent ethyl, might reduce adverse events among people who already have cardiovascular risk factors, such as hardening of the arteries, diabetes, or high blood fats known as triglycerides.

Overall, that study found there was a 25 percent risk reduction for patients taking the extract. These patients were less likely to die from heart disease, have a heart attack or stroke, be hospitalized for chest pain or need procedures such as angioplasty, stenting or bypass surgery, researchers reported.

But yes- no benefit for cancer.

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Tall_Allen

Thanks. Here are the full studies:

nejm.org/doi/full/10.1056/N...

nejm.org/doi/pdf/10.1056/NE...

This is the second large randomized clinical trial that proves Vitamin D supplementation has no effect on any cancer, including prostate cancer. That means we now have Level 1a evidence which supersedes all previous observational and lab studies.

I've updated my Vitamin D blog accordingly:

pcnrv.blogspot.com/2018/07/...

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cesanon
cesanon
in reply to Tall_Allen

I think I am going to keep up the vitamin D and fish oil. Just with much lower expectations of what if anything they can do.

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Tall_Allen
Tall_Allen
in reply to cesanon

At least it didn't show any harm, which is what I was afraid of.

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Tall_Allen
Tall_Allen
in reply to cesanon

What this RCT did NOT look at is what the effect of fish oil is AFTER a man already has prostate cancer, or the relative effect on low grade PC (which is most of it) vs high grade PC. There are trials in which omega-3s were associated with high grade PC:

ncbi.nlm.nih.gov/pmc/articl...

academic.oup.com/jnci/artic...

On the other hand, preventing myocardial infarction may be more important. I'll stick with fish.

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cesanon
cesanon
in reply to Tall_Allen

"There are trials in which omega-3s were associated with high grade PC"

This is all getting too too confusing.

Now I really don't know what to do. LOL

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j-o-h-n
j-o-h-n
in reply to cesanon

"drop back 10 yards and punt"....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 11/11/2018 6:46 PM EST

A shoutout to all the Veterans of our U.S.A. armed forces.

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cigafred
cigafred
in reply to Tall_Allen

Thank you for the links. For D and prostate cancer, I read the following:

Prostate cancer 192/12,927 with D, 219/12,944 without D, hazard ratio 0.88, 95% CI (0.72-1.07)

"Most groups had 25-hydroxyvitamin D levels close to, or above, 40 ng per milliliter (100 nmol per liter) after 1 year of supplementation with vitamin D."

My take, admittedly with some hopefulness swaying me, is that modest supplementation with D had a modest impact, and that heavier supplementation, say up to maybe 80 ng/milliliter, might have more. Yes, for now this proves nothing, but I also think it does not disprove the hypothesis that heavier D supplementation could be beneficial.

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Tall_Allen
Tall_Allen
in reply to cigafred

I'm afraid it doesn't work that way. When that Confidence Interval (CI) crosses 1.00 it means that the difference may be due to pure chance. You may as well surmise, for example, that it INCREASED incidence of prostate cancer by 7%. This study had a big sample size and was powered to detect a difference of 15% if there was one.

It is also NOT true that higher serum levels would be beneficial. They looked at people who had higher vs lower baseline serum levels and found no difference in outcomes. The VIDA trial used monthly doses of 100,000 IU after a loading dose of 200,000 IU and still did not have an effect on any cancer or on cardiovascular events. Other studies have shown there is no effect on bone mineral density.

pcnrv.blogspot.com/2018/07/...

Vitamin D is a steroidal hormone (not really a vitamin). As with other steroids, your body regulates the amount that gets into your cells using Vitamin D Binding Protein (VDBP - which UPregulates when you take more) and the number of Vitamin D receptors (which DOWNregulates when you take more). It may turn out that preventing formation of VDBP may allow some beneficial effect to occur from taking more, but we do not yet have a drug for that. As with any supplement/drug, bioavailability is an issue.

Your body also has mechanisms that interconvert one steroid into another. High Vitamin D levels are associated with high testosterone levels - not an effect that someone on ADT would want.

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cigafred
cigafred
in reply to Tall_Allen

Yes you are correct it does not prove, but the overall picture implies, to me, that the odds favor some benefit. The earlier, long discussion on the NZ trial shows that some of us do not find it convincing, but let us not go into that again. As for T and D, my last T was 5 ng/ml, last D 71 ng/ml preceded by 87, so it is possible to do both. I follow you religiously on all things PC, except for supplements where our ways part.

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Tall_Allen
Tall_Allen
in reply to cigafred

Wishful thinking is not evidence. There is NO benefit when the statistics do not support it. Otherwise, you could say for Vitamin D that the "odds favor" some INCREASED INCIDENCE of breast cancer, colorectal cancer, and death from myocardial infarction due to Vitamin D. It would also say that "odds favor" some INCREASED INCIDENCE of prostate cancer (by 15%), colorectal cancer (by 23%) and incidence of stroke (by 32%) due to omega 3s. None of your or these statements are supportable by the data.

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cigafred
cigafred
in reply to Tall_Allen

I promise this is my last post on this topic--I do not want to distract from the more important discussions on this forum. I understand and agree that 95% confidence limits is the standard (in some areas 99% is more common), but, as a thought experiment, consider a world that decided that 75% confidence is sufficient. My wild guess is that this survey, with its large number of participants, would meet that test, that 75% confidence limits would be something like 0.82 to 0.97, so in that world we could say that D is helpful. And if one has systemic PC, does not a 75% chance of benefit justify adding a bit of D to the diet?

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Tall_Allen
Tall_Allen
in reply to cigafred

The problem with your imaginary world is there is no basis for deciding if an effect, seen in a sample, is indicative of the population that you really want to know about. If you change the rules, you also have to conclude that Vitamin D CAUSES breast cancer, colorectal cancer, and MI deaths. You would also believe that almost every drug tested improved PC survival.

The reason 95% confidence was chosen is because it represents two standard deviations on a normal bell curve. (99% is 3 std deviations) By extending the confidence interval, don't forget that you would be extending it to both sides of the bell curve. It means that the true hazard ratio may be as high as, say 120% - meaning a 20% INCREASE in prostate cancer due to taking Vitamin D.

It also leaves you open to "p hacking" or "data mining" - spurious random correlations that become statistically significant. That's why these limits are set BEFORE studies are ever fielded.

motherjones.com/kevin-drum/...

As for what's the harm of "adding a bit of Vitamin D to the diet?"...I would also caution members of this forum, who have already been diagnosed with advanced or recurrent prostate cancer, that this trial had to do with prevention of INCIDENCE rather than prevention of RECURRENCE. The safety of Vitamin D supplementation in men who have ALREADY been confirmed to have prostate cancer has not been established. Observational studies have suggested that omega-3s and very high doses of vitamin D have been associated with HIGHER GRADE prostate cancer. For example:

academic.oup.com/jnci/artic...

academic.oup.com/jnci/artic...

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Stegosaurus37

Wow! I was part of the VITAL study. It's over now so I've found I was part of the placebo group. It terminated before my cancer diagnosis, so no connection. As far as fish oil goes, those of us of a certain age had daily doses of cod liver oil as children. I actually liked the stuff which started my familial reputation for eccentricity - which my wife heartily endorses.

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j-o-h-n

You and I are the only two people on this earth that actually liked cod liver oil when we were kids. We were so poor that I got a treat of a quarter of an orange as a reward for taking it without complaining. In fact, I would sneak taking my sister and my brother's dose so they would give me their quarter's of the orange. BTW coincidently I turned out the tallest in the family as well as the best looking one. LOL

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 11/11/2018 6:55 PM EST

A shoutout to all the Veterans of our U.S.A. armed forces.

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George71
George71
in reply to j-o-h-n

yah, but your brother and sister are a lot smarter ... LOL

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j-o-h-n
j-o-h-n
in reply to George71

I agree.... they don't call me dumbass for nuttin....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 02/10/2019 12:29 PM EST

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curt504a

One needs to look at the actual study. These guys are famous for designing studies to fail! IE the vitamin C study that dosed only 500mg. OMG! Where today we know that liposomal C dosed in the grams has many therapeutic benefits.

google.com/search?client=op...

Back to D: google.com/search?client=op...

What I've read in cancer studies/articiles is that LOW D <38 (??) is predictive of poor diagnoses, where if this study covered the scenario of low D patients and raising their D to >50 (??) I believe the cancer prevention outcome would be much different.

IE I bet they culled the cohort to be normal D folks and then gave minisquel dose so as to assure a poor outcome. I didn't dig into the methods of this study, just suspecting.

Its my view that its a very good idea to test for D and if low, raise it. But what is not mentioned is the co-dependance of D on vitamin A and vitamin K. Raise both at the same time. Some fish oils contain A, some do not. I take Emu Oil for my vitamin K*. Life Extention K is good but I have a condition that tells me when K is low and only Emu Oil (4 tabs / day) helps.

Masterjohn is an excellent vitamin D and lipids researcher: google.com/search?client=op...

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Tall_Allen
Tall_Allen
in reply to curt504a

In fact, it is a very well designed trial. I suggest you read it. It was sponsored by NIH, who has no skin in the game. Supplement manufacturers, who do have skin in the game, contributed the supplements; Pharmavite donated vitamin D and Pronova BioPharma and BASF donated fish oil (Omacor). They used 4,000 IU daily doses, which is considered high. The participants were randomly assigned.

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cesanon

Big fish oil study unveiled in Chicago shows promise in heart disease prevention.

chicago.suntimes.com/busine...

Although fish oil taken by healthy people, at a dose found in many supplements, showed no clear ability to lower heart or cancer risks, higher amounts of a purified, prescription fish oil, such as Vascepa, slashed heart problems and heart-related deaths among people with high triglycerides, a type of fat in the blood, and other risks for heart disease. | Amarin via AP

Taking fish oil or vitamin D? Major studies presented Saturday in Chicago provided long-awaited answers on who does and does not benefit from these popular nutrients.

Fish oil taken by healthy people, at a dose found in many supplements, showed no clear ability to lower heart or cancer risks. Same for vitamin D.

But higher amounts of a purified, prescription fish oil slashed heart problems and heart-related deaths among people with high triglycerides, a type of fat in the blood, and other risks for heart disease. Doctors cheered the results and said they could suggest a new treatment option for hundreds of thousands of patients like these.

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Egerdes

My Vit D was below 25ng when I was told I had prostate cancer 🤔

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Sid_Arthur

See also: fearlessparent.org/suppleme... . . . . and my comments on this thread: healthunlocked.com/advanced...

Sid ;~)

3 Feb 2019

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