You may have seen some of these overblown headlines a few weeks ago…
- Omega-3 supplements linked to prostate cancer (Fox News)
- Fish oil supplements linked to prostate cancer (Health News)
- Hold the Salmon: Omega-3 fatty acids linked to higher risk of cancer (CNN)
- Men who take omega-3 supplements at 71% higher risk of prostate cancer (NY Daily News)
Seeing these, you might figure that fish oil, one of the most popular supplements, the subject of hundreds of studies, has been revealed to be a deadly hazard.
And you might also assume the headlines were based on a thorough, careful, scientific study. Normally, that would mean a study where the researchers divided a population of men into two groups — one of which received fish oil supplements and the other a placebo… and found those taking the fish oil supplements got more cancer than the ones who didn’t.
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What the mainstream press “forgot” to tell you
The first thing you need to know is that the study raising all this hoopla was published in the Journal of the National Cancer Institute on July 10th.
It was what’s called an observational study. It was not a double-blind, placebo-controlled study like the sort I just described. There was no tight, rigorous experiment.
In an observational study, the researchers observe a population over a period of time and take note of what the people do or what they’re exposed to in the way of food, exercise and other habits or environmental factors. Then — usually over a long period of time — they look for links between the lifestyle factors and what happens to the participants’ health.
Nearly all the people in this study
were low in omega 3’s
This was NOT a study of fish oil and its possible effects. That came later, as sort of an add-on. No fish oil supplements — or other supplements, for that matter — were given to the people who participated.
And in fact, the participants’ omega-3 blood levels were only about 40% of the levels you’d expect in health-conscious folks who take adequate doses of fish oil.1,2 Note that the researchers just measured how much omega 3 was in the blood. They don’t know whether the men in the study got these essential fatty acids from taking supplements, eating fish, eating flax seed oil, or what. All they know for sure is the levels were low.
But naturally, the media hype-masters completely missed this point. If they’d got the story right, it would be obvious that this study had no meaning to anyone who boosts their omega-3 consumption through supplements and diet.
What’s more, associating the results of a one-time blood test for omega-3 with long-term prostate cancer risk is worse than absurd.
These levels can change quickly as a result of any short-term dietary changes. You had salmon last night? Expect your levels to be higher this morning. This doesn’t mean much for long-term absorption of omega-3 into your cells. The researchers did not use the erythrocyte (red blood cell or RBC) fatty acid test, which gives a far more accurate picture of cellular omega-3 uptake over time. They used a blood plasma test instead. Plasma is just the liquid that holds the blood cells.
Compare this to a study
that actually means something. . .
Life Extension did a case analysis of their staff and found that a healthy diet including fish but not supplementation gave an RBC equivalent of 6.06%. But a standard diet with 3.6 grams of fish oil supplements a day brought the level to 10.59%. This is also consistent with previously published literature.
These numbers should shed light on the glaring flaw that renders the so-called Fish Oil study conclusions meaningless.
- Omega-3 RBC equivalence of a moderate fish eater = 6.06%
- Omega-3 RBC equivalence when taking 3.6 grams/day = 10.59%
- Study group — higher cancer rate group, long-chain omega-3 percentage = 4.66%
- Study group — group with no prostate cancer, long-chain omega-3 percentage = 4.48%
Risky and foolish conclusions
As you can see from those numbers, the difference in omega-3 levels between the cancer and non-cancer groups of the “Fish Oil study” was tiny — 4.66 vs. 4.48. The difference is too small to be significant. At most, you might conclude that fish oil made no difference to the rate of prostate cancer, one way or another. But as already noted, it’s more likely that neither group was getting enough.
Further, their conclusions were based on only one baseline blood draw. Those who developed cancer years later were followed up and their present levels of omega 3’s were compared to their earlier baseline. This methodology is prone to misinterpretation and errors — even if the gap between cancer victims and cancer-free subjects was wide. In this case, there was almost no difference in omega 3 levels between cancer victims and non-victims.
But this wasn’t the end of the problems…
These factors threw off the results
There are numerous confounding factors at the baseline, making the statistical analysis invalid.
- Family history. Risk of prostate cancer increases 120 to 180 percent in men with a father or brother who had prostate cancer. In this study, men who got cancer had nearly double the positive family history compared to controls.
- Higher baseline PSAs. Aging men with PSA readings higher than 2.4 ng/mL are at higher risk of developing clinically relevant prostate cancer.In this study, 41.1% of those who eventually developed prostate cancer had baseline readings higher than 3.0 ng/mL, versus 7.3% of those who didn’t get cancer. That means that many of the eventual cancer victims already had high cancer markers at the very beginning of the study. It is impossible to rationally discount the fact that 5.6 times more men who got cancer already were at a PSA level of 3.0+ at baseline. The mad-mad media, anxious to frame omega-3s, conveniently ignored this “small” factor.
- 53% of the prostate cancer subjects were smokers.3 Don’t you think that might be a more important risk factor than omega 3 fatty acids?
- 64% of those getting cancer regularly consumed alcohol.4
- 80% of the cancer subjects were overweight or obese.5 A 2011 study in PLoS One showed that aggressive prostate cancer was associated with obesity.6 This has been confirmed in other studies. And the obesity link held true in all cases — low-grade, high-grade, early and late stage, nonaggressive and aggressive. The fact that 80% of these men were already heavy is a confounding factor.
Researchers like to say they control for various confounding factors.
But for reasons unknown, these researchers didn’t control for age, race, diet… and who knows what else! For the record, even if they tried to control for diet, in this type of study they’d have to rely on what the subjects SAY they ate. These so-called “food frequency questionnaires” are notoriously inaccurate. Most people can’t even remember every bit of food they ate yesterday, let alone a month ago.
It’s well known that smoking, obesity and frequent alcohol consumption are the biggest risk factors for cancer in general (I should add — not necessarily for prostate cancer). It’s absolutely incredible to home in on a tiny difference in omega-3 blood levels, using a second-rate blood test, as a cause of cancer in these men.
This study can be safely ignored
Quality scientific research is consistent, repeatable, and of course, designed so that other researchers can investigate the same issue in the same way and come to the same conclusions.
Put another way, the result of a study does not mean much if it’s an outlier — that is, a lone wolf — contradicting well-established medical and scientific literature.
In this case, the results are inconsistent with thousands of established studies, and are most likely utter nonsense. They conflict with countless studies showing that increased omega-3s reduce prostate cancer risk… while diets high in omega-6s promote cancer.
Overwhelming evidence favors fish oil supplementation for most people. So much so that even mainstream doctors have been recommending fish oil for the past several years. And not just for cancer, either. Many studies also indicate it prevents heart disease.
Watch out where you get your medical advice!
It’s easy to be deceived if you rely on news sound-bites from mainstream reporters who often don’t know much about the subjects they cover. They simply pick up press releases from hospitals or universities trying to get into the news and get their 15 minutes of fame. If the scientists have enough letters after their names and an affiliation with a high-prestige institution, the reporters accept it all as gospel truth.
In addition, advertising from the big drug companies is important to almost every media news outlet. I know for a fact the drug companies intimidate uncooperative media outlets by threatening to pull all their ads. “Uncooperative” means carrying favorable stories about supplements or alternative health, or carrying negative stories about prescription drugs. The easiest way for news outlets to keep these major advertisers happy is to trash supplements. So you’d be wise to remain skeptical when the mainstream media screams that a supplement is bad for you.
Especially when it’s based on one or two studies that fly in the face of the bulk of clinical research that you’ve been hearing about for years. Perhaps more studies are needed — no harm in that — but the way things stand, there’s way too strong a body of evidence to throw out your fish oil supplements based on one not-very-well-constructed study with the problems this one had.
Finally, this may be the first study to attack a supplement (or food) where the human subjects weren’t even taking the supplement or food at any kind of significant level.
Other ways to get your essential oils
By the way, fish and fish oil aren’t the only ways to get omega 3 fatty acids and other valuable nutrients found in healthy fats.
Also consider evening primrose oil (I take it), pumpkin oil, high linoleic safflower and sunflower oil, and organic flax oil (I take this one in the form of fresh-ground flax seed, which avoids the problem of spoilage). I also eat coconut oil, just about the healthiest food on earth.
There are also those who suggest that krill is a better source of omega 3’s than fish oil because it comes with its own antioxidants included, sidestepping spoilage issues.
With both flax seed oil and fish oil — whatever form you take — make sure they aren’t rancid. Look for a brand that’s high quality, purified, and uses a non-permeable caplet to minimize oxidation (oxidation is a fancy way of saying “going rancid”). I think it’s best to refrigerate these supplements. With flax seed oil, refrigeration is a must.
Lee Euler, Publisher