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Fish Oil-Arrhythmia Study Shows Confusion
6/20/2005
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Reader letter raises concerns belied by bulk of medical evidence 
by Randy Hartnell 


Last week, I received a letter from reader and healthcare professional Margaret Pfeiffer in response to a news story about a study of fish oil and arrhythmias: irregular heartbeats that can be life-threatening if not treated promptly.

 

She was concerned about its implications, so I dug a bit deeper, with reassuring results.  Here is her letter, and my response, with added information I uncovered subsequent to my initial reply.

 

To Randy:

 

Please comment on the study in JAMA [Journal of the American Medical Society] of June 15 that concluded that among patients with a recent episode of sustained ventricular arrhythmia and an ICD [implantable cardioverter defibrillator], fish oil supplementation does not reduce the risk of VT/VF [ventricular tachycardia and ventricular fibrillation are types of arrhythmia] and may be pro-arrhythmic [cause arrhythmia] in some patients. 

 

It took a lot of effort to convince our cardiologists to start recommending fish oils to our cardiac patients and now I'm getting flooded with calls saying EXPLAIN THIS. I'm hoping you can help me on this. 

 

My response to Margaret’s concerns

 

Hi Margaret,

 

I understand your concern and would be happy to try and help. First of all let me put forth the caveat that I’m not a physician or scientist so am not an authority on anything other than OUR fish oil. That said, here are my observations:

 

While this report may seem alarming, it’s good to keep things in perspective. There have been hundreds of published studies indicating manifold benefits associated with consumption of fish oil and omega-3 rich foods, particularly with regard to cardiac health.

 

These are the findings of five studies examining this issue, all published in the past two years:

 

  • “A large body of evidence suggests that n-3 fatty acids from fish prevent fatal heart disease. They may be an effective and safe alternative to drug treatment for reducing the risk of arrhythmia and sudden cardiac death.”
  • “The data indicate an antiarrhythmic action of n-3 PUFA under conditions of clinical practice which might help to explain the reduced incidence of fatal myocardial infarction and sudden cardiac death in cohorts [groups] on a fish-rich diet or supplemented with n-3 PUFA.”
  • “This study first demonstrates that PUFA administration during hospitalization in patients undergoing CABG substantially reduced the incidence of postoperative AF [(atrial fibrillation, a common cardiac arrhythmia] (54.4%) and was associated with a shorter hospital stay.”
  • “Among elderly adults, consumption of tuna or other broiled or baked fish, but not fried fish or fish sandwiches, is associated with lower incidence of AF (atrial fibrillation). Fish intake may influence risk of this common cardiac arrhythmia.”
  • “The available evidence still suggests that n-3 fatty acids may prevent fatal cardiac arrhythmia, but more conclusive studies are urgently needed.”

In addition, this isolated study included people who were hardly characteristic of the general population—200 omega-3-deficient participants with implanted defibrillators. This is how the authors described them: “…Patients taking class I or class III antiarrhythmic medications were excluded, as were patients who consumed more than one fatty acid (salmon, Chilean sea bass, sardine, herring, or mackerel) meal per week or who had taken flaxseed, cod liver oil, or fish oil supplements in the previous month. “

 

In addition, to my knowledge, the study has yet to be replicated.

 

It is unfortunate that the sensational anti-fish-oil headlines may result in thousands of people reducing or discontinuing their intake of fish oil, which is probably among the most well-established, beneficial, and safe supplements to be found. Were they to look beyond the bold type they would read the authors’ more positive comment:

“The fact that we were not able to demonstrate an anti-arrhythmic effect of fish oil does not call into question the potential benefits of fish oil or dietary fish intake in patients who have had a myocardial infarction…”

 

If I may, I’d like to share with you a theory I have as to why the results were not as expected: Last year I attended a fatty acid conference where the speaker made an interesting observation that came to mind when I learned of this study. Dr. Patricia Kane told the audience (mostly physicians) that she was hearing from researchers in the field that molecularly distilled (nutritionally denatured) fish oils were producing suboptimal results.

 

I note in this study that subjects were being given high dose—distilled, fractionated and concentrated—fish oil (72 percent omega-3s).

 

Our position on this type of common highly-processed “reformulated” fish oil is that it lacks the full fatty acid matrix found in fish or whole fish oils which may reduce its bio-available. On the contrary, our Alaskan sockeye salmon oil contains 32 distinct, naturally-occurring fatty acid molecules, present in their complete and balanced natural state.  (You can read more about our oil by clicking here. )

 

I’d love to see this study repeated with our whole sockeye oil!

 

Here are two quotes from Deepak Chopra, M.D., which I think eloquently sum up our philosophy with regard to this issue: 

 

“The first thing that is destroyed in the laboratory when a nutrient is isolated from a food, is the delicate web of intelligence that binds the components of food together. When a blood cell rushes to a wound site and begins to form a clot, it has not traveled there at random. It actually knows where to go and what to do when it gets there, as surely as a paramedic — in fact, more surely, since it acts completely spontaneously and without guesswork. Even if we break down its knowledge into finer and finer bits, looking for the secret in some minute hormone or messenger enzyme, we will not find a protein strand labeled ‘intelligence’, and yet there is no doubt that intelligence is at work. 

 

“… the essential properties of an organism, or living system, are properties of the whole, which none of the parts have. They arise from the interactions and relationships among the parts. These properties are destroyed when the system is dissected, either physically or theoretically, into isolated elements. Although we can discern individual parts in any system, these parts are not isolated, and the nature of the whole is always different from the mere sum of its parts.”

 

—Deepak Chopra, Quantum Healing

 

Finally, I’d like to share with you a letter I just received from Dr. William Sears (www.askdrsears.com) while composing my reply to you:

 

Randy,

 

I’ve recently been giving quite a few talks on healthy aging.  A few months ago I gave a talk at a senior citizens retirement village in Palm Springs and mentioned the importance of fish oil especially in lowering cholesterol and lowering the risk of cardiovascular disease.  I talked about Vital Choice Sockeye Salmon oil and gave them your website.

 

The host ordered your salmon oil and began to lower her cholesterol.  She amazed her doctor because within a few weeks her cholesterol was back to normal and she was able to drastically lower her dose of Lipitor. 

 

Her doctor asked her where she got the salmon oil advice, Sandy quipped: “from my pediatrician.”  Sandy has been recommending the Vital Choice to a lot of her friends in the Palm Springs area.  We just returned from giving a talk at a Neurology convention on a cruise ship in Alaska.  The topic of my presentation was Feeding the Brain in which I gave the latest research on fish oil and brain health.

 

 Naturally, all the doctors in the audience wanted to know where they could get pure fish oil and I gave them your website.  I asked Sandy to write you a personal thank you note and I hope she does.  Keep up the great products!

 

Best personal regards,

 

Bill Sears

AskDrSears.com, Inc.

 

Margaret, I hope you find this information helpful and reassuring. Please let me know if you have any additional questions.

 

Best regards,

Randy

 


Sources

  • Bucher HC, Hengstler P, Schindler C, et al. N-3 polyunsaturated fatty acids in coronary heart disease: a meta-analysis of randomized controlled trials. Am J Med. 2002;112:298-304.
  • Mozaffarian D, Psaty BM, Rimm EB, Lemaitre RN, Burke GL, Lyles MF, Lefkowitz D, Siscovick DS. Fish intake and risk of incident atrial fibrillation. Circulation. 2004 Jul 27;110(4):368-73. Epub 2004 Jul 19.
  • Singer P, Wirth M. Can n-3 PUFA reduce cardiac arrhythmias? Results of a clinical trial. Prostaglandins Leukot Essent Fatty Acids. 2004 Sep;71(3):153-9.
  • Geelen A, Brouwer IA, Zock PL, Katan MB. Antiarrhythmic effects of n-3 fatty acids: evidence from human studies. Curr Opin Lipidol. 2004 Feb;15(1):25-30. Review. 
  • Ewing T. Fish Oil Supplements May Be Risky to Defibrillator Patients.  MedPage Today. Accessed June 15 online at http://www.medpagetoday.com/tbindex.cfm?tbid=1201&topicid=2
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