This May, the New England Journal of Medicine came out with a big study showing that fish oil capsules don't prevent heart attacks, strokes or deaths. That came on the heels of other large studies showing that daily multivitamins and calcium supplements are not just useless, but are actually bad for you. What are we to make of this information? Does it mean there is not a simple pill we can swallow to reverse disease? Can we not keep death at bay with a tablet?
The NEJM study was a good one, overall. It was very large, with over 12,000 subjects followed for five years, comparing daily fish oil to a placebo. A lot of the subjects had diabetes, high cholesterol or high blood pressure. This was a high-risk group, exactly the people that need protection the most. The study was randomised and double-blinded, better than most studies that came before it. Sadly, but perhaps expectedly, fish oil didn't prevent strokes, heart attacks or death. Why not?
We know fish oil lowers triglycerides and we know diets high in (real) fish and low in saturated fats also prevent heart disease. What this points out is that a lower test result (like your triglyceride number) doesn't always translate to lowering things that actually matter to us, like heart attacks or deaths. And the benefits of whole foods are often greater than if those foods are stripped down to isolated nutrients. It's time to replace supplements with real food.
And all of these studies beg the question of why we keep looking for magic bullets when we know what works far better than any pills or potions - quitting smoking, curing your Type 2 Diabetes through simple weight loss, eating less, sitting less and being more active. Address these and you needn't worry about supplements.
Gary Payinda, MD, is an emergency physician who would like to hear your medical questions. Email firstname.lastname@example.org. This column gives general information and is not a substitute for the advice of your doctor.