Dr Rowen's Second Opinion Newsletter

Large doses of fish oil don't prevent heart attack or stroke

I've been embroiled in a controversy about marine oil efficacy for several years. I've warned against pharmacological doses of fish oil. And I was the first in integrative medicine to do so. A new report in the New England Journal of Medicine has closed the case, in my favor, according to eminent Scripps Institute cardiologist Eric Topol.

Let me tell you first who he is, and then, his conclusions of the latest study. Dr. Topol was voted as the number one "Most Influential Physician Executive" in the United States in a 2012 national poll conducted by Modern Healthcare. He is editor-in-chief of Medscape and He won't make recommendations without significant consideration.

Now for the study and Dr. Topol's analysis. The study began in 2004 and included 12,000 people. Over 800 primary care doctors participated. The researchers followed the participants for over five years. These patients were at high risk for heart disease. About 60% had diabetes, 70% had hypertension, and 70% had high cholesterol - but none had suffered a heart attack. They gave them either fish oil or a placebo (olive oil).

At first, the end point was death, heart attack, or stroke. They later changed it to death or hospitalization from cardiovascular disease. Dr. Topol says that though the investigators changed their primary end point, that it "really didn't matter." Dr. Topol analyzed a graph study showing "primary events" in the two groups. Amazingly, the line looked single, but a closer look shows that it was double, to include both experimental and placebo groups. Topol comments, "There's no difference. There's no difference on any end point: death, stroke, heart attack, hospitalization, you name it." So, the lines looked single.

Dr. Topol went on to stress that these were high-risk patients. The trial was therefore "loaded." That means if fish oil were to work, this trial should be biased toward success.

He closes his blog with "Fish oil is a "no-go.'" If it doesn't work in this group, "it's hard to imagine in lesser-risk groups that it's going to have any salutary impact."

You heard the story on fish oils in Second Opinion first, and years ago. I credit my fatty acid mentor Prof. Brian Peskin with showing me the huge holes in the flawed hypothesis and research on marine oils.

This study in the prestigious NEJM should close the controversy. If you are taking fish oil, I definitely suggest stopping it. Dr. Topol stated that he "implores" his patients to stop taking the stuff. "Fish oil does nothing, and we cannot continue to argue about either 'the right dose' or 'the right preparation.' It's a nada effect."

This NEJM report was so stunning that Prof. Peskin was contacted by and appeared on national radio Coast to Coast AM the evening of May 9, right after the story broke. Prof. Peskin and I are collaborating on a new book to address the fatty acid issue from two perspectives - his as a carnivore, and mine as a vegetarian. It's due out in several months, and I'll let you know when it's released.

This report doesn't specifically say that fish oils are harmful. However, I've addressed that in past issues showing how marine oils make rancid liver cell membranes in primates and exhausts all the vitamin E reserves in the organ. What this report does confirm is that marine oils are worthless in protecting you from vascular disease. So why use them at all?

There is one fault with the study as I see it. Olive oil was the control oil. Olive oil benefits heart disease with its polyphenols. It is loaded with omega 6, but no one credits that. So the fish oil pundits could claim that fish oil protects as well as olive oil. Well, why pay for fish oil and its rancidity and possible aging effects when you can enjoy the wonderful taste and economy of olive oil simply in your food?

Bottom line, your body needs parent oils. Parent oils will manufacture "fish-oil-like-fatty-acids" as needed. Don't overdose with marine oil supplements and risk premature aging. My choice of parent oils remains Advanced EFA Formula.

Yours for better health and medical freedom,

Robert J. Rowen, MD

REF: NEJM 5-09-13.