Friday, March 8, 2013

The benefits of Omega 3's may be dose related



The benefits of  taking omega 3 Fatty acids to reduce the risk of cardiovascular disease and death is still unsettled.  

A recent study , the* ORGIN Study , suggest that there is no benefit.
                   
This study was part of a larger study  evaluating the use of Lantus insulin and cardiovascular disease. They used a 1 gram dose of omega 3 's containing 465mg of EPA and 375 mg of of DHA and 1 gm of olive oil.
The study demonstrated an average 14mg/dl ( .16 mm/l )  decrease in triglycerides.
 2012 Jul 26;367(4):309-18. doi: 10.1056/NEJMoa1203859. Epub 2012 Jun 11.n-3 fatty acids and cardiovascular outcomes in patients with dysglycemia.

Comment. The Orgin study has some deficiencies .
    #1 There was no measure of inflammatory markers such as hs-CRP or others
    #2  There was no test of omega 3 blood levels to confirm compliance
    #3  other intake of omega 3's from diet or other sources was done by using a questionare
    #4   The dose may not have been adequate . What is the minimum effective dose ?


The benefits of Omega 3's may be dose related

 My personal experience supports the idea that the benefits are dose related.

 The Jellis study referred to a few days ago used 1.8 gms of purified EPA and did demonstrate a
 reduction in cardiovascular risk.

** The Anchor study , comparing  2 gm vs 4 gm of EPA  , demonstrated a difference in the beneficial
 effects of EPA on known cardiovascular risk factors.

                                        4 gram dose  EPA                    2 gram dose EPA
Triglycerides                     21 % reduction                         10.1 % reduction
 LDL                                 6.2 % reduction                        3.6% % reduction
Apo-b                                9.3 % reduction                        3.8 % reduction
hs-CRP                              22 %  reduction                        6.8 % reduction

Have fun , Be smart  check your dose of Omega 3's and talk to your doctor
David Calder ,MD

reference


 *  2012 Jul 26;367(4):309-18. doi: 10.1056/NEJMoa1203859. Epub 2012 Jun 11.n-3 fatty acids and cardiovascular outcomes in patients with dysglycemia.
ORIGIN Trial InvestigatorsBosch JGerstein HCDagenais GRDíaz RDyal LJung HMaggiono APProbstfield JRamachandran ARiddle MCRydén LE,Yusuf S.

 **Jelis Study (Japan EPA Lipid intervention Study) reported in Lancet 2007;369: 1090-8
***American Journal of Cardiology
      Volume 110, Issue 7 , Pages 984-992, 1 October 2012

(from    the ANCHOR Study    Efficacy and Safety of Eicosapentaenoic Acid Ethyl Ester (AMR101) Therapy in Statin-Treated Patients With Persistent High Triglycerides

      








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Your comments and questions are appreciated. David Calder,MD