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Fish oil / prostate new study

Ironbuilt

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Nov 11, 2012
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Everyone knows that fish oil is good for you, right? It’s a rich source of omega-3 fatty acids, which are marketed to reduce the risk of just about everything from heart disease to Alzheimer’s.

But a startling study shows men who have the highest levels of these compounds – the kinds found in fish but not in vegetable sources --have a higher risk of prostate cancer. Men with the very highest levels had a 71 percent higher risk of high-grade prostate cancer –the kind most tlikely to spread and kill, they report in the Journal of the National Cancer Institute.

It might be a sign that popping a pill is not only possibly a waste of money – it might be downright dangerous. And eating fish too often might be, also.

“These fish oil supplements in which some men getting mega, mega doses…in our opinion that is probably a little bit dangerous,” said Theodore Brasky of Ohio State University Medical Center, who worked on the study with a team from the Fred Hutchinson Cancer Research Center in Seattle.

The same team published a study in 2011 that showed men with the highest levels of one omega-3 fatty acid called docosahexaenoic acid, DHA for short, had double the risk of high-grade prostate cancer. Other studies have had similar findings.

To try to confirm their work, the team looked at data from a different prostate cancer trial called SELECT, for Selenium and Vitamin E Cancer Prevention Trial. That study showed 17 more cases of prostate cancer among men who took vitamin E alone for about five years compared to men taking placebos.

The effect was even stronger when they looked at omega-3 fatty acids – specifically, the kinds found in fish oil as compared to those found in vegetable oils.

Brasky’s team looked at 834 of the men in the SELECT trial who developed prostate cancer, and 1,393 randomly chosen others from the trial who didn’t have cancer. They divided the men into four groups based on their blood levels of three omega-3 fatty acids – EPA, DPA and DHA.

Those with the highest blood levels had a 71 percent higher risk of high-grade prostate cancer, compared to those with the lowest levels. Overall, their risk of any kind of prostate cancer was 44 percent higher.

The difference between the group with the highest levels of omega-3s in their blood and those with the lowest works out to about what someone would get by eating salmon twice a week, the researchers said.

Fatty acids found in vegetable oils, flaxseeds and other vegetable sources – including alpha-linolenic acid (ALA) – did not affect prostate cancer risk, the researchers found.

“A 70 percent increased risk in high-grade prostate cancer, given it’s the No. 1 cancer in men and fish is a commonly consumed thing and is thought to be a healthy food, I think it’d be a concern for people,” Brasky said in a telephone interview.

The American Cancer Society projects that 240,000 U.S. men will be diagnosed with prostate cancer in 2013, and about 30,000 will die from it.

"We've shown once again that use of nutritional supplements may be harmful," said Alan Kristal of Fred Hutchinson, who also worked on the study.

Brasky, who says he still eats fish “but in moderation”, says the study cannot answer the question of how fish oil might cause cancer. They took into account other factors that might be associated with eating fish and Brasky notes that mercury, which can be found in fatty fish, doesn’t cause prostate cancer.

The study also doesn’t say anything about the effects of fish oil on men who already have cancer. “This study is not about men with prostate cancer,” Brasky said, noting that some studies have suggested fish oil might be beneficial in men who already have cancer.

Men might be at a loss for what to do, as omega-3 fatty acids were also believed to lower the risk of heart disease, which is far more common than prostate cancer. The American Heart Association recommends that people with heart disease eat fish twice a week and people with heart disease might need fish oil capsules.

But the researchers point out that recent studies have shown taking extra omega-3 has little effect on heart disease – including a study published in the New England Journal of Medicine in May.
 

AtomAnt

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Oct 27, 2012
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Swole-Nation
Fellas, there appears to be some misrepresentation of the findings based on how the study was conducted. I asked Dr. Scott Stevenson about this here is his response:

If you read in Star magazine that your wife is cheating on you with your neighbor, would you believe it?...

(This is how I perceive most lay press-related info.)

This is the study, as far as I can tell:

http://www.ncbi.nlm.nih.gov/pmc/arti...pdf/kwr027.pdf

Interestingly, the researchers of the above initially hypothesized the opposite of what they found, ala:

Dietary omega-3 fatty acids, cyclooxygenase-... [Clin Cancer Res. 2009] - PubMed - NCBI


[Non-fasting Blood values were used for the analysis. My initial thought was that if sample acquisition were not controlled, especially in men who are enrolled in a cancer prevention program and aware of prostate cancer warning signs - their subjects - that you've got a nice psychological set-up for (rightfully) worrisome subjects to consume fatty acid / fish oil supplements, shown previously to impede prostate cancer development (see above) thus elevating levels, just before taking a blood draw.

I only skimmed the study, but did not see this mentioned as a weakness. Imagine taking bloodwork to confirm diabetes risk without controlling for food intake in a sample of subjects who know that high blood glucose suggests diabetes. Those perhaps rightfully worried will go in fasted and those not, will eat just before if no one tells them different. The conclusion would be that elevated blood glucose is associated withe reduced risk of diabetes mellitus... ]

-Scott

More information contradicting the results of the study:

Fish Oil and your Prostate - Examine.com Blog

Fish Oil Increases Risk of Prostate Cancer?

A new study has been making its rounds online claiming that fish oil causes prostate cancer, and more specifically the claim is that fish oil supplementation causes a 71% increase in high grade prostate cancer.

The study in question is one that appears to be a study based off of the SELECT trials (a large trial initially investigating the link between vitamin E and selenium with prostate cancer) which initially did not find a protective effect of supplementation on prostate cancer, but say an increased risk associated with vitamin E occurred during prolonged follow-up. This led to the current study.

A new study claims that fish oil supplementation causes prostate cancer, and was an observational study that used participants from a previous large scale intervention called SELECT


Lets Look at the Study

This will get science-heavy. If it's too heavy for you, just skip to the next section.

In short, this study initially looked at participants of the SELECT trial and got a sample of persons who were diagnosed with prostate cancer (n=834) and made note of how many had advanced cancer (n=156), then 1393 persons from the SELECT study who did not have prostate cancer were selected for comparison. The researchers then measured serum omega-3 fatty acids (EPA, DHA, and their intermediate DPA) and stratified the groups into quartiles to see if there was an association.

The results showed that persons who had prostate cancer were more likely to have higher circulating omega-3 fatty acid levels (excluding ALA, which was not associated) and that omega-6 was unrelated to prostate cancer. Trans fatty acids were mostly unrelated aside from a possible positive relationship with palmitelaidic acid (16:1). When comparing the quartiles against one another (the lowest quartile being set at 1.00 as a reference), the highest levels of fish based omega-3 fatty acids (collectively) was associated with increased risk as assessed by Hazard Ratio for low (1.07-1.40), medium (1.07-1.43), and high (1.00-1.54) grade prostate cancer. While DHA had an HR showing an association with low (1.07-1.37), medium (1.06-1.38), and high (1.03-1.54) grade prostate cancer, DPA was only associated with low (1.03-1.46) and medium (1.08-1.57) while EPA was not significantly associated with an increased risk. Alpha-linolenic acid, omega-6 fatty acids, and trans fatty acids were not related.

Note: The above ranges are known as the 95% confidence interval, and show the range of values that the researchers are 95% confident that the true value lies in. So for a range of 1.03-1.54 this means a possible 3-54% increase (with a 5% margin for error), and if the interval crosses 1.00 (the zero point where lower means reduced risk) then the observation is not considered significant

When adjusting for the omega-3 to omega-6 ratio, it seems that the HRs for low (0.98-1.36) and medium (0.97-1.36) grade prostate cancer became nonsignificant while there was still a significant relation with the high (1.40; 1.03-1.92) grade. The average value here, 1.40, may be where media sources are claiming a 40% increase in prostate cancer risk. The '71%' referenced in most publications was a direct comparison of the risk in the highest quartile against the lowest (with a confidence interval of 0-192%) with a 43% (9-88%) overall increase in risk.

Important Note: The actual association for people with high-grade prostate was in the range of 3% to 92% - this gets averaged to 40%. When comparing the highest quartile (25% of sample) to the lowest, the average risk was increased to 71% but became more variable at 0-192%.

The variables that were made note of in the analysis were education, history of diabetes, family history of prostate cancer, and SELECT intervention assignment (so, placebo or vitamin E groups). So despite the increased risk seen with vitamin E previously in SELECT it likely does not influence the results.

This study found that, when comparing the lowest 25% of subjects (assessed by how much fish oil was in their blood) against the highest 25% that the higher group had a higher frequency of prostate cancer at the time of measurement. They conducted a one-time measurement of blood lipids, and there was no supplemental intervention


What Should I Know?

Stating "fish oil causes cancer" due to this study would be a mistake, as it is a case-cohort study (conducted at one time point only), and a temporal relationship is not made. While unlikely, with the data available, it could also be possible to state "prostate cancer causes a higher n3 concentration in the blood."

The temporal aspect is important, since fish oil supplementation can drastically change serum levels of omega-3s in the blood. It is quite common for people diagnosed with prostate cancer to supplement with fish oil, as it is commonly touted to be cancer-protective (which would mean that prostate cancer precedes fish oil supplementation). A previous study using persons from SELECT using a design that could assess this temporal relationship found no relation (either protective or harmful) with prostate cancer incidence.

Furthermore, this study did not measure mortality. When looking at mortality, fish oil seems to be associated with reduced mortality. In simpler words, it was found to not help prevent prostate cancer, but reduced your chances of dying from it.

Also of interest is the large ranges observed (as in, the 71% value had an actual range of somewhere between 0% and 192% with a 5% margin of error), which either suggests other factors are at play influencing the results or large differences in how one’s body responds to omega-3 ingestion.

At the most, we can state that prostate cancer is associated with higher omega-3 ratios in your blood. This study poses a chicken-egg problem - which causes which?

This study and no other studies in existence can currently be used to say that fish oil causes prostate cancer. If anything, this study begets a plethora of questions in regards to the relationship between prostate cancer and omega-3 but proves nothing.
 

swolesearcher

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May 31, 2013
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so omega 3 are good for my hearth but bad for my prostate? ok i`ll keep eating them .. hearth is more important than prostate IMO
 
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Ironbuilt

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Nov 11, 2012
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Lol.↑ ..yeah i saw this in todays news and wanted peoples thoughts.i eat fish oil daily and my old prosser is gtg.. thanks for the study reply Atom im with u on it.