Monday December 17, 2018

The Final Take On Benefits of Fish Oil and Vitamin D

Vitamin D did not affect the odds of having a heart attack or stroke or developing cancer.

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Fish Oil
Vitamin D pills are displayed, Wednesday, Nov. 9, 2016, in New York. Doctors are warning about vitamin D again, and it isn't the "we need more" news you might expect. VOA
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Taking fish oil or vitamin D? Big studies give long-awaited answers on who does and does not benefit from these popular nutrients.

Fish oil taken by healthy people, at a dose found in many supplements, showed no clear ability to lower heart or cancer risks. Same for vitamin D.

But higher amounts of a purified, prescription fish oil slashed heart problems and heart-related deaths among people with high triglycerides, a type of fat in the blood, and other risks for heart disease. Doctors cheered the results and said they could suggest a new treatment option for hundreds of thousands of patients like these.

Up to 10 percent of U.S. adults take fish oil. Even more take vitamin D, despite no major studies to support the many health claims made for it.

“Those who peddle it promote it as good for everything,” but in this definitive test, vitamin D “showed a big nothing,” said Dr. James Stein, a heart specialist at the University of Wisconsin-Madison. He had no role in the studies or ties to the companies involved.

Fish Oil
Fish Oil can help in reducing osteoarthritis pain, Pixabay

Results were revealed Saturday at an American Heart Association conference in Chicago and published by the New England Journal of Medicine.

About fish oil

These oils, also called omega-3 fatty acids, are found in salmon, tuna and certain other fish. They reduce triglycerides and inflammation and may have other effects. There are different types, including EPA and DHA.

One study tested 4 grams a day of Amarin Corp.’s prescription Vascepa, which is concentrated EPA, in more than 8,000 patients with high triglycerides and a greater risk of heart problems for various reasons. All were already taking a statin such as Lipitor or Zocor to lower cholesterol. Half were given Vascepa and the rest, mineral oil capsules as a comparison.

After five years, about 17 percent of those on Vascepa had suffered one of these problems — a heart attack, stroke, heart-related death or clogged arteries requiring medical care — versus 22 percent of the others.

That worked out to a 25 percent reduction in risk. Looked at individually, heart attacks, heart-related deaths and strokes all were lower with Vascepa. Only 21 people would need to take Vascepa for five years to prevent one of the main problems studied — favorable odds, Stein said.

Fish Oil
Consuming one gram of fish oil every day and including spinach in the diet could help reduce the pain of patients with osteoarthritis, the most common form of arthritis that generally affects the hands, hips and knees. Pixabay

Side effects may be a concern: More people on Vascepa were hospitalized for an irregular heartbeat — 3 percent versus 2 percent of the comparison group. Doctors say that’s puzzling because other research suggests fish oil lowers that risk.

The concern with the heart rhythm problem is that it can raise the risk of stroke, but there were fewer strokes among those on Vascepa, said study leader Dr. Deepak Bhatt of Brigham and Women’s Hospital in Boston.

Vascepa costs around $280 a month; many insurers cover it. Amarin sponsored the study and some study leaders work or consult for the company.

The other study tested a lower 1 gram daily dose of a different type of fish oil — an EPA/DHA combo sold as Lovaza or Omacor and in generic form — in 26,000 people with no prior heart problems or cancer.

After about five years, rates of a combined measure of heart attacks, strokes and other problems were similar for fish oil users and a comparison group. Cancer rates and deaths also were similar.

Fish oil
Higher Vitamin D Levels Linked to Lower Colorectal Cancer Risk, Study Finds. Pixabay

There were fewer heart attacks in the fish oil group — 145 versus 200 in the comparison group. The study leader, Dr. JoAnn Manson at Brigham and Women’s, called that “a substantial benefit,” but several independent experts disagreed because of the way the study was set up to track this and certain other results.

“These findings are speculative and would need to be confirmed in a separate trial,” said the Cleveland Clinic’s Dr. Steven Nissen.

Fishy comparisons?

Both studies share a problem: the oils used for the comparison groups, which may not have been true placebos. The Vascepa study used mineral oil, which interferes with statin drugs, raises cholesterol, and might have made the comparison group fare worse and made Vascepa look better than it truly was.

The other study used olive oil, which might have helped that comparison group do better, possibly masking any benefit to the others from fish oil.

Leaders of both studies say any effect from the comparison oils isn’t enough to alter the main results, and independent experts agreed. But Nissen, who is leading another fish oil study, is using corn oil as a comparison.

The ‘sunshine’ vitamin

Manson’s study also tested vitamin D, which the skin makes from sun exposure. It’s tough to get enough from foods like milk, eggs and oily fish, though many foods now are fortified with it. Some studies have found that people with lower levels of D are more likely to develop cancer, but it’s not known if supplements alter that risk.

Fish Oil
The researchers found that Vitamin D in cells and mouse models can be beneficial in treating these damaged beta cells. pixabay

Study participants took 2,000 international units of D-3 (the most active form of vitamin D, also called cholecalciferol) or fake vitamin pills for five years.

Vitamin D did not affect the odds of having a heart attack or stroke or developing cancer. After excluding the first two years of use, researchers saw fewer cancer deaths among those on the vitamin — 112 versus 149 in the placebo group.

“Cancer can take years to develop” so a difference may not show up right away, Manson said. “This looks promising” and people will be studied longer to see if the trend holds up, she said.

Also Read: Consuming Cocoa May Improve Vitamin D Intake: Study

Several other experts said these numbers just hint at a possible benefit that needs more study.

“These ‘positive’ results need to be interpreted with caution,” Dr. Clifford Rosen of Maine Medical Center Research Institute and Dr. John Keaney Jr. of the University of Massachusetts wrote in a commentary in the medical journal. (VOA)

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The Young Miracle: Baby In Congo Suffering From Ebola Recovers

The latest WHO assessment, released Thursday, simply calls the circumstances "unforgiving."

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Ebola, baby
- In this photograph taken Dec. 3, 2018, and released by UNICEF, an Ebola survivor cares for one-week-old Benedicte who was infected at birth with the Ebola virus by her mother, at an Ebola treatment center in Beni, Democratic Republic of the Congo. VOA

They call her the “young miracle.” A baby who was admitted to an Ebola treatment center just six days after birth has now recovered from the virus.

Congo’s health ministry calls the baby the youngest survivor in what is now the world’s second-deadliest Ebola outbreak.

The ministry late Thursday tweeted a photo of the infant, swaddled and with her tiny mouth open in yawn or squall, surrounded by caregivers who watched over her 24 hours a day for weeks.

The baby’s mother, who had Ebola, died in childbirth, the ministry said.

The infant was discharged Wednesday from the treatment center in Beni. “She went home in the arms of her father and her aunt,” the ministry said.

 

Ebola, baby
Health workers treat an unconfirmed Ebola patient, inside a MSF (Doctors Without Borders) supported Ebola Treatment Centre (ETC) in Butembo, Democratic Republic of the Congo, Nov. 3, 2018. VOA

 

Experts have reported high numbers of children with Ebola in this outbreak, which Congo’s health ministry says has 515 cases, 467 of them confirmed, including 255 confirmed deaths.

 

The tiny survivor is named Benedicte. In video footage shared by UNICEF, she is shown in an isolated treatment area, cradled in the arms of health workers in protective gear or cuddled by Ebola survivors, called “nounous,” who can go without certain gear such as masks. The survivors are crucial with their reassuring presence, the health ministry said.

“This is my first child,” her father, Thomas, said. “I truly don’t want to lose her. She is my hope.” He gazed at his baby daughter through the clear protective plastic.

Infected children

Children now account for more than one-third of all cases in this outbreak, UNICEF said earlier this week. One in 10 Ebola cases is in a child under 5 years old, it said, and children who contract the hemorrhagic fever are at greater risk of dying than adults.

Ebola, Baby
A health care worker carries a cross next to a coffin with a baby suspected of dying of Ebola in Beni, North Kivu Province of Democratic Republic of Congo, Dec. 13, 2018. VOA

While Ebola typically infects adults, as they are most likely to be exposed to the lethal virus, children have been known in some instances to catch the disease when they act as caregivers.

Few cases of Ebola in babies have historically been reported, but experts suspect transmission might happen via breast milk or close contact with infected parents. Ebola is typically spread by infected bodily fluids.

The World Health Organization also has noted that health centers have been identified as a source of Ebola transmission in this outbreak, with injections of medications “a notable cause.”

Dangerous conditions

So far, more than 400 children have been left orphaned or unaccompanied in this outbreak as patients can spend weeks in treatment centers, UNICEF said. A kindergarten has opened next to one treatment center in Beni “to assist the youngest children whose parents are isolated” there, it said.

Congo, Ebola, Women, Baby
Marie-Roseline Darnycka Belizaire, World Health Organization (WHO) Epidemiology Team Lead, talks to women as part of Ebola contact tracing, in Mangina, Democratic Republic of Congo. VOA

Health experts have said this Ebola outbreak, the 10th in Congo, is like no other as they face the threat of attack from armed groups and resistance from a wary population in a region that had never faced an Ebola outbreak before. Tracking suspected contacts of Ebola victims remains a challenge in areas controlled by rebels.

Also Read: Women Hit Especially Hard In Congo’s Worst Ebola Outbreak

The latest WHO assessment, released Thursday, simply calls the circumstances “unforgiving.”

And now, Congo is set to hold a presidential election Dec. 23, with unrest already brewing. (VOA)