A massive omega-3 study has just been presented, and it has stoked fierce controversy
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Here are the links to the research papers referenced in the video:
https://www.acc.org/latest-in-cardiology/articles/2022/11/01/22/00/sun-7pm-respect-epa-aha-2022
https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2022/11/05/03/10/respect-epa
https://www.medscape.com/viewarticle/983621?reg=1#vp_2
https://pubmed.ncbi.nlm.nih.gov/30415628/
https://pubmed.ncbi.nlm.nih.gov/17398308/
https://pubmed.ncbi.nlm.nih.gov/33993205/
https://jamanetwork.com/journals/jamacardiology/article-abstract/2797283
https://www.mayoclinicproceedings.org/article/S0025-6196(20)30985-X/fulltext
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A massive omega-3 study has just been Presented and it sparked Fierce Controversy it’s called The Respect EPA Study so omega-3 is made up of EPA and DHA so this trial was only looking at EPA and the study wanted to see what Happens when EPA is given to patients That already have coronary artery Disease so this is diseased blood Vessels around the heart who are already Being treated with statins patients were Randomized to take either EPA at 1 800 Milligrams or a control and the study Was around two and a half thousand Patients patients were followed up for Around five years but here’s one of the Controversial things this was an open Label study so this means that the Participants they knew exactly whether They were taking the control or whether They were taking the EPA so it was not a Double-blind study moving to the results The primary outcome was cardiovascular Death and myocardial infarction so in The EPA group this happened in 10.9 Percent of people whereas in the control Group group it happened 14.9 so there’s A clear trend of improvement however This did not reach statistical Significance however in a couple of Secondary outcomes this did reach Statistical significance so it does look Like there is a trend towards Improvement when people are taking EPA
Supplements the study finished by Concluding that among Japanese patients With chronic coronary artery disease Already being treated with Statin Therapy EPA may be associated with a Reduction in adverse cardiovascular Outcomes that all sounds great but Here’s the first bit of controversy in Terms of Adverse Events there was an Increase in gastrointestinal disorders That’s not too big a deal what is a big Deal is the new onset of atrial Fibrillation in the EPA group so atrial Fibrillation is where the top bit of the Heart is going into spasm so there was Double the amount of atrial fibrillation In the EPA group so there are clear Risks of taking EPA so we need to be Absolutely certain that we’re going to Get significant benefits from taking EPA Because we certainly don’t want to take Something that’s only going to cause us Harm so how certain are we that we will Get benefits from EPA supplements well This study is certainly not the first to Look at EPA supplementation we have the Reducer trial and the jealous trial both Of which showed benefits with EPA Supplements however we’ve got a separate Study called the strength study which Showed no benefit even for patients at High cardiovascular risk so which study Are we to believe is there a benefit of Taking EPA well Dr Steve Nissen of the
Cleveland Clinic who was the lead Investigator of the strength study he is A fierce critic of the reducer trial and Here’s why in the reduced study they Used a mineral oil as a placebo now in a Perfect world a placebo should have no Effect on patients that way we can get a True representation as to the benefit or Harm of the intervention and in this Case the EPA the trouble is though the Mineral oil was actually increasing LDL Cholesterol as well as high sensitivity CR RP which is a marker of inflammation So this so-called Placebo was boosting Cholesterol and making inflammation Worse so in the reduced study is it just That the placebo was causing harm and The EPA had no effect and that explains The differences between the two groups Unsure but my point is that we cannot Rely on the reduced study to say that There’s going to be a clear benefit with EPA supplements and that brings us onto The controversy with the new respect EPA Study so Stephenson is highly critical Of the respect EPA study and does not Believe that it should be used to Support the EPA data from the reducer Trial he says that there are many Limitations of the respect EPA trial and Make it uninterpretable it just doesn’t Meet contemporary standards for clinical Studies he goes on to say that I don’t Think it sheds any light at all on the
Debate over the efficacy of EPA and Cardiovascular disease Dr Nissen notes That this new study had a large Dropout And protocol violation rate he says that There was a a massive loss of patience Over the six to eight year follow-up and Therefore it would have been a very Selective population that lasted the six Years in the study patients that dropped Out are different to those who stay in So they are cherry picking the patients That persisted in the study there is Enormous bias here another weakness is The open label design everyone knew who Was getting what and blinding is Important in a study My overall takeaway Is that there might be a benefit of Taking EPA supplements but that needs to Be balanced against the risks of atrial Fibrillation personally I still take Omega-3 supplements so that’s the Combined EPA and DHA and I do this Because a Mayo Clinic meta-analysis Found statistically significant Reductions in the risks of heart attacks With a high grade certainty and that’s The primary goal here we’re trying to Reduce heart attacks so make sure to Check out this next video here on Cholesterol and how to lower it Correctly a massive thank you to do Notage.org for their ten thousand dollar Donation to my rapamycin study they are A health research organization and to
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