• Fish Oil Monger’s Claim Rebutted That PCBs In Fish Oil Pills Pose Potential Problems

    Posted May 17, 2013: by Bill Sardi

    When radio listeners, like the 5 million-strong Coast-to-Coast nighttime radio audience, hear an interview with a so-called authority on essential oils and he casts a convincing pall over the idea of taking one of the most popularly used dietary supplements, fish oil, there are sure to be millions who pause before they put the next fish oil capsule in their mouth.

    The expert is Brian Peskin, an MIT graduate in electronic engineering, who mixes a lot of pseudoscience and straw-man arguments to falsely brand fish oil supplements as ineffective, even potentially dangerous.

    Like many of us, Mr. Peskin has his own product to peddle – a plant-based multi-ingredient formulation of sunflower, safflower, pumpkin, evening primrose seed oil along with coconut oil.  (Not wanting to lead naïve consumers to his website that disseminates factitious information, his website will not be divulged.)

    Mr. Peskin offers some self-published evidence that his formulation of what he calls “parent essential oils,” that is, oils that have not been heated or chemically processed and are organically raised, are superior to fish oil, generally because they have less (almost no) contaminants like PCBs.

    The attention-grabber: PCBs

    The way Mr. Peskin gains attention is to proclaim the merits of his 2009 Proposition 65 California lawsuit against manufacturers of fish oils for knowingly having PCBs in their products.

    PCBs are polychlorinated biphenyls that are man-made industrial chemicals that were banned many years ago.   Out of seven commercially available brands of fish oil tested, Peskin reports three low-priced brands exhibited far more PCBs than the others.

    But the fact Peskin promotes his own product as an alternative suggests he is grand-standing a bit, picking and choosing the science he wants to cite, to condemn fish oils and present his product as the only safe alternative left standing.

    His plant-based omega-6 oils may have little or no PCBs, and they may be beneficial oils in themselves, but his product cannot be said to be a substitute for essential omega-3 (EPA & DHA) and omega-6 oils, though Mr. Peskin vaguely says his plant-based oils convert into the essential omega-3 EPA and DHA via liver metabolism.

    Flaxseed oil converts to EPA but not DHA, and while I have no data to prove this, Mr. Peskin’s “parent essential oils” are not reported to metabolize into DHA in the liver.  DHA is an essential brain fat.  The oils in his formula are all omega-6 oils or saturated fat (coconut oil).

    Vegetable oils also do not reduce triglycerides, a known risk factor for heart disease, as fish oil does.

    Mr. Peskin says the liver produces just the right amount of EPA and DHA and supplements simply over-dose the body.  Of course, this is pure nonsense in a society that has a 20-to-1 intake ratio of omega-6 oils (corn, safflower, sunflower) versus omega-3s (flax, fish).

    The start of the omega-3 oil story

    The whole omega-3 story started in the 1930s when researchers found the Greenland Eskimos were largely free of western disease (heart disease, diabetes) and consumed large amounts of omega-3 fish.

    But modern medicine did nothing about this discovery and researchers again visited Greenland to conduct population (epidemiological) studies forty years later.

    These observational dietary studies conducted in the 1970s re-confirmed that both omega-3 and omega-6 oils are essential for human health.  Investigators compared fish eating Eskimos who consumed four times more omega-3 oil to a group of Danish people, who largely consumed omega-6 (corn) oil and who had a much higher death rate from heart disease than the Eskimos (Inuit).  Heart disease was a rarity among these natives.

    The anti-blood clotting properties of fish oil were exclaimed at the time and believed to be the primary agent responsible for its heart-health benefits.

    Later aspirin was adopted by western medicine because of its anti-clotting properties, only later to be found ineffective in required low-doses (81 mg) in order to avoid sometimes deadly side effects (bleeding gastric ulcers with standard 325 mg aspirin tablets).

    Three decades later modern medicine woke up to the fact omega-3s were strongly associated with a healthy lifestyle and began to reinvestigate.

    The turn of the century

    More than 4500 studies were published over that time.  At the turn of the century the conclusion was that omega-3 fish oil, at a dose of about 1000 mg (1 gram) per day, appears to stabilize heart muscle electrically and result in fewer sudden mortal heart attacks.

    The Gruppo Italiano study of 11,324 patients showed a 45% relative reduction in the risk for sudden cardiac death and a 20% reduction in all-cause mortality.  The last number is of importance because certain anti-inflammatory drugs (example: Vioxx) used in recent years reduced some markers of inflammation but resulted in higher death rates overall because of the side effects they produced.  High-dose omega-3 oils (3000-5000 mg) were also shown to lower triglyceride levels by 30-50%, triglycerides being a marker of arterial disease, something vegetable oils don’t do.

    It should be mentioned that the mortality rate for coronary artery disease in North America was 240 per 100,000 at the time of this analysis in the early 1990s.  Today it is ~200 per 100,000.  It may be tougher to produce dramatic reductions in heart disease today than it was years ago.

    However, even as early as the 1990s while fish oil was being extolled,  researchers conceded there were some negative studies as well as a wide range of responses to supplementation.  Fish oil is not a cure-all for everything, a fact which is borne out in recent studies.

    For example, recent studies indicate fish oil is not a therapy for autism, nor does it appear to be effective in reducing risk for colon cancer or diabetes.  Fish oil only modestly reduces risk for heart failure.  But these are null studies.  There was no benefit, but also no harm.

    These studies appear to be designed to fail because they cannot possibly be explained by shortages of omega-3 oils, though diabetes was largely absent among Eskimos who consumed more fish oil than any human population on the planet.  However, the fish oil pill trials haven’t employed that much omega-3.

    Mortality rates are the gold standard

    Omega-3 oils ARE considered to be effective overall against cancer, and they DO reduce mortality from coronary artery disease, and the evidence is lengthy.  Here are selected positive studies that aren’t erased by any negative studies:

    • In a review of 21 studies, fish oil reduced overall risk of suffering a cardiovascular event of any kind by 10% and a 9% decrease in risk of cardiac death and a trend to lower total mortality.  – British Journal of Nutrition 2012
    • In a review of 20 studies involving 68,680 patients, there was no statistically significant association for all-cause mortality (meaning the PCB-laden fish oils did not increase risk for cancer or cardiac death), nor was there a significant reduction in cardiac death or sudden death.  – Journal American Medical Association 2012
    • A daily 250 milligram dose of EPA/DHA substantially reduces the risk of coronary heart disease death and sudden cardiac death with a pooled risk reduction of 36% for coronary heart disease death.  – American Journal Clinical Nutrition 2008
    • A review of 20 studies did not show a significant reduction in any cardiac risk or total mortality  taking omega-3 fish oil.  (But again, no anticipated increased risk from PCB exposure either.)  – Circulation Cardiovascular Quality & Outcomes 2012
    • The Diet and Reinfarction Trial (DART) conducted among 2033 men recovering from heart attacks who opted to take fish oil capsules in preference over eating fish had a 29% reduction in all-cause mortality (even with PCBs) whereas consumption of fatty fish did not reduce mortality.  – Journal Membrane Biology 2005
    • A review of 11 studies involving 39,044 patients taking 1800 mg EPA and 1200 DHA daily over a period of 2.2 years resulted in a relative 13% reduction in cardiovascular death and 13% reduction in sudden cardiac death and 8% drop in all-cause mortality.  –Clinical Cardiology 2009
    • A 3-year stud of 563 Norwegian males age 64-76 years, most without overt cardiovascular disease, taking 2400 mg omega-3 fish oil resulted in a 43% relative reduction in all-cause mortality and 14% reduction in cardiovascular events.  – European Journal Cardiovascular Rehabilitation 2010
    • A review of 14 trials involving 20,485 patients with a history of heart disease employing omega-3 fish oil supplements did not reduce the risk of overall cardiovascular events (heart attacks, strokes) nor all-cause mortality.  – Archives Internal Medicine 2012
    • Twelve studies involving 32,779 patients were reviewed and fish oil reduced all-cause mortality by a relative 8% and a reduction in cardiac deaths of 20%.  – British Medical Journal 2008
    • Omega-3 fish oil in 8 trials involving 20,997 patients with a prior heart attack resulted in a 57% relative risk reduction for sudden cardiac death (however, among angina patients fish oil increased risk for sudden cardiac death by 39%.  –Annals Medicine 2009

    Even with the cherry picking of recent studies, the vast majority of studies show omega-3 fish oils are safe and effective even with assumed PCB contamination.

    Slow adoption

    However, agonizingly it took modern medicine decades to adopt fish oils.  One published report in 2001 was entitled: “Omega-3 Fatty Acids: From Eskimos To Clinical Cardiology – What Took Us So Long?”   In 2009 another published report in the journal Heart was entitled: “Omega-3 Polyunsaturated Fatty Acids Are Still Underappreciated And Underused Post Myocardial Infarction” (after a heart attack).

    Only when one pricy brand of fish oil concentrate was approved by the FDA as a drug for lower triglycerides, and it was covered by insurance plans, did doctors fully warm up to the idea of fish oil.  But fish oil isn’t necessarily intended to be a drug that targets individual diseases as drugs do.  It is a broad acting nutrient that promotes health rather than treats, prevents or cures disease.  Sadly, insurance plans don’t pay for non-prescription fish oil pills.

    Where fish oil science appears to fizzle is when a study among fish-eating Eskimos themselves shows that they in fact DO develop coronary artery disease (6% among young Eskimos and 26% among senior Eskimos).  Eskimo adults with coronary artery disease consume as much omega-3 oil (3000-4000 mg per day) as those without coronary heart disease.

    The problem here is that arterial plaque does not necessarily equate with mortality.  And mortality is the gold standard by which all fish oil products should be evaluated, including Mr. Peskin’s vegetable oil combination.

    The distraction

    With modern medicine now adopting fish oil into both preventive and therapeutic regimens, Mr. Peskin takes everyone on a self-appointed detour as a set up to promote his own product.  Shame, shame.

    We must be vigilant not to take our eye off the ball and start swatting flies.  Modern medicine misdirected the world to reduce cholesterol when it is not the primary component of arterial plaque and cholesterol reduction has not been shown to reduce the coronary artery disease death rate.  Using markers like inflammation or cholesterol does not correlate directly with reduction of cardiac death rates.

    Peskin’s pesky postulation

    The side argument that Mr. Peskin poses is that fish oil products have undue amounts of toxins and carcinogens (cancer-promoting molecules), particularly PCBs (polychlorinated biphenyls).  Reduction of PCBs rather than sudden cardiac becomes Mr. Peskin’s misdirected goal.

    PCBs are an industrial contaminant that is linked to low-grade inflammation and arterial stiffness.  Pay attention here, because Mr. Peskin uses an arterial stiffness test to validate his own product.

    One study found that every fish oil supplement intended for children’s use contains at least small amounts of PCBs with intake levels ranging from 2.5 to 50.3 nanograms of PCBs per day.

    PCBs were banned over 30 years ago but there are considered Persistent Organic Pollutants (POPs) because they simply don’t break down and degrade easily.  The highest rates of exposure however were in the 1970s.  In recent years exposure to PCBs has been reduced by over 35%.

    Food is the primary source of PCBs in humans, particularly fish.  There is no question that makers of some cheaply-made fish oil products could do a better job of reducing PCB content, particularly by using deep cold-water sources of fish.  One study shows a wide range of PCBs in fish oil supplements (0.8 to 793.0 nanograms).  Mr. Peskin filed a lawsuit against fish oil companies in California for this very reason.

    What Mr. Peskin doesn’t reveal is studies show that omega-3 products actually prevent the arterial problems caused by PCBs.   He also doesn’t cite studies showing fish oil pills reduce exposure to PCBs compared to eating fresh fish.

    First do no harm

    How much harm could come from consumption of fish oil pills?  A study set out to determine that very thing among older adults.  Ten studies involving nearly 1000 senior adults were analyzed and concluded that no severe adverse events occurred and the adverse event rate for non-serious side effects was not greater than an inactive placebo pill.

    Mr. Peskin has built a straw man argument against fish oil pills.  A toxicology review concludes that fish oil dietary supplements do not appreciably increase the total dietary intake of PCBs since they are ubiquitous in the environment.

    The Harvard Health Letter says “the benefits of omega-3 fats…… far outweigh the risks.  Mr. Peskin would unfairly characterize fish oil supplements as potentially carcinogenic and risk bringing the whole fish oil supplement industry to its knees in order to promote his own product.

    While Mr. Peskin points to two studies showing his “parent essential oil” (PEO) product does reduce arterial stiffness, he compares his product to statin cholesterol-lowering drugs which are known to be ineffective at reducing coronary artery disease mortality.  Water would likely reduce cardiac mortality better than liver-toxic statin drugs.

    What Mr. Peskin won’t do is compare his PEO product against fish oil.  Until PEO has some survival data behind it, it remains unproven.  It reduces a marker of arterial disease, admittedly an important one, but we have to keep our eyes on the gold standard — cardiac mortality.

    Fish oil is proven to reduce cardiac mortality, albeit modestly.  Copyright 2013 Bill Sardi, Knowledge of Health, Inc.

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