• Something’s Fishy About Macular Degeneration Fish Oil Studies

    Posted December 11, 2013: by Bill Sardi

    Just seven months ago National Eye Institute researchers claimed fish oil “doesn’t seem to help macular degeneration,” a sight-robbing eye disease that plagues adults in their senior years.

    So how could another newly published study produce exactly opposite results?  In fact, fish oil didn’t just slow down the insidious progression of this eye disease, it restored vision to every patient placed on high-dose fish oil.  It was therapeutic and curative, not just preventive.

    The study I’m referring to is likely to be dismissed.  The study group was small – only 25 patients.   There was no inactive placebo pill given to another group of patients for comparison, a requirement for scientific validity.  And it’s also possible (but not plausible) that all the patients in the study were abjectly deficient in omega-3 fish oils, producing an atypical effect.  But the study group was based in the Mediterranean where fish consumption is high.  And it’s not likely any placebo effect was involved.

    The study is so convincing, especially when combined with all of the positive fish oil studies conducted over the last decade (see chart below), eye physicians would now be derelict in their duty not to recommend every long-living senior adult to consume more fish, or better yet – take concentrated fish oil capsules, if they want to maintain their sight throughout their retirement years.

    Growing evidence

    The study I’m referring to was just published in the PharmNutrition journal.  It raises many questions, particularly why has it taken so long to discover high-dose fish oil can restore lost sight to many Americans.   The data pointing to fish oil as a dietary agent that can stave off vision loss with advancing age has been growing for over a decade.

    Except for one “fishy” study, all other human clinical fish oil studies published over the past 13 years indicate fish oil slows down or prevents macular degeneration, a sight-robbing condition that affects central vision used for reading, driving and face recognition.

    The latest published study was more momentous than prior studies as it didn’t just show fish oil slows down the progression of the disease, it actually began to restore vision to patients within days of starting a daily regimen of high-dose fish oil capsules.

    Slowing macular degeneration down is one thing, but reversing it is another.  There is no cure for the common form of the disease – called dry macular degeneration.  Antioxidant dietary supplements recommended for this disease slow down its progression by maybe 10 percent at best.

    Macular degeneration patients began experiencing improvement in visual acuity from the get-go.  After six months a third of the patients could see letters that were three lines smaller on the eye chart.  Another third saw two lines better and the remaining third a single line of improvement.

    One-hundred percent (100%) of patients with macular degeneration experienced improved vision when the normal course of the disease is insidiously progressive loss of central vision.

    High dose

    The dose of fish oil was the highest used in any study so far — 5000 milligrams (3400 mg EPA, 1600 mg DHA), or a bit less than two tablespoons a day.  That much fish oil is likely to be costly for retirees on fixed incomes, around two-dollars a day, but a six-month course would certainly be worth the investment, especially when some seniors might be able to renew their driver’s license or resume activities that help them stay independent.

    The one “fishy” negative study was reported in the Journal of the American Medical Association in May of this year (2013).  National Eye Institute researchers then said fish oil “Doesn’t seem to help age-related macular degeneration.”

    That study compared a low dose of omega-3 fish oil with an antioxidant formula providing lutein, zeaxanthin, zinc and copper (no true placebo group or inactive pill was used).   The dose of fish oils in the treatment group was much lower than prior studies.

    Some skeptical researchers I have consulted express concerns over the fact this study was conducted largely among well-nourished subjects who likely eat a lot of fish in their diet.  I’m informed that the comparison group consumed up to 720 milligrams of fish oil from their daily diet.  Also some study subjects in the comparison group may have been supplementing with folic acid which raises blood levels of omega-3 oils.  Researchers concede that “study results may not be generalizable, because the study population is a highly selected group of highly educated and well-nourished people.”  Was the study rigged to fail?  – ©2013 Bill Sardi, Knowledge of Health, Inc.

    COMPILATION OF STUDIES

    Fish Oil/ Age-Related Dry Macular Degeneration Studies Limited to human studies involving fish oil alone
    AMD= age-related macular degeneration

    Study published

    Type of study

    Length of time

    # of subjects

    Location

    Dose of fish oil

    Result

    PharmNutrition Dec 2013 Controlled THERAPY

    6 mos

    25(40 eyes) 50-85 yrs of age

    Cyprus

    3400 mg EPA/1600 mg DHA

    100% improved at least 1 line visual acuity; avg. 2 lines vision improvement (10 letters1)

    Ophthalmology Aug 2013 Controlled PREVENTION

    3 years

    263 55-85 yrs of age

    France

    270 mg EPA/ 840 mg DHA

    Highest EPA/DHA blood level = -68% risk reduction for new blood vessel formation.  No visual acuity improvement.  Note: placebo was olive oil2.

    Ophthalmology May 2013 Dietary intake PREVENTION

    5 & 10 yrs

    2531

    Boston, Mass

    Dietary intake

    8.1% and 16.9% of healthy eyes progressed (geographic atrophy) over 5 & 10 years; highest intake of DHA = -32% relative reduced risk

    J American Med Assn May 2013 Controlled TREATMENT

    4.3-5.1 yrs

    4203 73.1 yrs mean age

    Multi-center study USA

    650 mg EPA/ 350 mg DHA

    Omega-3 levels rose in blood but visual improvements were not significant

    J. Nutrition April 2013 Dietary PREVENTION

    32 mos avg

    963 Age 73+ yrs

    France

    Dietary intake

    Highest blood levels of omega-3 = -38% reduced risk for advance AMD

    Investigative Ophthalmology July 2011 Dietary intake PREVENTION

    3 yrs

    666

    France

    Dietary intake

    Fish oil intake decreased risk for early AMD (-17%) and advanced AMD (-74%)

    Archives Ophthalmology July 2011 Dietary intake PREVENTION

    38022 women- mean age 54.6 yrs

    Boston, MA

    Dietary intake

    1 serving fish/week compared to 1 serving/week reduced relative risk for AMD -42%

    Amer J Clinical NutritionDec 2009 Dietary intake PREVENTION

    13 yrs

    1837

    Multi-center study USA

    Dietary intake

    High intake fish oil 30% less likely to advanced AMD

    British J Ophthalmology Sept 2009 Dietary Intake PREVENTION

    8 yrs

    2934

    Multi-Center Study USA

    Dietary intake

    Highest intake (≥64.0 mg/d for DHA/ ≥42.3 mg/d EPA) had a significant ~25% decreased relative risk for disease

    Archives Ophthalmology May 2009 Dietary Intake PREVENTION

    4 yrs

    6734

    58-69 yrs of age

    Australia

    Dietary intake

    Highest intake fish oil reduced relative risk for advanced AMD by 15%

    Euro J Ophthalmology Jan 2009 Controlled THERAPY

    6 mos

    22

    France

    720 mg EPA/ 480 mg DHA

    Improved circulation (“blood enrichment”) observed

    Archives Ophthalmology Jan 2009 Dietary Intake PREVENTION

    12-yrs

    1837

    Multi-Center Study USA

    Dietary intake

    Highest intake fish oil 30% less likely to develop advanced AMD

    Archives Ophthalmology Sept 2008 Dietary intake PREVENTION

    6.3 yrs

    2132 71+ yrs

    Multi-Center Study USA

    Dietary intake

    Participants w/highest levels of DHA intake half as likely to experience progression (geographic atrophy)as lowest intake

    Archives Ophthalmology May 2007 Dietary PREVENTION

    4519 60-80 yrs of age

    Multi-Center Study USA

    Dietary intake

    -46% relative risk reduction for advanced AMD with highest DHA intake

    Archives Ophthalmology July 2006 Dietary PREVENTION

    5 yrs

    2335 49+ years

    Australia

    Dietary intake

    Highest intake of fish oil reduced relative risk for early AMD 59%

    Archives Ophthalmology Aug 2001 Dietary PREVENTION

    349 55-80 yrs of age

    Boston, MA

    Dietary intake

    Greater fish consumption reduced risk for AMD

    Am J Clinical Nutrition Feb 2001 Dietary PREVENTION

    72489 50+ yrs of age

    Boston, MA

    Dietary intake

    Highest DHA intake reduced relative risk for AMD 30%; more than 4 servings of fish/week reduced AMD risk 35%

    Archives Ophthalmology March 2000 Dietary PREVENTION

    3654

    49+ years of age

    Australia

    Dietary intake

    Fish consumption associated with reduced risk for advanced AMD

    1 One line of letters on the visual acuity chart = 5 letters

    2 Olive oil shown to halve risk to develop advanced AMD in another study (Archives Ophthalmology 127: 674, May 2009), so not wise choice of placebo.  Would have narrowed differences between fish oil and olive oil supplemented subjects.

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