An Illogical Position of the American Heart AssociationFebruary 2018
By William Faloon
If you could travel back to year 1980, you’d read some of the first published data revealing low heart-attack rates in those who consume coldwater fish.
These initial findings were based on observations of Eskimos and Greenlanders whose diets consist of foods high in omega-3s.1
Additional publications in the early 1980s provided biologic explanations for the arterial protective effects of omega-3s.2
Since then, many studies have been published describing the potential of omega-3s to reduce cardiovascular risks.
Here we are 38 years later and there is still a debate as to whether healthy people should supplement with fish oil.
What you need to know
Although a large amount of evidence has been gathered on the benefits of omega-3 supplementation, every now and then a study will show no effect, and it will gain great attention. Omega-3s from fish oil have been best known for helping prevent heart disease, but they do this by affecting only some of the 19 factors that contribute to heart disease. To circumvent heart disease, one must monitor all factors. Misguided reactions to the results of a small amount of studies have caused the American Heart Association to take a false position on omega-3 supplementation.
You may ask why anyone still questions fish oil’s value. After all, heart disease and ischemic stroke remain among the leading causes of disability and death.3
One answer can be found on the graphic at the end of this article. It describes 19 independent heart-attack risk-factors. Fish oil offers a degree of protection against some, but not all of these independent risks.
So when an isolated study fails to show a cardioprotective benefit, hurried doctors erroneously conclude there to be little benefit to omega-3 supplements.
Omitted from these knee-jerk reactions are the other vascular risks that must be corrected if one is to reduce their odds of ischemic stroke, coronary artery blockage, and sudden cardiac arrest.
This kind of misguided reaction occurred in 2017 when the American Heart Association issued an advisory stating that fish-oil supplements:
“...prevent death from heart disease in patients who recently had a heart attack and may prevent death and hospitalizations in patients with heart failure.”4
The American Heart Association immediately followed this advisory by stating there is “lack of scientific research” to support use of fish oil in the general population.4,5
An article on page 62 of this month’s issue refutes this illogic by describing studies supporting use of fish oil to mitigate vascular risks and a new study showing that omega-3s reduce all-cause mortality.
This editorial describes approaches to cardiovascular disease prevention that most Life Extension Magazine® readers already follow.
Fish Oil Use Sharply Increases
Surging numbers of Americans now supplement with fish oil that provides omega-3 fatty acids.
According to a report published by the National Institutes of Health, between 2002 and 2012, there was almost a four-fold increase in the number of people using a fish-oil supplement.6
Another survey published by the American Medical Association showed a nine-fold increase in fish oil supplement users between 1999 and 2012.7
This same survey, however, revealed only 12% of adult Americans are using an omega-3 supplement.7
This indicates that while fish oil-supplement use has increased over the past two decades, vast numbers of Americans are not achieving optimal EPA/DHA status.
And most people in the United States are not ingesting sufficient EPA/DHA potencies via their diet or supplement program.8
Results from the National Health Interview Survey Conducted by the National Center for Health Statistics
“Fish oil was the most popular natural product used by adults in the United States in 2012. Nearly 8 million more adults used fish oil in 2012 than in 2007.”9
The public is now so aware of the heart-health properties of coldwater fish that the media garner few ratings by reporting on yet another favorable fish oil study.
Instead, headline-hungry reporters latch onto any comment that challenges the benefits of omega-3s.
This happened in 2017, when the American Heart Association published a favorable report about fish oil’s newly discovered cardiac benefits,10 but then argued against fish oil supplementation for healthy adults.
American Heart Association Declares that Fish Oil Combats Heart Failure
Heart failure occurs when the heart cannot adequately pump blood. An estimated 5.7 million Americans currently suffer failing heart function.11
Headline news stories in 2017 report on “surprising” findings that fish oil supplements not only help prevent death in heart attack patients, but they may also prevent hospitalizations in patients with chronic heart failure.12,13
In response to this study, an American Heart Association physician stated:
“What is new is that people with heart failure also may benefit from omega-3 fish oil supplements.”4
This study, published by the American Heart Association, was based on a large, randomized, clinical trial.10
The results showed a low-dose fish oil supplement reduced death and hospitalization by 9% in heart-failure patients. This led the study authors to determine that doctors could consider fish oil supplements for heart-failure patients.4
When we saw only a 9% risk reduction in heart-disease patients taking approximately 1,000 mg a day of an omega-3 supplement, our reaction was how trivial this risk reduction and fish oil potency were.
We say this based on better improvements in cardiac function that have been observed in response to supplementation with coenzyme Q10,14-22 taurine,23-25 magnesium,26-29 and higher-dose fish oil.30-33
The fact that this modest dose (approximately 1,000 mg a day of EPA/DHA) produced such benefits in heart failure patients is a revelation.
Most of you supplement with double this EPA/DHA dose, along with healthy dietary choices AND other nutrients that protect against cardiovascular disease via different mechanisms.
American Heart Association Attacks Fish Oil Supplements
After publishing the favorable 2017 report on fish oil aiding heart failure patients and preventing cardiac death, the American Heart Association emphasized that healthy people would not benefit by taking low-dose fish-oil supplements.
This recommendation against healthy people using fish oil was based on earlier flawed studies that were discredited in rebuttals we long ago published that can be accessed at LifeExtension.com/fish.
The American Heart Association advisory concludes that:
“supplementation with omega-3 fish oil may benefit patients with specific, clinical, cardiovascular disease indications, including patients with a recent prior heart attack and heart failure.”4
According to this twisted logic, people should wait until after they have a heart attack or suffer heart failure before supplementing with fish oil.
We view these kinds of public decrees, such as “don’t take fish oil until after you suffer a heart attack,” as an example of widespread medical stagnation that causes so many premature illnesses.
Multiple Factors Involved In Heart Disease
The arterial system is our modern day Achilles tendon.
Normal aging results in loss of endothelial function and subsequent development of atherosclerotic lesions that impede blood flow.
When platelets bump up against jagged atherosclerotic plaque, they can abnormally aggregate and cause an acute blockage of blood flow to a coronary or cerebral artery. This can result in a myocardial infarction (heart attack) or ischemic stroke.
Unstable arterial plaque is prone to sudden rupture, which can acutely occlude blood flow to arteries in our heart or brain resulting in sudden death.
Serious plaque buildup in coronary arteries creates angina pain that mercifully can be relieved via insertion of stents into narrowed arteries. In cases of severe coronary blockage, open-chest surgery is needed to bypass the blocked arteries.
Multiple pathologies are involved in the initiation and progression of arterial disease. Fish oil helps circumvent some of them by:
- Reducing triglyceride levels34,35
- Reducing C-reactive protein (helps stabilize plaque)36,37
- Reducing platelet stickiness (a thrombotic factor)38-40
- Reducing inflammation41-45
- Increasing EPA/DHA blood levels46,47
- Increasing large buoyant LDL particle size and other sub-lipid profiles48,49
These six validated benefits make it obvious that healthy people should ingest sufficient omega-3s.
Fish oil, however, does not miraculously circumvent all independent vascular pathologies.
When one understands that fish oil protects against many, but not all arterial risk factors, studies showing benefit to omega-3 supplementation alone should be viewed with greater respect.
The inability of fish oil to circumvent other atherogenic risk factors mandates that people take additional steps to protect their delicate vascular system. Most readers of this magazine follow these preventive strategies.
Curcumin Mitigates Heart Failure
Popularity of curcumin in recent years has grown more rapidly than fish oil.
Relief from inflammation is one reason why people use standardized curcumin supplements.
Curcumin is a polyphenol contained in the curry spice turmeric. It has demonstrated anti-cancer effects and may protect against the deleterious changes involved with atherosclerosis and atrial arrhythmia.50
A hallmark characteristic of heart failure is enlargement of the heart muscle. In particular, the left ventricle that pumps blood directly into circulation enlarges and gradually loses functionality.
Heart enlargement can occur in response to stress signals that create adverse gene-expression changes in heart-muscle cells.
Curcumin has been shown to specifically inhibit gene-expression changes that contribute to chronic heart failure.51
Curcumin inhibits enlargement of cultured heart cells and prevents onset of heart failure caused by hypertensive heart disease and coronary infarction in rat models.52
One of several drugs used clinically to mitigate heart failure is enalapril. A group of researchers found that curcumin works similarly to enalapril monotherapy in rat studies.51,53
When researchers combined curcumin with enalapril, they observed additive improvements in heart function. This suggests the mechanism of action of curcumin differs from the conventional cardiac drug (enalapril).51,53
The researchers pointed out that:
“Combination therapy with curcumin and these agents [cardiac drugs] may be more effective for cardiac hypertrophy and heart failure.”51
When reviewing published data, it would appear that combining curcumin with fish oil (along with conventional therapy) would reduce deaths and hospitalizations more than the meager 9% reported in 2017 by the American Heart Association that focused on low-dose fish oil.
Fight Back Against Medical Apathy
Protecting against arterial disease and heart failure are paramount concerns for aging humans.
Pomegranate improves nitric oxide status in the inner arterial wall,54,55 vitamins like 5-MTHF (folate) slash homocysteine,56 while CoQ10,57-59 PQQ,60,61 and NAD+62 bolster mitochondrial energy in heart cells. All of this improves cardiac function.
No one should be deficient in vitamins D and K2 as these are low-cost supplements that readily absorb when taken with a meal that contains some fat.
While some supplements help lower blood pressure, most aging people need medications to achieve optimal systolic readings of around 115 mmHg. The drug telmisartan safely lowers blood pressure AND has vascular side benefits.63-67
AMPK- activating nutrients and/or drugs (like metformin) lower blood glucose and insulin.68
We advocate that LDL cholesterol be kept in the low normal ranges (under 100 mg/dL). This can usually be accomplished by following a Mediterranean style diet and/or using low-doses of prescription drugs.
Hormone balance should be initiated after comprehensive blood testing.
By understanding the many factors that underlie heart attack and stroke, one can readily dismiss allegations made by groups like the American Heart Association that claim fish oil benefits heart-disease patients but is of little value to the general population.
This illogic assumes heart-attack and stroke victims were not part of the general population prior to their vascular disaster.
Most readers of Life Extension Magazine® were alerted to these independent vascular risk factors decades ago and take appropriate preventive measures.
Obtain Premium Supplements at Lowest Prices
Thirty-eight years ago, Life Extension® embarked on a mission to radically extend healthy human lifespans.
Back in those early days, we advocated controversial positions relating to cardiovascular disease prevention. These included lower ranges for blood glucose, LDL, and blood pressure that are now recognized by mainstream medicine.
We currently fund projects aimed at systemically reversing aging in elderly persons. Every time you purchase a supplement from us you help support projects aimed at benefiting all of humanity.
Just once a year, we discount prices for all nutrient formulas. This enables you to obtain advanced supplements at the year’s lowest prices.
We’ve added more omega-3 choices this year to ensure you maintain optimal EPA/DHA status.
The annual Super Sale expires on January 31st, 2018. To order any of our advanced formulas at these discount prices, call 1-800-544-4440.
For longer life,
William Faloon, Co-Founder
Life Extension Buyers Club
19 Daggers of arterial Disease
This graphic shows 19 daggers aimed at an artery occluded with atherosclerotic plaque.
Any one of these “daggers” can initiate and propagate atherosclerotic vascular disease.
You’ve just read statements made by the American Heart Association claiming there is little value in fish oil supplementation to the general population.
Most readers of this magazine are aware of the pathologies involved in arterial disease and follow comprehensive preventive measures.
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