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I’m certainly not a proponent of low-fat diets, but 411 ng/dL on a low-fat vs 413 ng/dL on a Mediterranean diet may be a statistically but most definitely not a clinically significant difference
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The dose of fish oil is only 1g daily, not even 1g of EPA, just 1 gram of fish oil; a surprisingly low dose. Happy to see research that might help establish minimum effective dosages, but these doses aren’t significant enough to warrant some of the salacious headlines about “dissapointing results” or these supplements not working. As you said Timar, the jury is still out.
It’s pretty encouraging to see that there were modest benefits even at a low dose of fish oil, would love to see this study repeated at 2, 3, 4x these daily intakes.
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It wasn’t ordinary fish oil (~30% LC-PUFAs) though, but the highly purified 90% ethyl ester prescription form containing 460 mg EPA and 380 mg DHA per 1 g capsule (Omacor). Of course, for certain conditions, a much higher dose seems warranted, particularly with regard to EPA, but remember that this was a long-term trial (5.3 years) in a generally healthy population, making this dose it a perfectly reasonable choice, not only due to cost considerations but also the risk-benefit ratio, as high doses of fish oil have some potential downsides (such as increased risk of bleeding or possibly even of some cancers).
I don’t think that we will ever see a comparable trial using a larger of even similar dose LC-PUFAs in a generally healthy, multiracial population, let alone of this size (25,871).
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You shouldn’t eat a “beef, organs & meat” diet in the first place.
If long-term health and longevity is of any importance to you, you should rather ask what kind of animal food should be eaten along a plant-based diet.
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Keep in mind that phenolic antioxidants like those found in coffee, tea or healthy plant foods work completely differently from vitamin E and C - instead of excerting direct, physiologically relevant antioxidant effects, they work by triggering various signaling pathways (like nrf2) which are subject to complex physiological feedback mechanisms, making it almost impossible to overdose on those antioxidants. There is also no evidence to suggest that, taken in normal physiological doses, vitamin C or E interfere with exercise gains (to the contrary, there is some evidence to suggest that at dose slightly above the RDA, they may fasten recovery and protect against exercise-induced immune deficits). All studies showing a disadvantage administered what I would consider “megadoses” of both vitamins for which there is no evidence of beneficial effects in generally healthy people anyway. Just make sure that you don’t take more than 500 mg of vitamin C or 100 IU of vitamin E in supplemental form and you really don’t need to worry, in my opinion. And if you take a multivitamin, maybe do so in the evening, after exercising.
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Thanks for that clarification. Oh in my case I ram my 23andme dna data through the report generators here and it looks like in my case I need to keep my vitamin E below 75 IU.
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Interesting. What is the related SNP and what rationale does the report give for that recommendation?
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Fascinating study!
I wouldn’t be so sure about the long-term safety of ingesting large doses of sodium bicarbonate though, which is, after all, about 30% sodium, already way too abundant in our diets.
Fortunately, there is an even better and safer (albeit slightly more expensive) alternative: just drink a mineral water high in hydrogen carbonate and low in sodium. If you find one that is also high in magnesium it’s probably from the proverbial fountain of youth ;)
For example, I drink Gerolsteiner°, widely available in Germany, which contains ony 120 mg sodium but 1800 mg of hydrogen carbonate as well as 110 mg magnesium, 350 mg calcium and 130 mcg lithium per liter.
° the water used in this study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4753184/#!po=26.5152
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Are you kidding us? This is a study fron 1971. The cancer outcome is a fluke that has been falsified by dozens of later studies of higher methodological quality (did this study even control for smoking status?)
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Obviously, anything that contains significant amounts of macronutrients will break a fast. So cod liver oil or protein supplements should be avoided during fasting. Coffe is fine, as long as it doesn’t contain any milk or sugar.
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No, it found that the group encouraged to lead a healthier lifestyle actually (over)complied to that advice, as did the control group, who was told to continue their usual routine.
If that’s not a glaring methodological flaw I don’t know what else is… they ignored the psychological impact of their study design.
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This is just one very vocal practinioner’s opinion. There is no new evidence to suggest that the 40-60 ng optimum range recommended by most qualified experts on the subject (including Rhonda) should be lowered.
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While I always appreciate a critical view on supplements, I have to say that this is a really crappy paper that shouldn’t give you a bad feeling about or even keep you from taking B vitamin supplements - at least unless you are a smoker.
- It has severe methodological issues. Post-hoc analysis are problematic as they open the data to interpretation bias. The more subgroubs and end points you look at, the more likely some significant association will pop up purely due to chance. In this case, Brasky looked at such a variety of both subgroups and endpoints, that this is very likely indeed. What most mainstream media reports on his paper conveniently ignore is that he only found a positive association between B6 and B12 intake and certain types of lung cancers in male smokers - none in woman, none in non-smokers.
- The associations he found are not only inconsistent with the existing literature on B vitamins and cancer risk, but also, to some degree, self-contradictory. If vitamins B6 and B12 would fuel lung-cancer growth in smokers, there would be no plausible biochemical reason for this effect to be gender-specific (after all, lung cancer is not a hormone-related cancer), yet Brasky found no association in women (see point 1). Moreover, a RCT arm of the data he analyzed, the Physician’s Health Study II, found a significantly reduced risk of cancer in men taking a multivitamin that contained a rather high dose of vitamin B12 (Centrum Silver, 25 mcg B12).
- In contrast to the RCT arm, he entirely relies on self-reported, observational data about supplement intake. Apart from reliability issues with such data, there is the possibility of an ill-user effect, e.g. heavy smokers who already felt their lung-health deteriorating because of their habit may have been inclined to take high-dose supplement in a futile effort to counter the harm of smoking.
- Brasky, the lead author, is a known troll with an anti-supplement bias, who is seeking media attention by publishing this kind of “studies”. In 2013 he published a paper, showing a similarly spurious, biochemically implausible positive association between fish oil intake and prostatate cancer risk. Although this paper was harshly criticized by accomplished researchers in the field (see: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3828934/), it generated worldwide media attention and many wildly generalizing, sensationalist headlines - precisely because of the fact that it went against all previous knowledge on the subject, as if by intention. Seems he can’t stop doing it…
My take? Although the results are likely due to chance, and the way papers like this are promoted in the media really drives me mad, the associations, which are far from evidence, at least warrant some further investigations allowing for more definite conclusions. Until then, smokers (and only smokers!) may be well-advised not to take high dose B-vitamins, just in case. They are much better adviced, however, to quit smoking.
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Your first point is incorrect. There was a link between b6 and b12 intake and lung cancer in male non-smokers
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IRRC that link was not statistically significant - only when he looked and smokers and non-smokers together, it became significant.
Anyway, I have done some digging into the literature and finally found a study that clearly falsifies Brasky’s hypothesis:
https://jamanetwork.com/journals/jama/fullarticle/186130
A RCT in 12,064 mycordial infartion survivors, half of them taking 1 mg(!) of B12 daily (plus 2 mg of folic acid) for a mean follow-up of 6.7 years. No benefits for any of the primary endpoinds. BUT:
“By contrast, with more than 1300 incident cancers during up to 7 years of treatment with 2 mg folic acid and 1 mg vitamin B12 daily, SEARCH provides no evidence of adverse effects on cancer at any particular site including […] lung cancer in 116 (1.9%) vs 122 (2.0%) (RR, 0.95; 95% CI, 0.74-1.23)”.
Mind you, this is a RCT, the only kind of study that can actually establish a cause-effect relationship in humans. It was large and long-term. With a B12 dose 20 times as high as the dose range where Brasky’s data massage of an observatory study relying on self-reported(!) supplement intake found a sharply increased risk of lung cancer.
This is what bothers me about Brasky. Had he done his homework and was he an intellectual honest researcher, he would simply have published his results without fuss, cautiosly mentioning the conflicting and unconclusive evidence and encourging further research into a possible mechanistical between supplemental B12 and lung cancer to either validate or falsify his hypothesis - instead of going full-blown PR, passing correlation off as causation (to generate sensationalist media headlines) and - probably needlessly - scaring thousands people about the supplements they are taking.
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Ever wondered why vinegar intake has consistently been shown to have strong anti-inflammatory and anti-obesogenic effects, both in animal and human studies?
https://www.ncbi.nlm.nih.gov/pubmed/19661687 https://www.ncbi.nlm.nih.gov/pubmed/27595296 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4438142/
Despite those compelling result, there is little research into the actual mechanistic effects of dietary acetic acid. May an increased synthesis of acetoacetate due to the substrate availability be a part of the explanation? There is a curious study from 1940(!) showing that if rats and dogs are feed acetic acid, there is indeed an increase in blood acetone bodies. Surprisingly, this line of reasearch was never continued:
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Btw, regular coffee consumption has a strongly protective effect against Parkinson’s. So better have it black or with full-fat milk :)
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Hi Rhonda, do you think this or other studies provide an indication that sugar alcohol intake in general should be limited? I’m wondering because I eat Xylitol fairly regularly, and was under the impression that it was overall good for you in terms of lacking sugar, working against mouth and nasal bacteria, and acting as a prebiotic. Now I’m wondering if there may be unforeseen issues…
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This study is showing that erythritol is an intermediate metabolite (that can be formed from glucose) in the pentose phosphate pathway (PPP). The erythritol can then be converted into other metabolites that are important for fatty acid synthesis which can later be stored as fat, depending on the concentration. In theory, consuming excess erythritol from refined sources may also then shunt into the same pathway for fatty acid synthesis but this study did not show this.
Interestingly, the same pathway (PPP) also produces another metabolite called NADPH which can be used to makes antioxidants like glutathione. If that pathway becomes saturated (excess glucose and possibly excess erythritol) then the NADPH is used to produce fatty acids which are later stored as fat. Food sources do not contain high concentrations of erythritol.
To my knowledge, xylitol is not a metabolite for this pathway so would not have a similar effect. There are many studies showing it is great for mouth bacteria and prevents cavaties.
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Moreover, there’s an intruiging study from 2005 showing long-term xylitol supplementation causing a significant increase in collagen synthesis as well as a decrease in collagen fluorescence in the skin of aged rats, suggesting some anti-aging effect:
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I once made the mistake to buy “Brain Maker” for my kindle when it was on sale for 1€, although I should have known that there is little to expect from someone notious for fearmongering about grains. It was worse than expected. Self-absorbed, unscientific drivel. It really drives me mad when people with such credentials unscrupulously confound science with pet theories and conjecture in order to appeal to the masses and make a multi-million dollar business out of their misinformation - be it deliberate or due to their personal hubris.
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@geodesix: You posted some interesting studies but please try to restrict it to RECENT ones. After all, this is meant to be a NEWS blog and I personally find it annoying when it gets filled up with articles about studies that have been published years ago and which I may already have read about a long time ago.
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Sensationalist press releases by attention-seeking researchers and media departments are bad enough, repeating them after they have been all over the media four years ago is even worse.
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What a bold headline, given the fact that we know for more than decade that telomere length, although strongly correlated with aging, is certainly not its “master regulator”.
Just ask a mouse…
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Those results doesn’t make much sense to me, given a) the nonlinearity (milk abstainers having shorter telomeres), b) all the evidence showing beneficial effects from milk fat c) the fact that milk isn’t even the most significant contributor to total milk fat intake (butter and cheese are). I’d put my bet on risidual confounding.