Association Between Omega-3 Fatty Acid Supplementation and Risk of Major Cardiovascular Disease Events

Rizos, Evangelos C.; Ntzani, Evangelia; Bika, Eftychia; Kostapanos, Michael S.; Elisaf, Moses

doi:10.1001/2012.jama.11374

Cited by 892 publications

(604 citation statements)

References 46 publications

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“…These results are consistent with other rodent studies indicating that nutraceutical supplements have no effect on lifespan, or shorten it (Ristow and Schmeisser 2011;Selman et al 2013;Spindler et al 2013b). Our results also are consistent with studies of initially healthy humans indicating that the use of dietary supplements is associated with either no effect or a negative effect on survival (e.g., Bjelakovic et al 2004; Chowdhury et al Macpherson et al 2013;Miller et al 2005;Myung et al 2013;Rizos et al 2012). While some supplements may be effective in treating specific disease states, most data suggest that either simple or complex combinations of supplements are not effective in delaying the onset or progress of the major causes of death in mice or humans.…”

Section: Discussionsupporting

confidence: 90%

Lifespan effects of simple and complex nutraceutical combinations fed isocalorically to mice

Spindler

Mote

Flegal

2013

AGE

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Present data suggest that the consumption of individual dietary supplements does not enhance the health or longevity of healthy rodents or humans. It might be argued that more complex combinations of such agents might extend lifespan or health-span by more closely mimicking the complexity of micronutrients in fruits and vegetables, which appear to extend health-span and longevity. To test this hypothesis we treated long-lived, male, F1 mice with published and commercial combinations of dietary supplements and natural product extracts, and determined their effects on lifespan and health-span. Nutraceutical, vitamin or mineral combinations reported to extend the lifespan or health-span of healthy or enfeebled rodents were tested, as were combinations of botanicals and nutraceuticals implicated in enhanced longevity by a longitudinal study of human aging. A cross-section of commercial nutraceutical combinations sold as potential health enhancers also were tested, including Bone Restore®, Juvenon®, Life Extension Mix®, Ortho Core®, Ortho Mind®, Super K w k2®, and Ultra K2®. A more complex mixture of vitamins, minerals, botanical extracts and other nutraceuticals was compounded and tested. No significant increase in murine lifespan was found for any supplement mixture. Our diverse supplement mixture significantly decreased lifespan. Thus, our results do not support the hypothesis that simple or complex combinations of nutraceuticals, including antioxidants, are effective in delaying the onset or progress of the major causes of death in mice. The results are consistent with epidemiological studies suggesting that dietary supplements are not beneficial and even may be harmful for otherwise healthy individuals.

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Section: Discussionsupporting

confidence: 90%

Lifespan effects of simple and complex nutraceutical combinations fed isocalorically to mice

Spindler

Mote

Flegal

2013

AGE

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“…The active ingredient in fish is believed to be long-chain n-3 PUFA which are abundant in fatty fish, such as anchovies, herring, salmon (both farmed and wild), mackerel, sardines, trout and white tuna (22) . However, findings from RCT (mostly secondary prevention studies) have indicated a much weaker degree of reduction in risk of cardiac death (9 %) when subjects were given marine n-3 PUFA (23) .…”

Section: Cvdmentioning

confidence: 99%

Strategic nutrition: a vision for the twenty-first century

Temple

2015

Public Health Nutr.

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It is now widely accepted that poor nutrition plays a major role in the epidemic of various diseases, including obesity, type 2 diabetes and CVD. There has also been much research regarding the role of related factors such as advertising and food prices. Many intervention studies have been carried out where attempts have been made to persuade people to modify their behaviour, such as by making dietary changes, in order to enhance health (health promotion). There has also been much debate on the potential of government policy as a tool for achieving these goals. Various proposals have been made, such as a tax on sugary drinks, the redirection of food subsidies and how the salt content of food can be reduced. However, the great majority of previous papers have considered only single aspects of the topics discussed here. The present paper reviews strategies for improving public health, both health promotion interventions and the use of government policy approaches. Topics discussed include providing advice for the general population and the design of food guides and food labels. This leads to the conclusion that we need an overall strategy that integrates this diverse body of information and formulates a comprehensive action plan. I propose the term 'strategic nutrition'. The implementation of this plan opens up a path to a major advance in public health.

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“…Among these 59 surrogate endpoint trials that had a subsequent clinical endpoint trial, in 24 cases the clinical endpoint trial results validated the positive surrogate trials, while in 20 the subsequent clinical endpoint trial was negative (Table 3). 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50 A negative surrogate endpoint trial was less likely to be followed by a positive outcome trial and we identified only 3 such examples ( P =0.02, Figure 2). …”

Section: Resultsmentioning

confidence: 99%

Two Decades of Cardiovascular Trials With Primary Surrogate Endpoints: 1990–2011

Bikdeli

Punnanithinont

Akram

et al. 2017

JAHA

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BackgroundSurrogate endpoint trials test strategies more efficiently but are accompanied by uncertainty about the relationship between changes in surrogate markers and clinical outcomes.Methods and ResultsWe identified cardiovascular trials with primary surrogate endpoints published in the New England Journal of Medicine, Lancet, and JAMA: Journal of the American Medical Association from 1990 to 2011 and determined the trends in publication of surrogate endpoint trials and the success of the trials in meeting their primary endpoints. We tracked for publication of clinical outcome trials on the interventions tested in surrogate trials. We screened 3016 articles and identified 220 surrogate endpoint trials. From the total of 220 surrogate trials, 157 (71.4%) were positive for their primary endpoint. Only 59 (26.8%) surrogate trials had a subsequent clinical outcomes trial. Among these 59 trials, 24 outcomes trial results validated the positive surrogates, whereas 20 subsequent outcome trials were negative following positive results on a surrogate. We identified only 3 examples in which the surrogate trial was negative but a subsequent outcomes trial was conducted and showed benefit. Findings were consistent in a sample cohort of 383 screened articles inclusive of 37 surrogate endpoint trials from 6 other high‐impact journals.ConclusionsAlthough cardiovascular surrogate outcomes trials frequently show superiority of the tested intervention, they are infrequently followed by a prominent outcomes trial. When there was a high‐profile clinical outcomes study, nearly half of the positive surrogate trials were not validated. Cardiovascular surrogate outcome trials may be more appropriate for excluding benefit from the patient perspective than for identifying it.

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Association Between Omega-3 Fatty Acid Supplementation and Risk of Major Cardiovascular Disease Events

Cited by 892 publications

References 46 publications

Lifespan effects of simple and complex nutraceutical combinations fed isocalorically to mice

Lifespan effects of simple and complex nutraceutical combinations fed isocalorically to mice

Strategic nutrition: a vision for the twenty-first century

Two Decades of Cardiovascular Trials With Primary Surrogate Endpoints: 1990–2011

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