Something Fishy About Fish Oil? Probably Not

I take a lot of supplements. I'm cutting back drastically. But I still take something like 30 a day. In the essential oils category, I've been taking, a the recommendation of my doctor, two different kinds. I take 3 omega fatty acid softgels-- Udo's 3-6-9 Blend-- made from flax, sesame, sunflower, coconut, & evening primrose. And I've been taking two EPA-DHA 720 softgells made by Metagenics and made from sardine, anchovy and mackerel oil. My doctor says it's the best on the market. Then a few days ago, in the NY Times I read that this kind of fish oil may cause prostate cancer. I was confused. My doctor told me to start taking it because of prostate cancer. I decided, as a preliminary step-- and in line with my new cutting back drastically approach-- to only take one a day instead of two. There so expensive too, so I save some real money.

Then, this week I got an e-mail from Advanced Bionutritionals, a very reputable company, warning that the warning from the Times doesn't amount to much.

You may have seen the report that came out last week about fish oil raising your risk of prostate cancer. After all the positive news about fish oil we’ve seen in recent years, this report may come as a surprise. So what should you do about fish oil? Continue taking it-- or stop?

There is growing concern that overdosing on fish oil can be unhealthy. My good friend and colleague, Robert Rowen, MD, was the first to put forth the controversial idea that fish oil isn’t the panacea everyone thinks it is. So does this study confirm Dr. Rowen’s position? I don’t think it does.

Let’s look at the study. The researchers conducting this study did not set out to examine the effects of fish oil on prostate cancer. The results came out of a study on selenium and vitamin E. They started out by looking at 834 men with diagnosed prostate cancer. Of these, 156 had high grade cases. The researchers compared this group to another 1,393 men they randomly selected but matched to age and race.

They found that men in the highest quartile of fish oil consumption had a 44% increased risk of low-grade prostate cancer, a 71% increased risk of high-grade prostate cancer, and a 43% overall increased risk for any prostate cancer. Sounds very convincing. Here are the problems:

• This was an associative study only. The study was actually on vitamin E and selenium. The researchers did not set out to study cause and effect of fish oil consumption. That means their results are suspect as to the controls they used.
• There is no evidence that the participants actually took fish oil supplements.
• The test subjects were at higher risk for prostate cancer. Many of their doctors had told them to increase their EPA and DHA levels.
• They measured plasma amounts of fatty acids. Those readings will fluctuate with the last meal they consumed. A single fish oil dose results in a 100% increase in plasma omega-3 levels. A better indicator is the red blood cell level of fatty acids. That measures consumption over the past four to six weeks.
• The difference in the plasma fatty acid levels in the prostate cancer group versus the non-prostate cancer group was .2% (4.66% in the combined cancer group versus 4.48% in the control). That's virtually no difference.
• If you look at the data, it appears that non-smokers had more aggressive prostate cancer and that non-drinkers were at a higher risk for prostate cancer. So should you start smoking and drink more? Of course not! It just shows the major flaws in this study.

Other studies-- and these were studies specifically designed to show the impact of fish oil on prostate cancer-- have found just the opposite effect. In fact, many studies have found that fish oil prevents prostate cancer.

One thing that is fairly consistent in all the reports: Tainted, altered, or rancid oils almost always contribute to health problems. Add salt, smoke (as in smoked fish), oxidation, or any other alteration, and the fish oil ceases to be healthy.

Dr. Rowen brings up an important question in his observations. That question is whether you can take too much fish oil or not. The simple answer is-- of course you can. You can overdose on just about anything. The harder answer is knowing where that line falls with fish oil. Most studies show that eating fish is healthy. Even Dr. Rowen, a devout vegetarian, concedes that fish is good for you if it comes from cold, non-contaminated, non-farmed waters. That means trout and salmon for most of us.

We also know that omega-3 fatty acids are good for you. The problem comes when we overload our body with them. If you’re taking fish oil, consider how much flaxseed, fish, and other omega-3 sources you’re eating on a regular basis. If you’re eating enough of these, then you may not need a supplement (remember, supplements are what you add to your diet to make up for a deficiency).

This whole thing has stirred up a lot of controversy and even Hate Talk Radio host and right-wing psychotic Michael Savage has jumped into the fray! Academic condemnation of the study from leading prostate cancer experts has been overwhelming-- and nearly unanimous. Savage considers himself an "expert" and he did interview a real expert, Anthony D'Amico, professor of Radiation Oncology at Harvard Medical School and chief of Genitourinary Radiation Oncology at the Brigham and Women's Hospital and Dana-Farber Cancer institute. Savage's intro: "There is a very, very dangerous report out there, that many of you have panicked over, about fish oils and what happened was, the idiots in the media immediately jumped on this assistant professor's opinion that fish oil is somehow related to prostate cancer risk, which nothing could be further from the truth... it's junk science."

Professor D'Amico was a little more restrained in his comments but came to a similar conclusion: "I don't want to knock the guy that wrote it but he is really a kind of lowly assistant professor who I think was looking for some media attention." Oh, you can listen to the whole interview:



I think one a day is enough anyway.

Amazing How The Right Has Managed To Get The Teabaggers All Riled Up About Tort Reform

I wrote a few times about my lovely day in August with the teabaggers and somewhere along that way I think how I explained that the chief teabagger, Mike Alexander, when he wanted his teabaggers to disrupt a speaker, would signal a 16 year old kid with a drum who would tap out a signal for which chant Alexander wanted them all to shout in unison. "Read the bill" and "Liar" were most popular but "Tort reform" was another one they had all rehearsed.

I have a brother-in-law who seems to have lost his mind some time ago. I never really knew him well enough to figure out why, but he was a truck driver and I figured he just listened to too much Hate Talk Radio and it drove him mad. He's retired now, filled with bitterness, bitterness he allows Rush Limbaugh and Glenn Beck to direct for him. He's been pretty crazy for years but after hearing his theory about how Obama planned to get revenge on white people if he were to be elected, I decided to only call my sister on her cell phone going forward. You may have a brother-in-law like that too. Worse yet, a right-wing porno actor from Georgia sometimes IMs me to rant and rave about whatever he's heard on Fox. I try ignoring it since he adds nothing whatsoever to the brainwash routine but yesterday he started in about how high his taxes are and how liberal health care would ruin him. I didn't want to be unkind but after he started in about how Hitler was a leftist I told him I needed to finish writing and best of luck. Like I said, he didn't add anything but he certainly didn't leave much out either-- and "tort reform" was part of the gibberish he regurgitated. Who knew gay Republican porn actors from rural Georgia were so concerned with tort reform?

But more and more people have noticed that the teabaggers and dittoheads have been howling about tort reform and Dan Margolies at the Kansas City Star decided to try to get to the bottom of it on Friday... and on page one, no less! He had noticed the phenomena at a Claire McCaskill town hall there in town. Margolies approached the issue with an open mind and acknowledged that "few causes in the health care debate draw more support than tort reform-- the idea of reining in frivolous lawsuits that lead to unjust cash awards, soaring malpractice premiums and 'defensive medicine,' the unnecessary tests ordered by doctors to avoid being sued." He also points out that evidence paints a "much different picture." The Medical-Industrial Complex and Insurance industry spend far more on bribing members of Congress and lobbying them ($1,171,723,099 in thinly disguised bribes since 1990 and another $4.8 billion in lobbying just since 1998) than on settling jury awards.

The most reliable estimates peg the costs of malpractice litigation at 2 percent of overall health care costs. And while tort reform measures have helped tamp down malpractice premiums, national health spending continues to rise.

“If you’re talking about payments made on behalf of doctors or hospitals to plaintiffs, that’s actually a drop in the bucket compared to the nation’s $2.2 trillion in health care costs,” said Amitabh Chandra, a professor of public policy at Harvard University.

Ask any physician how he or she feels about tort reform and you’re likely to get an impassioned answer about how malpractice litigation has raised insurance premiums and led to an epidemic of defensive medicine.

“The one central goal that any health care reform should include is cost containment,” said Steve Reintjes, a local neurosurgeon. “I think that federal tort reform will go a great way to ease the practice of defensive medicine.”

It’s no mystery why Reintjes and fellow physicians feel that way. Six or so years ago, malpractice premiums skyrocketed, the latest in a series of liability crises that galvanized the medical community.

Doctors pressed state lawmakers to enact tort reform measures, including caps on non-economic damages such as pain and suffering, caps on punitive damages, and requiring verdicts to be reduced by amounts plaintiffs get from health insurance and other sources.

...Since the 2005 reforms in Missouri, malpractice premiums at Hagen’s practice have fallen 24 percent-- a decline he attributes to the reforms. Reintjes said his premiums have declined 30 percent.

But-- and here is where the debate gets sticky-- overall health care costs in Missouri continue to rise. The same is true in states that have enacted even more stringent tort reforms, such as Texas.

Which suggests that a tort system run amok is, at best, only a small contributor to the nation’s health care costs.

In fact, it’s not clear that malpractice awards have risen anywhere near as dramatically as tort-reform proponents insist. Nor is it clear that jackpot justice, as opposed to declines in insurers’ investment income, is to blame for rising malpractice premiums.

Missouri is one of the few states that issues regular reports on medical malpractice. Its most recent report states that from 2006 to 2007, the number of paid claims increased from 514 to 719, but declined to 564 in 2008.

From 2005 to 2006, average awards in the state declined by 15.9 percent, from $253,888 to $213,454, and by an additional 8.5 percent to $195,239 in 2007, according to the report. And while average awards rose by 3.8 percent in 2008 to $202,612, that amount was still below the 2005 high of $253,888.

And those awards represent only a fraction of all claims. Most claims result in no payment at all to the plaintiff.

So how much do the costs of malpractice lawsuits — defined to include verdicts, settlements and the costs of defensive medicine — contribute to health care spending? In 2004, the nonpartisan Congressional Budget Office pegged those costs at less than 2 percent.
More recently, a study by WellPoint, a large insurer, found that medical malpractice was “not a major driver of spending trends.”
Tort reform, WellPoint said, would lower health insurance premiums, “but medical malpractice is not currently driving the rate of increase.”
Physicians frequently cite a higher figure — 10 percent — as the share of overall health care costs attributable to malpractice litigation and defensive medicine. The figure appears to come from a 1996 study by two Stanford University economists that estimated the costs of defensive medicine at 5 to 9 percent of health care spending and the costs of litigation at 2 percent.

The authors found wasteful defensive medicine in the treatment of elderly heart disease patients and extrapolated their findings to other areas of health care. But other experts, including the Congressional Budget Office and researchers at Dartmouth College, have been unable to replicate those findings.

“The fact that we see very little evidence of … dramatic increases in the use of defensive medicine in response to state malpractice premiums places the more dire predictions of the malpractice alarmists in doubt,” the Dartmouth researchers wrote.

While some studies have shown that caps on non-economic and punitive damages have led to lower malpractice premiums, most experts say the savings don’t have a significant effect on overall health care costs. The Congressional Budget Office, for instance, noted that “even a reduction of 25 percent to 30 percent in malpractice costs would lower health care costs by only about 0.4 percent to 0.5 percent, and the likely effect on health insurance premiums would be comparably small.”

And when the Congressional Budget Office took into account the larger, albeit harder-to-measure costs of defensive medicine, it found no significant difference in per capita health care spending between states with and states without limits on tort liability.

On the other hand, doctors find it beneath their dignity to be sued and the emotional costs may have more to do with the medical professionals tort hysteria than actual financial costs. And people pay attention to their doctors and respect them. Tom Baker, a law professor at the University of Pennsylvania and author of The Medical Malpractice Myth, theorized that having “a common enemy” keeps insurance and pharmaceutical companies-- the real culprits behind rising costs, he said-- from fighting among themselves. And then there's this:

Yesterday Was A Sad, Sad Day: Cheney Demands He Be Served Only Blood Red M&M'S

... but not so good for America

There were two things that happened yesterday that were so overwhelmingly sad that I couldn't write about either. No, I'm not talking about McCain's latest bout with cancer or Novak's brain problem, as moving as both those stories are, especially the part about Novak not writing any more columns. But neither of those stories rises, at least not for me, to the stature of the mass shooting in Knoxville by a crazed right-wing terrorist. I'm still so mortified by that one-- and still trying to process the enormity and sheer evil of the deed-- that I just can't come up with anything worthwhile to say other than this is what happens when Republican hate "literature" is made widely available to the mentally deficient. And yes, the murderer admits to being a reader and admirer of GOP hate-mongers Michael Savage, Bill O'Reilly and Sean Hannity. (I hope that that qualifies as kicking in the "with prejudice" clause in sentencing and Jim David Adkisson gets the chair or the rope or whatever they give to those guilty of mass murder in Tennessee.)

The deranged right-wing psychopath went on his murder spree at the Tennessee Valley Unitarian Universalist Church-- killing two and wounding six-- "because of its liberal teachings and his belief that all liberals should be killed because they were ruining the country, and that he felt that the Democrats had tied his country's hands in the war on terror and they had ruined every institution in America with the aid of media outlets." He told an officer that since "he could not get to the leaders of the liberal movement, he would then target those that had voted them in to office." Now where would he get ideas like that?

While we wait to find out about which hate talk radio hosts he is most devoted to, we can just judge by some of the books the police found in his home: Liberalism Is A Mental Health Disorder by Michael Savage (recently kicked off the air in several markets for his vicious assault on autistic children, but still on in most markets because the unmitigated greed of irresponsible corporations that own the radio stations could care less about what kind of hatred and divisiveness their "entertainers" stir up in the communities they're supposed to be serving), Let Freedom Ring "by" Sean Hannity, and The O'Reilly Factor by... yes, that one.

But it's the other sickening story of yesterday, that I want to make sure everyone knows about. You may recall the faux controversy of another decade in which Van Halen's concert production rider included a demand that no brown m&m's be included in the backstage goodies they were served. Now, if you think they were cheeky divas, Vice President Cheney's rider is far worse. And he had it thrown in his draft dodging face today by Disabled American Veterans, whose annual conclave he was scheduled to address next month. His invitation was yanked because his demands are far more "Draconian and unreasonable" than Van Halen's.

His staff insisted the sick vets be sequestered for two hours before Cheney's arrival and couldn't leave until he'd finished talking, officials confirmed.

"Word got back to us... that this would be a prerequisite," said the veterans executive director, David Gorman, who noted the meeting hall doesn't have any rest rooms. "We told them it just wasn't acceptable."

When Cheney spoke to the group in 2004, his handlers imposed the same stringent security lockdown, upsetting members, officials said.

Many of the vets are elderly and left pieces of themselves on foreign battlefields since World War II, and others were crippled by recent service in Iraq and Afghanistan. For health reasons, many can't be stuck in a room for hours.

"It was a huge imposition on our delegates," added David Autry, another Disabled American Veterans official.
Autry said vets would've had to get up "at Oh-dark-30 and try to get breakfast and showered and get their prosthetics on."

Once inside, they "could not leave the meeting room, and the bathrooms are outside," he said.

Neither Bush, McCain nor Obama have the kinds of "security precautions" Cheney, arguably the most hated man in America, has. Today, Cheney's staff is denying the demands were anything more than suggestions and that he would never impose on the disabled vets. Disabled American Veterans responded:

"I appreciate that they're trying to put their spin on it but when [Cheney] spoke to our convention in 2004, that's the the way it went down and we were concerned that was going to happen again... Somebody’s got to face up to fact regardless of what Cheney’s office says, that’s what happened last time and this is what we understood was going to happen this time."

So, as of now, the venal Darth Cheney is still out on his ass.