According to foreign information, the U.S. Food and Drug Administration (FDA) approved a new fish oil drug mainly containing EPA (Eicosapentaenoic acid) for the market for treating high triglycerides. The FDA Consultant Committee referred to the clinical study REDUCE-IT published on January 3, 2019. The study used 8,179 patients with high triglycerides and cardiovascular risk after using Statins drugs. The results showed that compared with the pacifier, the drug can effectively reduce the risk of major adverse cardiac envents (simple MACE) by nearly 25%. But there are also several side effects, including cardiac arrhythmia and internal bleeding.

For many years, domestic and foreign nutrition experts have suggested that fish species are rich in natural Omega-3 fatty acids, which can prevent the occurrence of cardiovascular diseases. Omega-3 fatty acids are mainly composed of three polyvinyl and fatty acids, including "α-dilinoleic acid" present in tofu, yellow beans, mustard oil and fruit, as well as three essential fatty acids such as EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) obtained mainly from fish and other marine organisms. These three fatty acids cannot be synthesized by humans and must be taken from food, which makes fish oil popular among health foods.

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It is not easy to prove whether eating fish can prevent the occurrence of cardiovascular disease. Previous research has been mostly observational reports. It was not until in the past two years that internationally renowned journals have published three clinical trials related to fish oil-tonified products, mainly based on EPA ingredients, and it was considered to be determined.

High doses of fish oil can reduce cardiovascular disease

The new fish oil drug approved by the United States is based on a January 3, 2019 article published in the New England Journal of Medical Journal of In the article "Medicine", the study targeted 8,179 high-risk patients with cardiovascular disease, of which 71% of the subjects used EPA fish oil as a continuous prevention because they had cardiovascular diseases such as myocardial infarction or had cardiac tubes and coronary tract surgery; another 29.3% of the subjects did not have cardiovascular disease.

The study found that using high-dose fish oil (4 grams per day) mainly based on EPA ingredients can reduce the continuous cardiovascular risk by 25% for subjects who originally had cardiovascular disease, including reducing deaths caused by cardiovascular disease, ischemic cardiac disease, non-fatal intermediate disease, etc., and has a significant effect, especially for those who are younger than 65 years old and who have triglycerides exceeding 150 mg/dL. However, for the prevention of people with no cardiovascular disease, although it is effective, it does not achieve a statistical difference.

This study can be said to be the first time that high doses of fish oil containing EPA have a preventive effect on people with existing cardiovascular diseases.

Low dose of fish oil is ineffective in preventing cardiovascular disease in patients with diabetes

Another study in October 2018, also published in the New England Medical Journal, targeting more than 15,000 diabetic patients. The report shows that if one gram of fish oil (omega-3) is used daily, it will not have a significant effect on preventing cardiovascular disease. By comparing the previous article, we can estimate that if the amount of fish oil is too low, the prevention effect will be ineffective for patients with diabetes or hypertension.

One gram of fish oil per day, the incidence of myocardial infarction decreased

Another clinical trial of VITAL (VITamin D and OmegA-3 TriaL) is also very representative. There are two articles in total, and it was found that high doses of fish oil have obvious effects on patients with myocardial infarction. The study subjects were more than 20,000,000 people, with a very large sample size and generally people who do not suffer from cardiovascular disease. The study was divided into four groups: one took vitamin D, one took fish oil (omega-3), one took two kinds of food, and one group did not eat two kinds of food. Observe whether it is effective in cardiovascular disease and cancer prevention.

The study found that supplementing two thousand vitamin D per day did not reduce the risk of cardiovascular events and cancer. However, supplementing one gram of fish oil every day does not reduce the incidence of major cardiovascular events and cancer, but the incidence of myocardial infarction and death risks will indeed decrease, and the incidence of skin coronary interventional therapy and all coronary heart disease has decreased significantly. The report pointed out that myocardial infarction can be reduced by 28%, and those who need coronary intervention treatment can be reduced by 22%, and the mortality rate for myocardial infarction can be reduced by 50%, but no effect is seen in reducing the trend of the middle.

In summary, if the results of the three important clinical trials published from 2018 to 2019, it can be found that low doses of fish oil have certain effects on reducing cardiovascular diseases, and there is no obvious effect in diabetic patients; the effects of high doses of fish oil are more obvious, and the effect is more obvious for those who already have cardiovascular diseases.

Domestic studies have found that fish oil can reduce triglycerides

The clinical study initiated by Taiwan University Hospital in 2013 and participated by eight major medical centers in China. A total of 253 patients with triglycerides exceeding 200 mg/dL were admitted, and 40 of them exceeded 500 mg/dL.. Give the patient a purified fish oil (Omacor? Pronova BioPharma), one gram of fish oil, contains 460 mg EPA and 380 mg DHA. The patient was divided into 3 groups, one group of 2 grams a day, one group of 4 grams a day, and the other group was used as consolation agents, and the treatment lasted for 8 weeks.

The results found that fish oil can indeed reduce triglycerides, patients with 4 grams per day can reduce 32.1%, and patients with 2 grams per day can reduce 29.7%. For cases with higher triglycerides, the reduction can be as high as 48% to 50%. From this we can see that no matter taking 2 grams or 4 grams, the effect of lowering triglycerides is good. Therefore, based on the results of Taiwan's research, whether you must eat 4 grams is necessary to further consider.

Fish oil is used to make medicines, and it needs to be removed (agricultural medicine, heavy metal), purification, purification (deoxide quality) and other steps. It can effectively lower blood lipids (mainly triglycerides). Usually, the dose of 1 to 2 grams is used, and the effect is good, but it is not suitable for every patient.

The triglycerides in some patients may be as high as 2 or 3,000. It is caused by genetic factors and dietary habits. If they exceed 1,000 mg/dL or more, they often have chylosaemia (the blood radius is mixed milky white), and it is also easy to develop acute pancreatitis. Repeated occurrence is the candidate for pancreatic cancer, and diabetes may also be combined. Once the pancreas is damaged, it will face many diseases in the future. Therefore, for patients with severe high-triglycerides, it is recommended to use fish oil as aid for treatment, because traditional medicines are no longer helpful.

In addition, by using blood lipid-lowering drugs for a long time, the patient's kidney function will be affected. If the blood creatinine value has reached abnormality, the blood lipid-lowering drugs can be slightly reduced and fish oil supplemented to restore normal kidney function, and triglycerides can also be maintained below 500 mg/dL.

Many studies have shown that the effect of fish oil is related to the dosage of the dose. The higher the dosage, the better the effect. The problem is that when you eat too much, too much fish oil will affect the digestion and peristalsis of the stomach, feel disgusting, and make your stomach uncomfortable and difficult to treat. Moreover, it has a fishy smell, which is not acceptable to everyone.

Eat different types of fish 3 times a week to spread the risk

Therefore, if ordinary people want to prevent cardiovascular diseases, it is recommended to eat more fresh fish. The American Academy of Healthcare Medicine suggested in 2013 that ordinary people should take at least two to three fish meat every week, about 100 grams at a time, and choose to be diverse, and use deep-sea fish as the first priority, including fish with high content of Omega-3, sardines, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, flagfish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, cherry fish, and cherry fish with high content.

In terms of eating, cooking fish soup and grilled fish are healthier than fried or fried. When choosing fish, different types of fish should be eaten alternately to disperse the risks and reduce the health threats caused by environmental, heavy metal and environmental hormone pollution.

As for additional supplementation of EPA and DHA capsules, we should first discuss with the cardiologist, especially for people with excessive triglycerides. Although it is recommended that 2 to 4 grams of EPA and DHA supplements be consumed per day, it should still be taken under the instructions of the doctor.

After the fish oil is turned into a drug after the thickening process, it is not only expensive, but also only suitable for some patients with hyperlipidemia; and the quality of fish oil health foods on the market cannot be determined. Although they are all called fish oil, there are still big differences in ingredients, content and process. Therefore, taking fish oil from fresh fish is not natural and you don’t have to spend too much money, which is the best choice for health.

Q: Why can fish oil prevent cardiovascular disease? Why is the machine transfer?

A: According to literature, fish oil can resist inflammation, lower blood pressure, lower triglycerides, and lower thrombosis. Some inflammation indicators will drop. Some articles also mentioned that there are several mechanisms of fish oil: it can inhibit the synthesis of extremely low-density lipoprotein (VLDL), reduce the synthesis of general lipoprotein B (Apo B), strengthen the conversion rate of extremely low-density lipoprotein, and reduce the post-flood lipid concentration. In addition, fish oil will not deteriorate blood sugar and can also slightly lower blood pressure. The most important role In terms of blood clotting, fish oil can reduce platelet aggregation and prolong the clotting time, which is the main reason why fish oil is considered to reduce coronary disease.

[This article is reproduced from "Good Health Magazine" No. 52 (published on 2020-04-15), original text link]