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Long-Awaited Study Results on Vitamin D and Fish Oil Supplements

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Re: Long-Awaited Study Results on Vitamin D and Fish Oil Supplements

#61

Post by mirekrusin »

Why came up with this title?

""We are reporting a remarkable degree of risk reduction," says Dr. Deepak Bhatt, who headed the study and is a cardiologist at Brigham and Women's Hospital."

"Taking fish oil lowered the risk of heart attack by about 28 percent, which is a "statistically significant" finding".

"African-Americans in the study experienced a 77 percent lower risk of heart attack when compared to placebo, which is a "dramatic reduction," Manson says".

"Overall, that study found there was a 25 percent risk reduction for patients taking the extract. These patients were less likely to die from heart disease, have a heart attack or stroke, be hospitalized for chest pain or need procedures such as angioplasty, stenting or bypass surgery, researchers reported."

Re: Long-Awaited Study Results on Vitamin D and Fish Oil Supplements

#62

Post by baccheion »

SubiculumCode wrote: post #28
SubiculumCode wrote: post #3

https://www.nejm.org/doi/full/10.1056/NEJMoa1809944 Abstract: 'It is unclear whether supplementation with vitamin D reduces the risk of cancer or cardiovascular disease, and data from randomized trials are limited. Methods We conducted a nationwide, randomized, placebo-controlled trial, with a two-by-two factorial design, of vitamin D3 (cholecalciferol) at a dose of 2000 IU per day and marine n−3 (also called omega-3…

I'm curious as to whether 2000 IU per day is considered a large dose by the HN community. I've a bottle of 5,000 IU.

Serum is more relevant. 40-60 ng/mL 25(OH)D, a commonly preferred range, is usually achieved with 50-100 IU/kg vitamin D3.

10 IU D3 : 2 mcg+ MK-4. And chelated/TRAACS magnesium.

Re: Long-Awaited Study Results on Vitamin D and Fish Oil Supplements

#63

Post by James1738 »

peterxpark wrote: post #44
cavisne wrote: post #30

"At this point, if one is thinking about supplementation, either omega-3s or vitamin D, talking to your physician or healthcare provider is the next step" Does anyone actually talk to their doctor before taking a vitamin? What information could they possibly provide

I have a terrific new naturopathic doctor who actually cares about my health and will run blood panels frequently and let me know what lifestyle changes and supplements would help me. I never knew before that I was deficient in zinc. Before her though, most of my doctors were of the bland "if you aren't in extreme pain then it's not a problem" camp.

You're part of the problem, congratulations on giving a a witchdoctor money!

Re: Long-Awaited Study Results on Vitamin D and Fish Oil Supplements

#64

Post by baccheion »

avinium wrote: post #49
BadassFractal wrote: post #5

Been taking 10k IU of D3 for a few months now, managed to get my measurement from the teens or 20s into the 90s of whatever unit that's in. I believe 100 is the max of the healthy range. Can't tell the difference, but allegedly you're going to feel "worse" if you're low on this stuff. It would be amusing to find out that it actually makes no difference at all and it's all placebo.

Yeah, I've tried the same (my theory was it would help mitigate the effects of SAD through the long, dark winter). I've noticed no difference (though to be fair, it was hardly an empirical approach). I have a pretty well-rounded diet, so I assume I'm not deficient. I do think that fish oil makes a difference, at least in terms of exercise.

Do you also take magnesium? Have you verified serum levels via blood work?

Re: Long-Awaited Study Results on Vitamin D and Fish Oil Supplements

#65

Post by Dylan16807 »

LeifCarrotson wrote: post #46
tarr11 wrote: post #27

Earlier quoted context omitted.

I don’t know, the findings about African Americans seem to be a case of “outcome switching” [0] since it does not appear that this trial was specifically designed to test against that group. [0] https://www.vox.com/2015/12/29/10654056/ben-goldacre-compare...

A more approachable description of why this is bad: "Green Jellybeans cause acne, p=0.05" https://xkcd.com/882/ No, outcome switching is not exactly the same as P-hacking, but either could be blamed here.

But on the other hand if you do the equivalent of 20 parallel trials and one of them has a naive p value of .001 then you still have a good result.

I don't know how what heart attack values normally look like, but those percentages are pretty huge. They sound like numbers that might stand even after you compensate for the subsetting.

Re: Long-Awaited Study Results on Vitamin D and Fish Oil Supplements

#66

Post by hashbig »

peterxpark wrote: post #44
cavisne wrote: post #30

"At this point, if one is thinking about supplementation, either omega-3s or vitamin D, talking to your physician or healthcare provider is the next step" Does anyone actually talk to their doctor before taking a vitamin? What information could they possibly provide

I have a terrific new naturopathic doctor who actually cares about my health and will run blood panels frequently and let me know what lifestyle changes and supplements would help me. I never knew before that I was deficient in zinc. Before her though, most of my doctors were of the bland "if you aren't in extreme pain then it's not a problem" camp.

I would much rather have a "if you aren't in extreme pain then it's not a problem" doctor, than one who would over diagnose every minor issue.

Re: Long-Awaited Study Results on Vitamin D and Fish Oil Supplements

#67

Post by dmix »

jryan49 wrote: post #43

So wait, what is disappointing about this: "Taking fish oil lowered the risk of heart attack by about 28 percent, which is a "statistically significant" finding, says Dr. JoAnn Manson, who is chief of the division of preventive medicine at the Brigham and Women's Hospital in Boston. She led the research." and "African-Americans in the study experienced a 77 percent lower risk of heart attack when compared to placebo,…

The fact fish oil and vitamin d have been touted for couple decades as helping prevent cancer?

I remember both my parents taking both regularly growing up in the 90s and they both separately mentioned cancer prevention as the big reasons.

Re: Long-Awaited Study Results on Vitamin D and Fish Oil Supplements

#68

Post by ekianjo »

Leary wrote: post #48
ekianjo wrote: post #26

Earlier quoted context omitted.

Does not matter. The effects on African American populations were probably not part of the pre defined endpoints, so yes, it is perfectly acceptable to say the study is negative. Looking at subgroups a posteriori is essentially what leads to p hacking and this is the behavior that we want to discourage in sciences.

Shouldn't one consider what the p-value is in weighing whether it is a fluke or not?

The study is designed to evaluate precise and well-defined endpoints. Any additional observation not planned from the start does not have the same rigor (since the study does not control for all thousands of variables at once, obviously), so in practice you should never draw conclusions from what was not agreed to evaluate from the start.

Re: Long-Awaited Study Results on Vitamin D and Fish Oil Supplements

#69

Post by dmix »

a_bonobo wrote: post #51
resters wrote: post #11

This headline is quite misleading (and arguably very biased toward white readers). It describes a marked improvement in outcomes for African American study participants. So perhaps NPR views this as "disappointing" but the headline suggests broadly that everyone should stop taking those supplements, when in fact the results are far more nuanced. HN's absurd title policy is using a clickbait (and misleading) title cho…

I don't know, the linked editorial in NEJM summarises it pretty well: >However, these “positive” results need to be interpreted with caution. First, there was no correction for multiple comparisons, as would be required to attenuate the chance that these are spurious results, owing, in part, to the number of secondary end points. Second, these putative effects have not been consistently observed across other large, r…

So HNs "click bait" is not the issue at all then... The article merely misrepresented the positives for cardiovascular health but was largely correct about cancer (which was the entire point of the study as well as the topic of the headline).

Re: Long-Awaited Study Results on Vitamin D and Fish Oil Supplements

#70

Post by clumsysmurf »

dmix wrote: post #67
jryan49 wrote: post #43

So wait, what is disappointing about this: "Taking fish oil lowered the risk of heart attack by about 28 percent, which is a "statistically significant" finding, says Dr. JoAnn Manson, who is chief of the division of preventive medicine at the Brigham and Women's Hospital in Boston. She led the research." and "African-Americans in the study experienced a 77 percent lower risk of heart attack when compared to placebo,…

The fact fish oil and vitamin d have been touted for couple decades as helping prevent cancer? I remember both my parents taking both regularly growing up in the 90s and they both separately mentioned cancer prevention as the big reasons.

Even until recently I still see studies consistent with this idea (o-3 & cancer)

https://medicalxpress.com/news/2018-01-omega-3s-fish-flax-ca...

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