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Finally, the highly anticipated result of the VITAL Study are in - at least for the major endpoints CVD and cancer.

While at first sight they may seem disappointing and have already prompted the usual, overgeneralizing negative reports from many media outlets, there are some remarkable findings if you look more closely - such as a whopping 77% reduced risk for heart attacks in African Americans taking fish oil (all those media who are now sweepingly reporting that fish oil dies “not reduce CVD”, without mentioning this, such as MdMag*, musk ask themselves whether they are looking at the results through racist glasses, as the investigators certainly didn’t make a secret of this remarkable finding).

With regard to vitamin D, the results certainly don’t support the strong effect on cancer risk suggested by some observational studies, but there seems to be a modest effect building up over time, and given the fact that 2000 IU is a rather modest dose indeed and not expected to raise the blood level by more than 10 ng/ml, the jury is far from out on vitamin D and cancer.

Anyway, this is a very high quality trial providing the researchers with a treasure-trove of data that will be subject to many auxillary studies. I’m particularly curious about the upcoming studies regarding autoimmune and mental health endpoints.

*https://www.mdmag.com/conference-coverage/aha-2018/vital-study-supplements-of-omega3s-or-vitamin-d-do-not-reduce-cvd-or-cancers

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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).