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James J. DiNicolantonio, PharmD
James J. DiNicolantonio, PharmD, is through the Mid America heart Institute at Saint Luke’s Hospital, Kansas City and also Wegmans Pharmacy, Ithaca, NY
Carl J. Lavie, MD, is at man Ochsner Heart and Vascular institute at the university of Queensland college of Medicine, new Orleans and Pennington Biomedical research study Center, Baton Rouge, LA
James H. O’Keefe, MD, MSMA member due to the fact that 2003, is v the Mid America love Institute at Saint Luke’s Hospital and also University the Missouri-Kansas City, Kansas City
Corresponding author.

You are watching: Does omega 3 cause prostate cancer


There has actually been recent controversy as to whether fish oil rises the hazard of prostate cancer. The concern stems native a file published recently by Brasky and colleagues finish that increased blood levels of long-chain omega-3 in plasma phospholipids are associated prospectively with an enhanced risk for total as well as high-grade prostate cancer.1 They reached this conclusion based upon their very own retrospective evaluation of serum samples and also data obtained from the pick trial, and also a meta-analysis of ahead pertinent prospective epidemiological studies. The writer speculate the this finding might reflect a pathogenic role for fish oil omega-3s in the induction that prostate cancer. Extensive publicity provided to this speculation through the well-known media has triggered both consternation and also skepticism among the public.

It need to be emphasized the this research cannot prove that fish oil reasons prostate cancer, together it is observational; the was not a managed trial in i beg your pardon patients were randomized to obtain fish oil additional or placebos. Furthermore, dietary consumption of fish or fish oil was not assessed in this study, so, even as epidemiology, that cannot develop an association in between fish oil consumption per se and also prostate cancer risk. Rather, it only creates a correlation that prostate cancer danger with omega-3s in plasma phospholipids. Even if it is this correlation mirrors a pathogenic function for omega-3s is hypothetical, and also there is substantial reason to believe that this theory is incorrect. Conceivably, if their observation proves to be confirmable in succeeding research, the usually elevations of plasma phospholipid omega-3s observed in topics who go on to construct prostate cancer might reflect part metabolic variable influencing omega-3 partitioning and/or oxidation that also influences prostate cancer induction.

It must be detailed that the test supplied by Brasky and colleagues to evaluate “omega-3 status” – plasma phospholipid omega-3s – is not the many accurate method to assess long-term omega-3 dietary intake. Rather, the percentage of EPA + DHA in erythrocyte membranes as defined by Harris together the “omega-3 index,”2 is much more useful in this regard. The parameter measure up by Brasky et al. Is highly susceptible to day-to-day sport in omega-3 fatty acid intake, rendering it less than optimal as a surrogate because that the characteristic omega-3 intakes or organization levels that the subjects studied.

More importantly, a substantial variety of epidemiological studies, both prospective and also case-control, have actually previously examined the association in between fish or fish oil ingestion and prostate cancer risk, and these findings clearly do no incriminate long-chain omega-3 sloop down as factor in prostate cancer induction.3–9 A current meta-analysis of this studies shows that fish intake has a null or contempt protective influence on prostate cancer incidence, but is strongly protective with respect to prostate cancer mortality.4 Moreover, the limited prospective epidemiology that has actually evaluated the association of fish oil supplementation with prostate cancer threat – consisting of one study by Brasky’s own group – walk not provide any grounds for issue in this regard.3 through respect to patients who currently have prostate cancer, frequent fish usage has been associated with boosted survival.

Prior evidence has presented that patients through a higher mean baseline blood level that omega-3 fatty acids are at a reduced risk that cardiac sudden death.10 Indeed, one study discovered that reasonably high omega-3 blood levels (5.63% and also 6.87%) were connected with a 72% and 81% reduced risk of sudden death, respectively, compared to patients through a average omega-3 blood level that 3.58%.10 Brasky and also colleagues report a 43% boosted risk of total prostate cancer through an omega-3 blood level > 5.31% vs. < 3.68% (hazard ratio


1.43, 95% conference expression : 1.09–1.88, p=0.007).1 Hence, also in the unlikely event that Brasky and also colleagues room correct in their speculation that omega-3 rises prostate cancer risk, one would have to balance a 43% increased risk the prostate cancer associated with replete omega-3 status, versus a 72% greater risk of sudden cardiac death connected with low omega-3 status.

If fish omega-3 did indeed an increase prostate cancer risk, then populaces with high omega-3 fatty acid intakes can be supposed to have a relatively high risk for prostate cancer; this does no seem to it is in the case. The input of fish in Japan is among the highest in the world,11–13 being around eight times an ext than the of American men,2 and yet the age-adjusted mortality from prostate cancer in Japan was approximately seven times reduced than the in the U.S. In the 1950s.14 Additionally, omega-3 fatty acid levels in red blood cells are roughly 8 come 10% in Japanese patients,15 approximately twice that of those in the combined cancer team (4.66%) and also controls (4.48%) in the record by Brasky and colleagues.1 Thus, the typical omega-3 fatty acid blood levels in the Brasky research are quite low from the standpoint of cardiovascular (CV) protection, and only differed through 0.18% in situations vs. Controls - a negligible distinction from a clinical perspective.

The really high omega-3 input of the traditionally-living Inuit, evoked as a most likely reason for their low threat for CV disease, first brought omega-3 nutrition to renowned attention several years ago. Less famed is the reality that the Inuit were also at very low hazard for prostate cancer incidence and mortality.15, 16

Japanese men have actually a two-fold greater serum level that omega 3-fatty acids 보다 whites and also Japanese american in the United says (U.S.),11 and also coronary heart an illness in Japan is about fifty percent as usual as in the U.S.17 Contributing come the proof that a greater omega-3 intake is connected with a reduction in coronary heart an illness is JELIS, a randomized controlled trial which showed that including 1.8 grams the eicosapentaenoic mountain (EPA) daily as an adjunct come statin treatment in males with a relatively high baseline intake of omega-3s (Japanese patients) reasons a significant reduction in the danger of major coronary heart an illness events and also stroke.18, 19 uneven the examine by Brasky and also colleagues, this trial could prove causation, demonstrating that fish oil to reduce the threat of CV disease. It would certainly be a dead if patients quit taking your fish oil supplements, fan to an unwarranted fear regarding prostate cancer, and also subsequently knowledgeable a CV event or suddenly death.

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A feasible indication the Brasky’s paper is serious flawed is that their data confirmed that the hazard of prostate cancer decreased as the amount of pack-years of cigarette smoking increased.1 contrasted to non-smokers, there to be a 3%, 13% (trend for reduction) and significant 19% reduced risk because that prostate cancer in those who smoked ≤ 12.5 pack-years, 12.5–25 pack-years and also ≥ 25 pack-years, dong (relative hazard 0.97, 95% CI:0.84–1.11, p=0.63, RR 0.87, 95% CI:0.74–1.02, p=0.09, RR 0.81, 95% CI:0.69–0.95, p = 0.01). Moreover, those with diabetes had actually a 33% reduced risk of occurring prostate cancer contrasted to those that were not diabetic (RR 0.67, 95% CI:0.54–0.83, p=0.0003). However, a reduced risk for prostate cancer in diabetics is, in fact, a well developed phenomenon.20

In conclusion, the Brasky record only displayed an association between plasma phospholipid omega-3s and subsequent prostate cancer risk; it cannot prove the omega-3 fat acids (and specifically fish oil) cause prostate cancer. A an ext thorough summary of the pertinent literature argues that raised omega-3 fat acid intake does not increase prostate cancer risk, and also notably reduce prostate cancer mortality – and most certainly decreases danger for suddenly death and also CV events.