Dr. Rhonda Patrick on fish oil: what the evidence says · JRE #1178
SUBJECT: FISH OIL
Not a true/false call. Every claim is logged with its sources; read the exhibits below.
And they were given four grams a day for five years, 8,000 patients, randomized placebo-controlled different countries, and it reduced, and these actually were patients that had high triglycerides and also were on statins. It lowered cardiovascular disease risk by like 28 or close to 30% or something like that.
What the evidence says 01 / RECORD
The trial design Patrick describes, 4 grams/day of EPA (icosapent ethyl) given to 8,179 statin-treated patients with elevated triglycerides across multiple countries, with a median follow-up of 4.9 years and a 25% relative risk reduction in the primary cardiovascular composite endpoint (17.2% vs 22.0%, HR 0.75), matches the REDUCE-IT trial, published in the New England Journal of Medicine in 2019, not the VITAL study. The actual VITAL trial tested a much lower dose, 1 gram/day of mixed EPA/DHA fish oil, in 25,871 generally healthy US adults not selected for elevated triglycerides or statin use, over a median 5.3 years, and found no statistically significant reduction in the composite major cardiovascular event endpoint (hazard ratio 0.92, 95% CI 0.80-1.06, p=0.24), though it did find a reduction in total myocardial infarction specifically. Patrick's reported risk-reduction figure of 28-30% and the described patient population do not match VITAL's null primary result. The dose, patient count, and duration she cites correspond closely to REDUCE-IT rather than VITAL, indicating the trial name and outcome were conflated between the two studies.