Costco in Southern California over the Easter holiday weekend) in a Ferrari 458 Italia and then complaining that something was wrong with the car because it wasn't driving properly. Putting diesel into this sports car wouldn't have helped either. While the former is akin to giving the wrong dose, the latter is more like giving the wrong medication altogether. But what about timing? After all, is there really any need to go to another the gas station after you've driven 5 miles from the previous one? Seems like a waste of time to me.|
But that's the whole point of my story. For medications to work, we have to prescribe the right drug (gasoline vs diesel vs electrical charge) in the right dose (87 octane vs 91 octane) at the right time (somewhere around three-quarter empty or when the low fuel signal first lights up seems right to me) using the right administration route for the right person. Likewise, while many observational studies have demonstrated the benefit of fish consumption and omega 3 fatty acids in cardiovascular disease in both 1o & 2o prevention , the cause & effect data is still quite murky and interpretation is open to debate.
So you can imagine my surprise when a meta-analysis was published earlier this week in the Archives of Internal Medicine suggesting that there really isn't enough evidence to suggest that omega 3 fatty acids prevents recurrent heart disease. The authors arrived at their conclusion after culling through 1,007 articles, 14 randomized, double-blind, placebo-controlled trials involving 20,485 participants followed in some studies for over 2 years. Remember that observational studies can only prove correlation while it takes a randomized controlled trial to prove cause & effect. So how can we explain the discrepancies?
The editorialists noted that perhaps we need to consume real fish to gain the desired benefits since fish would surely suppress the desire to consume less healthy protein options. So in this case, we have all 3 tenets to consider: are omega 3 fatty acids really good for us, even equivalent to "real fish"; how much omega 3 fatty acids (EPA + DHA) do we need, and are they only effective in 1o prevention (before clinical manifestation).