Update on Vitamin D and Fish Oil Supplementation

Vitamin D and fish oil are some of today’s most popular dietary supplements.

One reason many people take them is widespread news coverage showing marked reductions of degenerative disorders in response to higher intake of these nutrients.

Since it is no longer “news” that fish oil and vitamin D favorably influence human health, some media sources run tabloid-like headlines that often misinterpret findings from clinical trials.

A clinical trial called VITAL used modest potencies of EPA/DHA from fish oil and vitamin D3 that did not meet challenging primary clinical endpoints. This caused many media sources to proclaim there to be no value in supplementing with these low-cost nutrients.

That’s regrettable because people who need them the most, i.e. those living in difficult socioeconomic circumstances, are often more adversely impacted by a lack of these kinds of protective nutrients.

This article describes studies in which higher potencies of omega-3s or vitamin D have demonstrated remarkable health benefits.

Vitamin D and Cancer

An explosion of research in recent decades has demonstrated that vitamin D impacts almost every aspect of health, including protection from cancer and cardiovascular disease.

As new studies have been published, many experts have revised their recommendations upward for daily vitamin D intake and blood levels.

Many now suggest that a target 25-hydroxyvitamin D blood level of 50 ng/mL to 80 ng/mL is ideal for optimal protection from cancer. This level is far above what aging individuals obtain from sun exposure and dietary sources.

Recommendations for higher vitamin D target levels are based on a growing body of evidence that individuals with low levels of vitamin D are at the greatest risk of developing cancer and dying from the disease—while those with the highest levels have reduced cancer incidence.

Vitamin D deficient women have been found to have greater odds of developing breast cancer and a 253% increase in risk for colon cancer, compared to those with the highest vitamin D levels.^1,2 One study found that higher levels of vitamin D in men prior to a prostate cancer diagnosis were associated with improved survival rates.³

Another study evaluated individuals being treated for advanced colorectal cancer.⁴ During chemotherapy treatment, these patients were randomized to either receive a low (standard) dose of vitamin D (400 IU per day) or a high dose (starting at 8,000 IU per day and later decreasing to 4,000 IU per day).

The higher dose resulted in better outcomes. During the follow-up period, the individuals receiving higher doses were 36% less likely to suffer from cancer progression or to die, than those given the lower (400 IU/day) dose.

These studies and others suggest a dose-response relationship: The higher the level of vitamin D, the lower the risk of cancer or dying from cancer.

One study found a 12% reduction in mortality from breast cancer for every 8 ng/mL increase in vitamin D blood level.⁵

Other studies have estimated a 10% decrease in death due to colon cancer for every 8 ng/mL increase in vitamin D. Overall risk of cancer was as much as 35% lower in those with 25-hydroxyvitamin D levels of 55 ng/mL or higher.^6,7

Several types of studies, including geographical ecological studies, observational studies, laboratory studies of mechanisms, and clinical trials have tested the vitamin D and cancer-prevention connection.

Some clinical trials reveal that even low-dose vitamin D3 may reduce cancer risk.

One study published in The American Journal of Clinical Nutrition evaluated the impact of vitamin D3 and calcium supplementation on cancer risk reduction in postmenopausal women.

The study found that improving calcium and vitamin D status by supplementation of 1,100 IU/day of vitamin D3 plus 1,450 mg/day of calcium reduced all-cancer risk.⁸

Another study involving more than 36,000 postmenopausal women found that supplementation with 1,000 mg/day of calcium and 400 IU/day of vitamin D significantly decreased the risk of total, breast, and invasive cancers by 14% to 20%.⁹

Vitamin D and Cardiovascular Disease

A similar link between vitamin D levels and cardiovascular disease has been demonstrated in medical research.

Several studies have shown that lower vitamin D levels are associated with high blood pressure, elevated blood glucose, atherosclerotic plaque in blood vessels, arterial stiffness, and higher rates of cardiovascular events.^10-19

In humans, vitamin D supplementation can reduce some of these markers of blood vessel disease. For example, 4,000 IU daily was shown to reduce arterial stiffness.^15,19

One study evaluated the association of vitamin D and strokes, which often result from cardiovascular disease. Vitamin D status was measured in 3,316 patients with evidence of blood vessel disease who were followed for almost eight years. What scientists found was a dramatic increase in the number of fatal strokes for every incremental decrease in vitamin D blood level.²⁰

Omega-3 Fatty Acids and Cardiovascular Disease

Several studies have shown a close link between high levels of omega-3 fatty acids from fish oil and protection from aspects of cardiovascular disease.

Like vitamin D, the highest blood levels of omega-3s have been shown to be the most protective. For example, individuals with the highest omega-3 blood levels are 50% less likely to suffer from congestive heart failure than those with low levels.²¹ Overall survival in patients with existing heart failure is 35% better in those with higher omega-3 levels.²²

A study in Atherosclerosis found that an omega-3 index of 8% or higher, far above the 4% achieved by the dosing in the VITAL trial, was protective against fatal heart disease.²³ Compared to those with an index below 4%, these optimal levels (8% and higher) reduced risk of death from coronary heart disease by about 30%.

Another study, published in the journal Preventive Medicine, found that the greatest protection from death by cardiovascular causes was found in individuals with an omega-3 index greater than or equal to 8%.²⁴

Moreover, studies with long follow-up periods have found that an omega-3 index of 8% or higher reduces the risk of death from any cause, with a 7% lower overall risk of dying gained by each additional 200 mg of fish oil consumed per day.^25,26

In one study, researchers enrolled patients at high risk of experiencing cardiovascular events. Those who were randomized to receive 2,000 mg of a supplement containing 930 mg of EPA and 750 mg of DHA (two omega-3 fatty acids) had a 70% reduction in heart attacks, and a 60% decrease in other coronary events.²⁷

Several other studies using daily doses of 2,000 mg to 4,000 mg of fish oil have also shown benefits for various cardiovascular disease outcomes.^28-30

It is important to note that comprehensive management of cardiovascular disease risk requires a comprehensive assessment of risk factors beyond cholesterol and blood pressure.

A paradigm shift is crucially needed to move away from focusing on a single number for LDL-cholesterol to focusing on the complete patient, by taking into account a range of biomarkers that can yield additional insight.

Although lowering low-density lipoprotein cholesterol (LDL-C) is a primary target for cardiovascular disease risk reduction, lifestyle related factors, such as tobacco use, obesity and sedentary routines, are also very important.³¹

In addition, many other risk factors, such as insulin resistance, hormonal imbalances, hypercoagulable states, hyperhomocysteinemia, vascular inflammation, hyperglycemia, and others also play important roles.³²

Nutrients like magnesium, CoQ10, fish oil omega-3s, vitamin K2, and others also play an important, underappreciated role in cardiovascular health.^30,33-48

Further, advanced testing of lipoprotein fractionation identifies the full spectrum of lipoprotein particles, along with direct quantification of particles in each lipoprotein subclass fraction.

The sub-particles of LDL have a set of distinct properties including size and density. The small LDL particles are much more strongly related to risk than the larger LDL particles. Advanced lipoprotein subclass testing (such as the NMR blood test) provides additional information not otherwise identified through routine lipid testing for total cholesterol, LDL, HDL and triglycerides.

Omega-3 Fatty Acids and Cancer

Fish oil consumption, both from the diet and supplementation, has a profound effect on cancer. It appears to reduce the abnormal changes in cells that can lead to tumors, and to reduce the growth and aggressiveness of existing cancers.

Research has even found that factors which predispose cells to tumor growth are reduced with omega-3 supplementation. In one trial, 4,000 mg of an omega-3 supplement each day protected the skin from the harmful effects of solar radiation.⁴⁹ The damage caused by sun exposure was reduced, including a 36% improvement in sunburn protection and significant reduction of DNA damage, which can contribute to skin cancer.

In another study, 2,000 mg of omega-3s daily reduced the number of precancerous cells on colonoscopy inspection.⁵⁰ This indicates a minimized risk for colon cancer.

Another clinical trial used a dose of 5,000 mg of fish oil daily in men with prostate cancer, leading up to surgery.⁵¹ When the patients underwent surgery, pathologists found that those men who received fish oil supplementation demonstrated a significant reduction in proliferation of cancer cells. Less aggressive tumors typically equate to better control with treatment—and better long-term survival.

Omega-3 fatty acids also help support treatment for cancer. Studies of lung cancer patients found that supplementation with fish oil prevented some adverse effects associated with cancer treatment, such as weight loss, and boosted the response of the cancer to chemotherapy.^52,53

Various animal and human studies show that omega-3s are protective against cancer, improve response to cancer treatment, and even reduce cancer relapse after treatment.^54-56

The benefits of vitamin D and omega-3 fatty acids discussed are just a sampling of those related to cardiovascular disease and cancer. Additionally, these nutrients are beneficial for brain health and cognition, eyesight, metabolic health, overall longevity, and more.

Summary

Research has shown that vitamin D and omega-3s impact almost every aspect of health, including protection from cancer and cardiovascular disease.

Life Extension recommends doses of 5,000 IU to 8,000 IU of vitamin D and 2,400 mg of EPA/DHA from fish oil daily to maintain optimal levels. Regular blood testing is important to guide adjustments to these doses to achieve the maximum benefits.

Experts suggest maintaining blood levels between 50 ng/mL and 80 ng/mL for vitamin D and an omega-3 index of 8% to 12%.

If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.

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