Essential Fatty Acids and Prostate Cancer
I have had a few enquiries about the recent article (Brasky et al. Serum Phosholipid Fatty Acids and Prostate Cancer Risk: Results From the Prostate Cancer Prevention Trial) which claimed that DHA omega-3 fatty acid was positively associated with risk of high-grade prostate cancer.
These reports just did not make sense based on all the other studies I have read regarding omega 3 fatty acids (EPA and DHA). I thought I better read the whole study and take a look at the raw data, methodology, and statistical analyses. Good thing I did!
First of all the study is an observational study and NOT an intervention study so any conclusions are deduced from association NOT cause and effect. This study design is USELESS in terms of establishing cause and effect and when you add this to the actual data this study is less than useless it is misleading.
Second of all the actual absolute effect was very very very small. They use relative differences among both fatty acid levels and number of cases of cancer in different cohorts. So if you look at fatty acid levels in Table 2 (which by the way are reported as weight percentages of total phospholipid fatty acids) the ABSOLUTE differences are very very minute. The ABSOLUTE, meaning ACTUAL level of DHA in the high grade cancer group was 2.8%, the level in the control group was 2.73% meaning the absolute difference was .07% meaning 7/100 of a hundredth or a whopping difference of 7/10,000th absolute difference in amount of DHA between the cancer group and the control group.
Also, and MOST importantly, they don’t give any indication if these subjects were sufficient or deficient in terms of essential fatty acids or in terms of omega 3 to omega 6 ratio (remember this should be 1:1). They did not measure total amounts of fatty acids so we cannot tell if these subjects were sufficient or not or what their omega 3 to Omega 6 ratios were. As the subjects did not supplement with omega 3 (it was not an omega 3 intervention trial) and the literature is clear that the average citizen is not only deficient in omega 3 fatty acids but also VERY SIGNIFICANTLY deficient in Omega 3 fatty acids in terms of ratio to Omega 6 fatty acids, AND that this ratio is reported to be as or more important as total fatty acid levels, this study is useless in terms of determining the effect of omega 3 levels and cancer development or prevention. We have no idea if these subjects were deficient in omega 3 or toxic with omega 6!!! If you look at table 2 what you will find is that the amount of omega 6 fatty acids in terms of percentage of total weight is SIGNIFICANTLY greater (in BOTH absolute and relative terms) to the amount of Omega 3 fatty acids.
Still, this ratio was consistent in the control group so why did having more DHA cause more cancer?? IT DIDN’T!! This is the point, this study CANNOT validly conclude this for two reasons. First, this study did not determine if fatty acid levels caused anything, this study observed if there was a correlation. The actual data reveals that no valid conclusions can be made even regarding correlation because there was ONLY SEVEN TEN THOUSANDTHS difference between the cancer group and the DHA group in terms of absolute amount of DHA!
Also, we have no idea what the source of the omega 3 fatty acids present in these subjects was. What if they were from oxidized cheap fish oils? What if they don’t consume any antioxidants and thus cannot properly prevent endogenous oxidation? What if, because they reported amounts of fatty acids based on percentages of total fatty acids, that the reported changes in relative amounts of the fatty acids were based on the changing amounts of other fatty acids and not differences in levels of DHA at all? Remember, these were average citizens eating an average (suicidal) diet. Still all IRRELEVANT because there was NO DIFFERENCE between fatty acid levels from the controls!! It is all a moot point!
The real question, which was NEVER asked or answered by this study, is whether or not being sufficient in ESSENTIAL fatty acids is healthier than being deficient. The answer is ABSOLUTELY, UNEQUIVOCALLY – YES!! If a nutrient is given the title of essential that means that science has shown that the cells of the body require it for proper function and health and that the cells cannot manufacture it so it must be ingested.
This study provides no useful information and in fact offers misleading data analysis and conclusions.
Let’s be clear, omega 3 fatty acids are an essential nutrient required by Everybody, Everyday, For Life! They are not a treatment for prostate cancer or any other disease and they are most certainly, when present in sufficient amounts and in proper ratio with omega 6 fatty acids, NOT a cause of cancer or any other illness. Concluding that an essential nutrient is a cause of illness is an oxymoronic. It is not possible that a nutrient REQUIRED for cell function and health and present at required levels for sufficiency can be a cause of illness. Being sufficient in essential nutrients promotes health and function and thus prevents illnesses associated with deficiency of said nutrients. Whether you have prostate cancer or not is NOT relevant to whether or not you require omega 3 fatty acids or whether or not they are healthy. If you are human then omega 3 fatty acids are a required, essential nutrient for health and prevention. This fact has been unequivocally established in the peer-reviewed scientific literature. In fact, it is IMPOSSIBLE for a nutrient to be categorized as essential unless it is ESSENTIAL.
Paradigm is EVERYTHING when it comes to research because in research the question is everything and the paradigm of the researchers determines the questions they will ask.
Welcome to the Wellness & Prevention Paradigm; life is better, longer, and healthier here.
Yours in the Wellness & Prevention Paradigm
Dr. James L. Chestnut B.Ed., M.Sc., D.C., C.C.W.P