Nigel Denby, RD, and Dr Clemens von Schacky, MD, told NutraIngredients-USA that there are many valuable data points within the research into natural alternatives for health, and that the large-scale trials are only one of these. While many within the field have come around to this point of view, there remains a substantial and influential subset who have not.
“It is less difficult to get this idea across to researchers working within the field,” said Dr von Schacky, who, along with William Harris, PhD, was the founder of the concept of the Omega-3 Index. Dr von Schacky is currently the head of preventative cardiology at the University of Munich in Germany.
View fixed on certain kind of trials
“It’s more difficult to get this idea across to clinicians. They tend to think only certain trials are important,” he said.
Dr von Schacky said that when looking at research into the effects of nutrients such as omega-3s, a comprehensive look at all of the evidence is helpful. Dr von Schacky is, along with Prof Harris, accorded as one of the world’s foremost experts on omega-3s. Along with Denby, he is one of the founding members of the Global Nutrition & Health Alliance. The group says it was formed to help educate consumers and healthcare professionals around the world about optimal nutrition, including the use of vitamin, minerals and supplements (VMS) as part of a healthy lifestyle.
“Research is a puzzle where I am looking to see if I can put the pieces together,” Dr von Schacky said. “We have provided so much evidence over the years that the omega-3s picture has gotten pretty clear.”
Dr. von Schacky said the one big failure has been just the sort of large-scale, long term trials that certain clinicians, such as those who put together the Cochrane reviews, tend to focus on to the exclusion of all else.
“The only piece that does not fit into this picture are those large interventions. A lot of them have design issues. Almost all of these trials gave one capsule and they gave it for breakfast. In many countries breakfast is a low fat meal or no meal at all,” he said.
“If you are not cranking up that fat digestion you may not be absorbing that nutrient properly,” he said.
Starting in the middle
Dr. von Schacky said that the history of omega-3s research saw trials that dived in to trying to determine the nutrients’ cardiovascular health or overall mortality benefits without answering some of the basic questions first.
“We should have started at the bottom in the omega-3s field and we didn’t,” Dr von Schacky said. “We started somewhere in the middle. Bioavailability was not supposed to be a problem in omega-3s. It was only years afterward that we learned it was a huge issue.”
Another critical baseline issue was that before the advent of the Omega-3 Index and an easy pinprick method to test for this, the large scale trials sallied forth without knowing where they started from. Dr von Schacky and Prof Harris each market a simple test kit in their various markets (under the company names of Omega Metrics and OmegaQuant, respectively). But little research in the field to date has used this technology to measure baseline levels of omega-3s in the blood of test subjects.
“It’s like doing a trial on hypertension and never measuring the subjects’ blood pressure,” Dr von Schacky said.
Matter of continuing education
Getting the message across to consumers and even some practitioners about the overall research picture of omega-3s and other nutrients can be a challenge, Denby said. This is particularly true in the wake of the kind of negative headlines that arise out of reviews such as the one Cochrane recently published.
“You really have to bring it down to a pretty low level. You just keep trying to make the point that many of these big trials are flawed and often designed with a desired outcome already in place,” he said.
“As an example, I like to use the idea about fruit and vegetable servings. If you look at the research, most of us should really be eating nine or ten a day. The reason why you always hear about five a day is that the World Health Organization decided that is a target that most people might reasonably reach. That is how these messages can get diluted,” he said.
“In many respects that is why I wanted to get involved with the GNHA. I’m not necessarily a fan of trade organization responses to things like the Cochrane publication, because they clearly have an agenda. Our agenda is to bring accurate, clear and concise information to consumers directly or to at least start that conversation,” Denby said.