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  1. #1
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    Default Ωμέγα-3 Λιπαρά Οξέα Και Πρόληψη Καρδιακών Νοσημάτων

    Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease


    Asmaa S Abdelhamid,
    Tracey J Brown,
    Julii S Brainard,
    Priti Biswas,
    Gabrielle C Thorpe,
    Helen J Moore,
    Katherine HO Deane,
    Fai K AlAbdulghafoor,
    Carolyn D Summerbell,
    Helen V Worthington,
    Fujian Song,
    Lee Hooper


    First published: 18 July 2018


    Abstract
    Background
    Researchers have suggested that omega-3 polyunsaturated fatty acids from oily fish (long-chain omega-3 (LCn3), including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)), as well as from plants (alpha-linolenic acid (ALA)) benefit cardiovascular health. Guidelines recommend increasing omega-3-rich foods, and sometimes supplementation, but recent trials have not confirmed this.


    Objectives
    To assess effects of increased intake of fish- and plant-based omega-3 for all-cause mortality, cardiovascular (CVD) events, adiposity and lipids.


    Search methods
    We searched CENTRAL, MEDLINE and Embase to April 2017, plus ClinicalTrials.gov and World Health Organization International Clinical Trials Registry to September 2016, with no language restrictions. We handsearched systematic review references and bibliographies and contacted authors.


    Selection criteria
    We included randomised controlled trials (RCTs) that lasted at least 12 months and compared supplementation and/or advice to increase LCn3 or ALA intake versus usual or lower intake.


    Data collection and analysis
    Two review authors independently assessed studies for inclusion, extracted data and assessed validity. We performed separate random-effects meta-analysis for ALA and LCn3 interventions, and assessed dose-response relationships through meta-regression.


    Main results
    We included 79 RCTs (112,059 participants) in this review update and found that 25 were at low summary risk of bias. Trials were of 12 to 72 months' duration and included adults at varying cardiovascular risk, mainly in high-income countries. Most studies assessed LCn3 supplementation with capsules, but some used LCn3- or ALA-rich or enriched foods or dietary advice compared to placebo or usual diet.


    Meta-analysis and sensitivity analyses suggested little or no effect of increasing LCn3 on all-cause mortality (RR 0.98, 95% CI 0.90 to 1.03, 92,653 participants; 8189 deaths in 39 trials, high-quality evidence), cardiovascular mortality (RR 0.95, 95% CI 0.87 to 1.03, 67,772 participants; 4544 CVD deaths in 25 RCTs), cardiovascular events (RR 0.99, 95% CI 0.94 to 1.04, 90,378 participants; 14,737 people experienced events in 38 trials, high-quality evidence), coronary heart disease (CHD) mortality (RR 0.93, 95% CI 0.79 to 1.09, 73,491 participants; 1596 CHD deaths in 21 RCTs), stroke (RR 1.06, 95% CI 0.96 to 1.16, 89,358 participants; 1822 strokes in 28 trials) or arrhythmia (RR 0.97, 95% CI 0.90 to 1.05, 53,796 participants; 3788 people experienced arrhythmia in 28 RCTs). There was a suggestion that LCn3 reduced CHD events (RR 0.93, 95% CI 0.88 to 0.97, 84,301 participants; 5469 people experienced CHD events in 28 RCTs); however, this was not maintained in sensitivity analyses ? LCn3 probably makes little or no difference to CHD event risk. All evidence was of moderate GRADE quality, except as noted.


    Increasing ALA intake probably makes little or no difference to all-cause mortality (RR 1.01, 95% CI 0.84 to 1.20, 19,327 participants; 459 deaths, 5 RCTs),cardiovascular mortality (RR 0.96, 95% CI 0.74 to 1.25, 18,619 participants; 219 cardiovascular deaths, 4 RCTs), and it may make little or no difference to CHD events (RR 1.00, 95% CI 0.80 to 1.22, 19,061 participants, 397 CHD events, 4 RCTs, low-quality evidence). However, increased ALA may slightly reduce risk of cardiovascular events (from 4.8% to 4.7%, RR 0.95, 95% CI 0.83 to 1.07, 19,327 participants; 884 CVD events, 5 RCTs, low-quality evidence), and probably reduces risk of CHD mortality (1.1% to 1.0%, RR 0.95, 95% CI 0.72 to 1.26, 18,353 participants; 193 CHD deaths, 3 RCTs), and arrhythmia (3.3% to 2.6%, RR 0.79, 95% CI 0.57 to 1.10, 4,837 participants; 141 events, 1 RCT). Effects on stroke are unclear.


    Sensitivity analysis retaining only trials at low summary risk of bias moved effect sizes towards the null (RR 1.0) for all LCn3 primary outcomes except arrhythmias, but for most ALA outcomes, effect sizes moved to suggest protection. LCn3 funnel plots suggested that adding in missing studies/results would move effect sizes towards null for most primary outcomes. There were no dose or duration effects in subgrouping or meta-regression.


    There was no evidence that increasing LCn3 or ALA altered serious adverse events, adiposity or lipids, although LCn3 slightly reduced triglycerides and increased HDL. ALA probably reduces HDL (high- or moderate-quality evidence).


    Authors' conclusions
    This is the most extensive systematic assessment of effects of omega-3 fats on cardiovascular health to date. Moderate- and high-quality evidence suggests that increasing EPA and DHA has little or no effect on mortality or cardiovascular health (evidence mainly from supplement trials). Previous suggestions of benefits from EPA and DHA supplements appear to spring from trials with higher risk of bias. Low-quality evidence suggests ALA may slightly reduce CVD event risk, CHD mortality and arrhythmia.

    http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD003177.pub3/full

    Τι λέτε?

  2. #2
    Junior Bodybuilder
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    Default

    Quote Originally Posted by LuNaT1C View Post
    Τι λέτε?
    Δε διαφωνώ με τα αποτελέσματα της έρευνας, αλλά λείπουν πολλές σημαντικές παράμετροι, για παράδειγμα, για τι ποσότητα συμπληρωμάτων Ω3 μιλάμε, ποιά είναι η χαμηλή και ποιά η υψηλή ποσότητα, ποιά ήταν τα υπόλοιπα χαρακτηριστικά της διατροφής, τόσο όσο αφορά τα macros, όσο - κυρίως - αφορά την ποιότητα της τροφής, τι ποσοστά λίπους και φυσικής κατάστασης είχαν οι συμμετέχοντες, τι ηλικία, κάπνιζαν ? γυμνάζονταν ? πώς παρακολουθούνταν η διατροφή τους, συμπλήρωναν απλά ερωτηματολόγιο ή τους έδιναν συγκεκρινένο μενού το οποίο ακολουθούσαν όλοι ? κλπ....

  3. #3

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    Αυτο ακριβως θελω να δω και εγω, τι ηλικιες ειχαν, και πως ηταν η ολη ζωη τους. Γιατι αν εχεις χαλια διατροφη, υπνο, δε γυμναζεσαι, κλπ, οσα ωμεγα-3 και αν παρεις δε θα γινει τιποτα.
    "Just remember that you are doing something that so few people in the world have the will power or determination to do. It takes much more than physical strength for us to build and sculpt our bodies. It takes an enormous amount of mental strength as well, and that's what people are truly jealous of. Take it as a compliment, for you stand out in a crowd full of followers."

    "You got a dream, you gotta protect it. If people can't do something themselves, they wanna tell you that you can't do it. If you want something, go get it. Period." ~ Chris Gardner

  4. #4
    Pumping Iron
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    Quote Originally Posted by Musclemar View Post
    Αυτο ακριβως θελω να δω και εγω, τι ηλικιες ειχαν, και πως ηταν η ολη ζωη τους. Γιατι αν εχεις χαλια διατροφη, υπνο, δε γυμναζεσαι, κλπ, οσα ωμεγα-3 και αν παρεις δε θα γινει τιποτα.
    Αυτά υπάρχουν στις έρευνες που διερευνησαν. Εδώ δεν είναι κλασσική έρευνα, είναι μετά ανάλυση οπότε προσπαθούν να βγάλουν γενικά συμπεράσματα εξετάζοντας πολλές έρευνες.

  5. #5
    Junior Bodybuilder
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    Quote Originally Posted by conan1982 View Post
    Αυτά υπάρχουν στις έρευνες που διερευνησαν. Εδώ δεν είναι κλασσική έρευνα, είναι μετά ανάλυση οπότε προσπαθούν να βγάλουν γενικά συμπεράσματα εξετάζοντας πολλές έρευνες.
    Το ξέρω, αλλά αυτό που λέω, είναι ότι αν δεν έχουμε περισσότερα στοιχεία για τις αρχικές έρευνες, δε μπορούμε να βγάλουμε ασφαλή συμπεράσματα.
    Από τη στιγμή που δεν υπάρχει σχεδόν καμία έρευνα στο pubmed που να μη σχετίζει τη λήψη ιχθυέλαιων με βελτίωση κάθε παραμέτρου που σχετίζεται με την υγεία, είναι πολύ δύσκολο για εμένα να πειστώ ότι η λήψη ιχθυέλαιων δεν βοηθάει σημαντικά στη καλύτερη υγεία.

 

 

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