This is post #114 on the site, about another biased, unscientific fish oil study by Brian Peskin. His review attacks fish oil as a supplement and claims that fish oil is carcinogenic, especially causing prostate cancer. Ridiculous, of course! Prostate cancer has many causes and fish oil is NOT one of them! NOTE: if you came here from another domain for Peskin and fish oil, welcome!
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I started this second Peskin debunk on October 24, 2014, shortly before another Peskin review was retracted on October 30. This new Peskin debunk is based on another of his ridiculous, unscientific studies, the SELECT study review called, SELECT Trial Results Examined: Why Fish Oil, DHA and “Oily Fish” Are Inflammatory, Leading to Increases in Prostate Cancer, Epithelial Cancers and CVD.
Like the previous Peskin review I debunked (and was eventually retracted by Hindawi, another pay-to-play publisher), this review was published by the open access, pay-to-play publisher called Scientific Research Publishing (SCIRP.org), specifically, their Food and Nutrition Sciences (FNS) journal. This review has similar content (sometimes verbatim) and citations to the previous anti-fish oil review by Peskin.
Peskin’s Hindawi anti-fish oil review was retracted on October 30, 2014 after I sent over 15 e-mail messages to Hindawi, including a link to a final, 18-page rebuttal with 75 links (Peskin’s Fish Tale a Whopper?) linked below in the Peskin history section. I include it because it offers additional background relevant to this rebuttal. Peskin’s Fish oil and 21st Century Lipids was a bogus review on many levels. And that review was submitted shortly after this was review was accepted, in September 26, 2013, explaining the similar content.
The purpose of this post is to expose the biased foundation of Peskin’s work. I’ll also expose the incompetent peer review system at FNS and SCIRP, along with their constant solicitations for me to send them money to publish my complaint (it’s clear that SCIRP is really a cash-to-publish company). It’s checkbook research!
Peskin’s reviews are all based on his bias, beliefs and business interests. Peskin uses and abuses science for its appearance and trappings, but science is not the foundation of his work. And below, you will see that SCIRP violates the COPE guidelines for ethics in research, in spite of their website claims that they follow the COPE guidelines.
In fact, Peskin is involved in several non-fish oil EFA/omega-3 formulas, book sales, speaking tours, interviews, etc., including online promotions of his business activities and patents on his formulas. He is building his career and business ventures based on his special brand of pseudo-scientific, anti-fish oil views and reviews. Here are just a few of his business-oriented sites:
http://www.brianpeskin.com/
http://www.naturalhealingtools.com/yes-efas-liquid.aspx
http://www.buzzhealth.co.uk/products/yes-peo-capusuls
http://www.naturalhealingtools.com/yes-efas-liquid.aspx
http://www.peskinpharma.com/
http://www.peo-solution.com/
Peskin’s Scientific Research/FNS journal review is titled SELECT Trial Results Examined: Why Fish Oil, DHA and “Oily Fish” Are Inflammatory, Leading to Increases in Prostate Cancer, Epithelial Cancers and CVD, and it demonstrates his infamous, pseudo-scientific approach.
Peskin piggy-backs this anti-fish oil commentary onto an anti-omega-3 study rehash of the old SELECT trial. The 2013 SELECT rehash is another biased, non-interventional, recycled study with no omega-3 fats or fish oil given, tracked or monitored, yet it claims that omega-3 fats increased prostate cancer. In other words, SELECT does not provide a scientifically credible platform to support Peskin’s claims. Rather, SELECT matches Peskin’s bias so he uses it.
The established science behind omega-3 fats, covering many hundreds of studies, does not support Peskin’s exaggerated, unfounded claims, it undermines them. And the SELECT rehash is itself riddled with bias and poor methodology; it reflects the anti-supplement bias and nutritional ignorance of its authors (see quote below). The study scapegoats omega-3 fats as a cause of high-grade prostate cancer, a claim that ignores reality, established science, and the real causes of prostate cancer.
Prostate cancer (covered in more detail below), like most cancers, a multi-factorial disease that is decades in the making, not just a few years of a study rehash where no omega-3 fats or fish oil were even used. The entire premise is unscientific, but it provides a perfect platform for Peskin’s bias, beliefs and business goals. At times, he uses fawning language in his review, like he wants the admiration of its authors.
Peskin quickly reveals his anti-fish oil stance in the first few lines of his abstract when he misstates the basis of both the SELECT and Prostate Prevention rehash studies, calling them trials and conflating poorly-done retrospective, associative studies for interventional trials:
In July 2013, using data and plasma collected in the Selenium and Vitamin E Cancer Prevention Trial (SELECT), results were shown consistent with prior results of the controversial 2011 Prostate Cancer Prevention Trial. Both trials exhibited unexpected associations: 1) Fish oil and fish oil’s DHA significantly increase prostate cancer in men; in particular, high grade prostate cancer. . .
In his rush to demonize fish oil, Peskin misstates the research designs of the 2 studies: neither was a prospective, interventional trial designed to study fish oil and any possible connections to cancer. Neither study included any fish oil or fish intake in any form.
Both studies are rehashed, retrospective exercises from different cancer drug and supplement studies that didn’t focus on fish oil at all. Additionally, there was no measuring or tracking of fish intake in any subject. Dietary intakes were also not tracked. In short, the SELECT authors have no idea of the subject’s fish or fish oil intake.
Peskin unscientifically assumes that the levels of omega-3 fats in plasma must all be from fish oil, a demonstrably false conclusion (links/info below will show why this is a highly unscientific and false).
And this passed the Scientific Research peer review? How? I’d like to know who did the peer review on Peskin’s work, and what level of competence, background and training they have. This rebuttal will expose how little credibility Peskin’s work has. Only a highly gullible person would get caught up in Peskin’s unscientific language and exaggerated claims!
The SELECT rehash was quickly debunked
When the SELECT rehash was released in mid-July, 2013, its conclusions and headlines were debunked and rebutted by many health experts, including me. The author bias was obvious right in the press release:
“We’ve shown once again that use of nutritional supplements may be harmful,” said Alan Kristal, Dr.P.H., the paper’s senior author and member of the Fred Hutch Public Health Sciences Division.
Many debunkers have observed Kristal’s quote and the anti-supplement bias it exposes in the SELECT rehash (which continues throughout the study). This associative, retrospective work is an outlier compared to other fish oil studies that show less cancer risk and lower inflammation with fish oil intake. I include many links below that show fish oil lowers inflammation it doesn’t raise it!
Compare to larger VITAL study
The VITAL study was also done by Brasky (same author involved in the SELECT rehash) with 35,000-plus subjects, the VITAL supplement and prostate cancer study was done in 2011. That extensive study showed no such associations or relationships for fish oil and increased cancer. Here is the main VITAL finding (see link below):
Multivariate-adjusted hazards ratios (HR) and 95% confidence intervals (95% CI) were estimated by Cox proportional hazards models. Any use of grapeseed supplements was associated with a 41% (HR 0.59, 95% CI: 0.40-0.86) reduced risk of total prostate cancer. There were no associations for use of chondroitin, coenzyme Q10, fish oil, garlic, ginkgo biloba, ginseng, glucosamine, or saw palmetto. . .
Of course, Peskin ignores that study and its findings. I ran a check of his SELECT review PDF file and the VITAL study is completely left out. Why? Like most other studies on fish oil, it undercuts Peskin’s bias, beliefs and business interests. He consistently omits all competing studies to further his business interests. He does this routinely, as the analysis and 80-plus links below will show.
Here is a link to that large, Brasky VITAL trial. It found no increase in cancer for fish oil with over 35,000 subjects:
http://www.ncbi.nlm.nih.gov/pubmed/21598177
My SELECT rehash history
I debunked the SELECT rehash thoroughly in 2013 after it was released during the July sweeps (to maximize media attention). Indeed, mass media hyped and exaggerated the claimed findings with their usual hysterics and theatrics: Fish oil causes cancer!
That study and media campaign still represents a real low for so-called medical research. And you will soon see that the study details expose unmistakable bias and pseudo-science in the work (more details and links below).
Even so, Peskin is in need of the few studies that fit his own unscientific, oft-proffered claims about fish oil dangers, claiming fish oil is worse than trans fats (that’s a big clue for how specious Peskin’s claims are). This SELECT rehash study offers a perfect platform for Peskin, with its biased, retrospective, associative nature, packaged in unfounded, exaggerated claims that omega-3 fats cause cancer when they clearly do not.
More bias in Peskin’s Introduction
Peskin uses the biased SELECT study, and promptly misstates the study designs. He jumps to unfounded conclusions about fish oil as the sole origin of omega-3 fats (omega-3 fats can come from veggie oils, nuts, seeds, etc., not just fish oil, something he knows because he has his own EFA supplements).
Let’s take a few sentences from Peskin’s review Introduction, where he writes the following paragraphs (citation numbers removed to avoid confusion):
Evidence is presented that the country with the highest consumption of fish oil (predictably) experiences the most prostate cancer [Australia]. Lastly, a possible explanation is presented why analysis did not show carcinogenic transfats to be causal to prostate cancer.
Prostate cancer is the most diagnosed cancer in men. The 2011 Prostate Cancer Prevention Trial demonstrated that the high concentration of serum phospholipid of long-chain metabolite, ù-3 series [omega-3] fatty acids was associated with a large increase in the risk of high-grade prostate cancer.
These paragraphs again expose Peskin’s manipulative, pseudo-scientific approach. The evidence for the quote’s first paragraph is from an article cited in his section 10.2 from the Nutraingredients site. It’s an article about the fish oil industry on a global scale. The focus is the economic impacts of Gross Domestic Product (GDP) comparisons for different countries, a focus which has no relationship to health research or cancer statistics for fish oil supplements. Peskin connects the economic report to some 2008 stats found in the World Cancer Research Fund (WCRF) archive. He makes a totally unscientific connection to make his point! Let’s dig a bit deeper.
Peskin assumes that only men use fish oil in Australia? What about all the women and children who use fish oil supplements? (Studies show more women use supplements compared to men, see links below.)
Peskin also assumes that all the fish oil in the GDP article is for supplements. But that’s also false! The full GDP article shows that a large proportion of fish oil is used for areas outside of supplements, including animal/fish food, food manufacturing and fortification, infant formulas, drugs, and other uses. These non-supplement uses account for 35-40% of that total GDP usage for fish oil, including Australia. That alone undercuts Peskin’s claim significantly. But there’s more.
Here are several links that show that women use more supplements compared to men (they are more health conscious). Women also tend to have higher levels of omega-3 fats:
http://www.ncbi.nlm.nih.gov/pubmed/24724775
http://www.ncbi.nlm.nih.gov/pubmed/15286019
http://www.ncbi.nlm.nih.gov/pubmed/23327902
Here is an important caveat from that WCRF site, explaining why prostate cancer (PC) rates seem to be rising in Westernized countries, including Australia (Note: most cancers don’t have a simple blood test to detect cancer):
Incidence rates for prostate cancer have increased in recent years. This has been largely due to the increased availability of screening for prostate-specific antigen (PSA) in men without symptoms of the disease. The test detects many prostate cancers that are small and /or would otherwise remained unrecognised and which may or may not develop further into higher stage disease. One reason for the high rate in some countries is the frequent use of PSA testing.
So Peskin’s work manipulates critical details about fish oil GDP usage (by ignoring significant uses beyond supplements) and the appearance of PC rates, just like he does throughout his reviews, because again, the details in studies and articles often undercut his pseudo-scientific positions and extreme bias.
Ironically, Peskin complains that associations are not causations right in his abstract, just a few sentences above his Introduction, which is exactly what he just did with global GDP fish oil usage and PC rates:
Pre-21st century studies mistook irrelevant associations for cause/effect relationships, disregarding known incontrovertible science. . .
Here are some links to remind people about the meaning of associations, correlations and causations (and often the resulting exaggerations like Peskin’s):
http://www.drbriffa.com/2012/08/15/note-to-medical-researchers-correlation-does-not-prove-causation/
http://scienceblogs.com/thepumphandle/2012/11/19/what-causes-disease-association-vs-causation-and-the-hill-criteria/
Peskin’s double standard is expansive and obvious: He bases his review on the biased SELECT rehash, itself a non-interventional, associative, retrospective, poorly-done analysis, based on that single blood sample from the previous SELECT trial from the early 2000s (remember, SELECT studied selenium and vitamin E, not fish oil).
SELECT cannot prove any causation between fish oil and prostate cancer because it was a non-interventional, associative, retrospective exercise in number crunching that had no connection to fish oil!
Peskin adds to his hypocrisy when he claims it’s predictable that the country that uses the most fish oil has the most prostate cancer. Peskin’s astonishing, unscientific claim demonstrates his flimsy evidence and unscientific leaps of logic, driven by his bias, beliefs and business interests: the claimed association is simply invented.
It’s also disproven by many studies that show the true risks and causes of prostate cancer (PC), and by the many studies showing fish oil has anti-inflammatory mechanisms, shown in the links below.
If you remember the quote above from the WCRF, showing the critical, but unrelated reason why prostate cancer rates seem higher in Western countries is simply more PSA testing (again, Peskin ignores that critical detail). That same page on the WCRF site showing higher rates from PSA testing, shows that Asian countries have the lowest rates of PC. But studies show that those same cultures have much higher intakes of fish and seafood than Westernized countries, with expected higher levels of omega-3 fats.
So Asians have higher rates of fish consumption/omega-3 fat levels, yet they have some of the lowest incidence and death rates from PC (only about 25% of the rate of more Western countries).
These scientific realities again undermine Peskin’s thesis and claims. And Peskin seems to have no grasp or understanding about the true, established risks and multifactorial causes of cancers, including PC.
What does the American Cancer Society (ACS) say about prostate cancer (PC)?
Here is the ACS list of the main risks for prostate cancer:
Age (65% of all prostate cancers are in men over 65 years old)
Nationality, including North American, European, Australian
Family history (especially if a first degree relative had it)
Diet (especially from red meat and dairy)
Genetics
Obesity
Smoking
Notice that fish oil and omega-3 fats are NOT listed nor would they be expected to be. They clearly don’t cause cancer and there is no mechanism that explains how or why they would, in spite of Peskin’s endlessly unfounded hype and claims. Peskin irrationally sees fish oil as the cause of many diseases, claiming it’s carcinogenic and causes cardiovascular disease, while he ignores the overwhelming scientific evidence of cancer’s multifactorial origins and decades of time. That includes the lack of immune health to destroy cellular mutations. The truth is that we all fight cancer mutations every day, unless our immune system is not working at its best.
These research links explore various dietary, lifestyle and country connections to prostate cancer development (none support Peskin’s ridiculous claims for fish oil as a cause):
http://www.ncbi.nlm.nih.gov/pubmed/20843485
http://www.ncbi.nlm.nih.gov/pubmed/24584961
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3720164/
http://www.ncbi.nlm.nih.gov/pubmed/25264293
http://www.ncbi.nlm.nih.gov/pubmed/18951003
http://zerocancer.org/learn/diet-and-lifestyle
http://www.prostate-cancer.com/location-prostate-cancer.html
http://www.cancer.gov/cancertopics/factsheet/disparities/cancer-health-disparities
http://www.hopkinsmedicine.org/news/media/releases/chronic_inflammation_linked_to_high_grade_prostate_cancer
In the second paragraph quoted from Peskin’s introduction, he clearly didn’t read the study because again there were no omega-3s, fish oil or fish used in that Cancer Prevention trial (remember, omega-3 fats can come from fish oil, or be converted from veggie oils, nuts and seeds or other sources).
And in spite of Peskin’s claim of a “case-closed” connection for high omega-3 intake for Australia and New Zealand, resulting in more prostate cancer, the study links below show that the most consumed fats in Australia are saturated fats from meat and dairy, both high-risk dietary factors for prostate cancer from the list above. Australians also have an unhealthy ratio of omega-6 to omega 3 of 9:1, with low overall intakes of omega-3 fats. These truths again undercut all of Peskin’s early claims.
http://www.ncbi.nlm.nih.gov/pubmed/17468090
http://www.ncbi.nlm.nih.gov/pubmed/12848284
The above studies and summaries expose Peskin’s unscientific, dishonest approach and exaggerated claims early in his review, a pattern which continues throughout: it permeates his work (more proof and links below). His claims are unproven and pseudo-science at their core, yet this review was published by Scientific research! How did this junk review pass a peer review?
I will include many more links below that show that fish oil lowers inflammation, it doesn’t raise it. Nor does fish oil increase peroxidation, it lowers it, again contrary to Peskin’s later review claims (many debunking links below). First, some perspective on Peskin’s history.
Peskin’s troubled history
Brian Peskin has quite a history of misrepresentations, illegal medical claims and other problems. For example, he had to sign an injunction with the state of Texas and pay a fine of $100,000 U.S. Peskin’s work is also full of serial exaggerations, heavily dosed with unproven claims and fiction. Peskin sells books, has designed alternative supplements to fish oil, and does speaking and radio interviews to peddle his wares (a simple Internet search will bring up his many business endeavors). Peskin recently had a study with similar claims that fish oil causes heart disease and cancer retracted by Hindawi.
These links offer some perspective on Peskin’s background and some previous work:
http://www.westonaprice.org/health-topics/brian-peskin-and-essential-fatty-acids/
http://www.westonaprice.org/book-reviews/the-hidden-story-of-cancer-by-brian-s-peskin-and-amid-habib/
http://www.quackwatch.com/11Ind/Peskin/injunction.html
A detailed debunking of another Peskin review (now retracted) which includes this SELECT study rehash and his CVD study also published by Scientific Research:
http://www.endsicknessnow.com/peskins-fish-tale-a-whopper
What is Research Misconduct?
Although different organizations and countries have somewhat differing standards and definitions, this one from CODEX and the Medical Research Council is a reasonable description for research misconduct (see link below quote):
Misrepresentation of the research process in another way, for example through incorrect use of methodology, dishonest inclusion or exclusion of data, deceptive analysis of data that intentionally misrepresents their interpretation, or dishonesty toward granting authorities. . .
http://www.codex.uu.se/en/etik6.shtml
Here are the COPE Retraction Guidelines (Committee on Publication Ethics) from The SCIRP website, which SCIRP claims to follow. The guidelines don’t allow for a do-over, which is how this ridiculous situation is being handled (here are some relevant points from the link below, ones that SCIRP and FNS are in violation of now):
Journal editors should consider retracting a publication if:
they have clear evidence that the findings are unreliable, either as a result of misconduct (e.g. data fabrication) or honest error (e.g. miscalculation or experimental error). . .
[and] published promptly to minimize harmful effects from misleading publications
http://publicationethics.org/files/retraction%20guidelines.pdf
SCIRP and FNS are doing neither of these, in violation of their own guidelines!
Based on debunking Peskin’s work here and elsewhere, it’s obvious he consistently manipulates, misrepresents and distorts his reviews; he consistently excludes research and data that expose his bias. Peskin omits standard reference ranges and uses weak or conflicting citations. Most of his claims are unfounded and unproven. More examples and links below.
And later, I’ll also expose the non-responsive Editorial Board members for the Food and Nutrition Sciences journal at SCIRP who helped to stonewall my complaint. Based on their lack of care or concern for research misconduct in their journal, and their lack of interest in getting at the truth, I will expose their names, universities and credentials. There needs to be more accountability in science. Now back to the science.
Debunking the original SELECT trial
In order to understand why SELECT was often panned by health experts, let’s look at the original SELECT trial to uncover the details of its bias and poor methodology. SELECT was started back in 2001 (over 10 years ago) and ran for several years. SELECT looked at synthetic Selenium (SEL) and synthetic Vitamin E (E) in high doses in a Cancer (C) prevention Trial (T) to see if they would reduce the risk of prostate cancer in high-risk male subjects (ages 50 to 70-plus), including age, a PSA up to 4 ng/ml (which is quite high), etc.
The original SELECT study has been discredited for its obvious bias and poor methodology. The recycled/rehash version continues the same biased approach and analysis.
Here are multiple links that expose the bias and poor methods in the original SELECT trial:
http://www.wellnessresources.com/health/articles/flawed_select_study_attacks_vitamin_e/
http://healthtipsfromtheprofessor.com/selenium-vitamin-e-increase-prostate-cancer-risk/
http://www.northstarnutritionals.com/articles/vitamin-e-and-prostate-cancer/
http://www.naturalnews.com/033911_vitamin_E_prostate_cancer.html
http://engineeringevil.com/2014/02/22/vitamin-e-and-selenium-raise-cancer-risk-oh-really-let-us-disect-the-research-and-the-researchers/
http://drgeo.com/vitamin-researchers-are-idiots-vitamins-are-important
http://www.nutraingredients-usa.com/Research/Vitamin-E-selenium-may-alter-genes-in-prostate-cancer-Study
The 2013 SELECT rehash analysis: the pseudo-science behind Peskin’s review
Now that you know a bit more about the original SELECT study and why it lacked credibility, let’s look at the SELECT rehash, published in July, 2013. Like its predecessor, it’s rife with problems:
It’s a misleading study based on a recycled, retrospective analysis (looking back at a different study’s data and recycling it into new, often faulty conclusions, because the original study was based on a different design with different objectives). It’s an associative and non-causative study (no cause-and-effect conclusions can be drawn), so it’s ridiculous that Peskin uses it to build on as it proved nothing useful! This was not an interventional trial with fish oil; the data had nothing to do with fish oil or fish intake. There was only a single blood test taken initially for the previous SELECT study done more than a decade ago (a blood plasma test that measures only the last few hours of fat intake that can originate from many sources, including veggie oils, nuts and seeds).
Additional Study problems:
Cancer, like HD is multi-factorial. It takes decades to materialize, with known risks of age, genetics, smoking, weight, diet, etc. Most damning is that the omega-3 levels in all the SELECT subjects were actually quite low compared to most fish oil users: the omega-fat differences between the cancer and non-cancer groups was not clinically significant (less than .025% difference).
The numbers were rehashed and exaggerated to ridiculous levels of over 71%, using Relative Risk to manipulate headlines, media coverage and the public. Critical confounders were not tracked effectively (such as diet, exercise, smoking, alcohol use, prescription drug use, weight, etc,), and the strongest associations for cancer subjects were obese subjects who were also smokers and drinkers (remember the main PC risk list above and what lifestyle factors are more likely to be the cause of cancer). See more research details below.
The SELECT rehash of those previous subjects who already had diagnosed prostate cancer had to rely on relative comparisons, not hard numbers (again, this was not a trial using fish oil so there was no ability to compare actual dosages or omega-3 source intake and cancer incidence). They could only analyze relative levels of assumed omega-3 fats from a single blood test and then create the associations to cancer. None of these subjects probably got their high grade cancer because of any fish or fish oil. It’s all assumptions built on more assumptions and the associations are unproven, weak and easily disproven.
As I observed in a previous debunking of Peskin’s lipid review on Hindawi, he selects only studies that support his bias, beliefs and business goals. He uses them very superficially, mainly focusing on their abstracts (often the initial summary of the study), while not addressing or properly analyzing the full study, including critical details, limitations, positive outcomes and relevant citations.
Peskin continues to seem like a research amateur with a checkbook ready to pay and a career to build. And again, how did Peskin’s review pass a peer review? Did the reviewer have no background in research, nutrition or cancer risks/development? Did they even do a peer review?
Data analysis from SELECT and Peskin’s review: more bias and poor science
Many expert debunkers (including doctors and PhDs, see numerous links below) have exposed key discrediting issues for the SELECT rehash, including the fact that the subjects in the rehash all had relatively low levels of omega-3 fats (not high levels), as measured by that single plasma lipid blood test at the beginning of that trial (enrollment back in 2001 to 2004). So even those who were claimed to have high omega-3 levels had relatively low levels of omega-3 fats in their plasma, again undercutting all of the SELECT rehash and Peskin’s review claims.
The blood plasma test used is an older-style test and is only measures short-term fat intake, a test that measures what was probably eaten within a few hours of the test. As there was only a single test, the associative outcome had to be grouped in relative-terms (as in, these subjects had more cancer than those subjects) because again, there was no fish oil or fish intake ever given or tracked; there were no dosages to chart over time to make more direct, credible comparisons.
Here is a quote from a Life Extension analysis, describing the problems of the short-term lipid test used and why it’s a poor basis to extrapolate any meaning from (see link below):
Remember, plasma phospholipid testing for fatty acids was used in this study. However, this type of fatty acid testing can vary widely depending upon short-term dietary intake. In contrast, long-term uptake by cells and tissues of the body is far less dependent upon short-term changes in diet. For this reason, the omega-3 RBC equivalence score is far better at evaluating cellular uptake over time as a result of fish ingestion and fish oil supplementation.
There was only one baseline blood draw. The men were followed up to six years (low-grade and high-grade cancer), with a smaller group followed up to nine years to see who would get high-grade prostate cancer. Those who developed prostate cancer were then compared against their baseline blood draw done years earlier.
This fact also undercuts the associative study and exaggerated headlines because there were no additional tests or means to assess the subject’s dietary habits and/or of fish oil/fish intake and how those might have affected their PC.
The tests should have been done several times per year at least, along with detailed dietary intakes (but remember, SELECT was never designed to use fish or fish oil so none of this was done).
Another confounding variable is that many dietary fats, including those from nuts, seeds, veggies, veggie oils, beans and animal products like eggs can be converted to omega-3 fats via the Alpha-Linolenic Acid (or ALA) conversion pathway in the body. This means that some of the claimed omega-3 fats probably came from other sources like nuts, seeds, veggie oils or dairy! They really don’t know the source of the omega-3 fats from that single test and neither does Peskin!
In fact, a low fat diet can raise omega-3 levels via conversion of ALA. But again, none of these dietary habits or food intakes were tracked, rendering the single, initial blood draw from the early 2000s as meaningless and wholly inadequate as a reliable data source over the many years of the SELECT rehash. Can you begin to see the poor science behind this SELECT rehash and why the results are misleading?
Here are some links showing some of the foods with ALA that can be converted to omega-3 fats:
http://www.prostate.net/nutrition-cancer-diet/foods-that-contain-ala/
http://www.hsph.harvard.edu/nutritionsource/omega-3/
If you wonder why the inaccuracy of one-time plasma tests can skew the SELECT rehash results, here are additional and important details from the Life Extension article linked below:
Now look how narrow the difference is between men with higher prostate cancer rates. In the group whose average baseline blood draw showed 4.48% plasma long-chain omega-3 fatty acids, there was no increased prostate cancer risk. But if the omega-3 percentage average went up to 4.66% (about 1/5 of one percent), prostate cancer rates skyrocketed, according to the report’s authors.
We’re talking here of a difference of 0.18% in the percentage of plasma omega-3 fatty acids that supposedly caused a 43% to 71% increase in prostate cancer incidence. Dedicated fish oil supplement users, on the other hand have over 100% higher omega-3 levels than seen in this study of men who apparently consumed little cold-water fish and no omega-3 supplements.
To put this into real-world perspective, the trivial difference (0.18%) in plasma omega-3 between men with no prostate cancer and those with prostate cancer could occur if a man ate just a few ounces of a cold-water fish like salmon the night before.
This quote is telling! The SELECT authors (and Peskin) want us to believe that some servings of salmon cause prostate cancer! Apply a bit of common sense to this absurd idea. Based on Peskin’s claims, a single meal of healthy fish can cause a small rise in blood plasma, and you get prostate cancer.
Now consider this quote from Dr. William Harris who similarly helped to debunk the SELECT rehash study results so embraced by Peskin (citation numbers removed to avoid confusion, see link below):
Dr. Harris cited extensive literature on fish intake and higher omega-3 fatty acid intake that demonstrated a lower incidence of prostate cancer incidence and death, better survival among men who already had prostate cancer, and a reduced risk of aggressive prostate cancer.
Furthermore, citing World Foundation of Urology data, he noted that the incidence of prostate cancer is high in North America and Northern Europe (among Caucasians and African-Americans (63 and 102 per 100,000, respectively) but low in Asia. With the Japanese intake of omega-3 fatty acids at about eight-fold that of Americans and with their blood levels twice as high, one would expect a higher risk. However, the Japanese prostate cancer rate of 22.7 per 100,000 in 2008 was dramatically lower than the U.S. rates of 83.8 per 100,000.
The Brasky article stated that the mean percentage of total omega-3 fatty acids (EPA + DPA + DHA) was 4.66% (range, 4.56%–4.75%) in cancer patients.
“These omega-3 levels,” according to Dr. Harris, “were far lower than would be expected from individuals taking omega-3 supplements.”
And here is a quote from Dr. Murray, MD, offering additional insight and perspective on this bogus work (see link below):
The study was not new but merely an elaboration of a 2011 study (SELECT) that showed, implausibly, that higher levels of omega-3 in the blood cells were associated with higher risk of prostate cancer and that more trans fats in the cells conferred protection against prostate cancer! It follows that the dietary recommendation that would logically ensue from this finding would be: stop eating fish and start eating hydrogenated margarine and Crisco to prevent prostate cancer.
Of course we know that’s not true. Harvard’s Walter Willett, one of the world’s pre-eminent nutrition researchers, once estimated that consumption of trans fats was responsible for at least 60,000 additional cancer deaths per year in the U.S. alone! Biologically, there’s no plausible reason to suspect that too much omega-3 could be cancer-causing. Mere observational studies that present no credible mechanism of action are considered low on the totem pole of academic credibility. But they don’t teach that in journalism school. . .
Additionally—and sorry, this gets a little technical—the study purports to be “case-controlled”— which means that the non-cancer group was identically matched to the cancer group with respect to all variables except omega-3 levels. This is said by trialists to provide a study with more statistical “power.” But several research experts—and they are far more sophisticated study analysts than I am—have pointed out that, curiously, the subjects in this study were not matched as to smoking status, race, weight and diabetes as well as several other important variables that affect prostate cancer risk.
And here is a quote from Dr. William Davis, MD and Cardiologist, regarding the values in the SELECT rehash, making similar observations about the weak, even misleading data (see link below):
First, the reported EPA+DHA level in the plasma phospholipids in this study was 3.62% in the no-cancer control group, 3.66% in the total cancer group, 3.67% in the low grade cancer group, and 3.74% in the high-grade group. These differences between cases and controls are very small and would have no meaning clinically as they are within the normal variation. Based on experiments in our lab, the lowest quartile would correspond to an HS-Omega-3 Index of <3.16% and the highest to an Index of >4.77%). These values are obviously low, and virtually none of the subjects was in “danger” of having an HS-Omega-3 Index of >8%. So to conclude that regular consumption of 2 oily fish meals a week or taking fish oil supplements (both of which would result in an Index above the observed range) would increase risk for prostate cancer is extrapolating beyond the data.
Do you begin to see that the very underpinnings of this SELECT trial rehash, with its stunning bias and Peskin’s add-on review are all poorly-done science? Like a house built on a weak foundation, the walls are now full of cracks and the doors don’t open! The wild claims do not pass any test of credible science, careful methodology or search for truth in research. And Peskin, with his usual sloppiness, exclusion of normal reference ranges or more replicated research embraces it!
I could add quotes from each of the numerous links below and it would be 15 pages more! So please review the following links to gather the complete picture of why so many experts debunked this bogus fish oil and prostate cancer study as biased junk and non-meaningful science.
As I said earlier, Peskin is drawn to studies like this because it’s these outliers that support his own clear and undisputed biases against fish oil. Most other studies run counter to Peskin and this SELECT rehash. Here are numerous links that debunk the SELECT rehash study Peskin relies on, including more detailed breakdowns of the data that show why the study is simply not credible:
http://www.medscape.com/viewarticle/808402
http://www.lef.org/featured-articles/2013-08_Fish-and-Prostate-Cancer-Risk-Fact-or-Fiction.htm
http://www.cureality.com/blog/post/2013/07/18/omega-3-fatty-acids-likely-not-associated-with-prostate-cancer.html
http://drhyman.com/blog/2013/07/26/can-fish-oil-cause-prostate-cancer/?utm_source=WhatCounts+Publicaster+Edition&utm_medium=email&utm_campaign=drhyman+newsletter+issue+%23135&utm_content=Get+the+story+…#close
http://doctormurray.com/how-a-selected-bad-study-became-big-news/ (click on Read more)
http://drhoffman.com/article/something-fishy-this-way-comes/
http://www.integrativecanceranswers.com/do-fish-oils-really-cause-prostate-cancer/
http://www.nutraingredients-usa.com/Research/Experts-slam-omega-3-link-to-prostate-cancer-as-overblown-scaremongering
http://www.marksdailyapple.com/fish-oil-prostate-cancer/#axzz3HCzTdjlZ
http://www.anh-usa.org/flawed-study-fish-oil-cancer/
http://www.wellnessresources.com/health/articles/fish_oil_prostate_cancer/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3828934/
http://www.crnusa.org/CRNPR13-Omega3071113.html
http://www.precisionnutrition.com/research-review-fish-oil-prostate
http://www.publicity.com/press-releases/the-truth-about-the-fish-oil-study/
http://www.nutraingredients-usa.com/Research/A-Whale-of-a-Fish-Story-for-Omega-3s
http://www.nutraingredients-usa.com/Research/Not-just-industry-slamming-omega-3-prostate-cancer-links
http://articles.mercola.com/sites/articles/archive/2013/07/31/omega-3-fats.aspx
A study comparing plasma and RBC tests for omega-3 (EPA/DHA) levels after fish and fish oil consumption (something Peskin doesn’t provide):
http://ajcn.nutrition.org/content/86/6/1621.full
These studies counter SELECT’s results and Peskin’s claims:
http://www.ncbi.nlm.nih.gov/pubmed/23613715
http://www.ncbi.nlm.nih.gov/pubmed/21310299
http://ajcn.nutrition.org/content/79/6/935.full
And here is a telling quote from the last link above (full study, citations removed to avoid confusion, broken into 2 paragraphs for easier reading):
However, there is evidence that, compared with the intake of n−6 fatty acids, the intake of n−3 fatty acids suppresses so-called free radical diseases, such as cancer, ageing, and atherosclerosis, which suggests that lipid peroxidation in vivo may not correspond with that in vitro. For instance, several studies found that increasing the dietary intakes of EPA and DHA does not increase the oxidative susceptibility of LDL cholesterol. Moreover, Takahashi et al reported that genes coding for some antioxidant enzymes (eg, glutathione transferases and manganese-superoxide dismutase) were up-regulated in mice fed a fish-oil diet, which suggests a protective effect against the production of reactive oxygen species and thus against cancer initiation.
Studies in healthy humans also showed that consumption of a diet providing >2.3 g EPA plus DHA/d decreases superoxide production. Inflammation has been hypothesized to increase the production of free radicals and reactive oxygen species, which leads to carcinogenesis. Although n−6 fatty acids augment these events through the overproduction of AA-derived proinflammatory eicosanoids, the n−3 fatty acids suppress inflammation and thus the overproduction of free radicals and carcinogenesis
Here are links to the original SELECT trial (for reference):
http://www.ncbi.nlm.nih.gov/pubmed/19066370
http://www.cancer.gov/newscenter/qa/2008/selectqa
Here is a link to the newer rehash version, based on the initial lipid plasma testing:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3735464/
That vitamin B and omega-3 retrospective trial (once again, this is not an interventional trial for cancer but one that was done for heart disease, using heart attack, stroke and chest pain as endpoints), meaning the trial was not causative for any cancers but merely associative in nature:
http://archinte.jamanetwork.com/article.aspx?articleid=1134841
Here are some debunks of the previous 2011 Brasky study (also an observational rehash of a 1990s trial) again falsely linking omega-3 levels and prostate cancer (but again, no fish oil):
http://www.marksdailyapple.com/fish-oil-prostate-cancer/#axzz3HNxnfG5A
http://www.publicity.com/press-releases/the-truth-about-the-fish-oil-study/
http://www.drfuhrman.com/library/omega3_cancer_risk.aspx
I hope this is sinking in. What is before you are multiple examples of research fraud and misconduct, tangled into a nest of ulterior motives including career, money and delusions of grandeur. But there is more to follow!
I must address a few more sample quotes in Peskin’s review, again showing his constant exaggeration and misstated research to make his biased case and support his business endeavors.
For example, in section 2.4, Peskin states the following:
In IOWA, the plant-based oils (described in section 4), overpowered all CVD confounding factors.
As shown below, the significant causal variable in SELECT was only the EPA/DHA amounts from fish oil/marine oil as measured in plasma.
The IOWA experiment was done by Peskin and was a small pilot study with 34 participants, divided into smaller groups, with NO direct comparison to fish oil. There was no credible study design, analysis or methodology outlined. It’s an extension of Peskin’s bias and beliefs, so naturally, he touts it like it’s a breakthrough. It looks more like a high school experiment.
Peskin’s IOWA experiment is also full of embarrassing self-congratulatory and boastful statements (see my previous article called Peskin’s Fish Tale a Whopper?), linked above for more details on IOWA). Basically, the 34 participants were broken down into smaller groups in his rather primitive study that mainly looked at arterial compliance in those small groups of subjects with no confounders or credible analysis included.
Like most pilot studies, it’s too small to prove anything by itself (pilot studies are often used to test a theory in a small group of human subjects), but in Peskin’s biased mind, it’s a scientific blockbuster? No credible journal would ever publish such a primitive bit of biased research (except SCIRP and FNS who allowed Peskin to include his biased IOWA experiment in his FNS/CVD review)!
Peskin goes on to claim that the causal variable in SELECT were the EPA/DHA from fish/marine oils. But as you might recall, there were no fish or marine oils used, dispensed, tested, or tracked in SELECT: There was NO causation shown; it was an associative, retrospective, non-interventional study that proved nothing!
And remember that omega-3 fatty acids can be converted from other dietary sources, including veggies, greens, veggie oils, nuts, seeds, eggs, etc. Peskin’s statement is demonstrably false. Yet this passed the Scientific Research Publishing peer review? Who did this review?
Similarly, in Peskin’s section 2.6 of his Scientific Research review, he makes the following false claim:
Furthermore, the 2013 JNCI article’s lead author (Dr. Theodore M. Brasky), in the 2013 analysis of SELECT, used two (2) blood draws in a separate prior trial, showing the same positive correlations between increased marine oil levels and increased prostate cancer cases.
Again, this claim is false, there were no interventions, intake or tracking for any marine oil, fish oil or dietary fish intake in the SELECT trial. Can you see how consistently manipulative and dishonest Peskin’s work is? Can you see how he abuses science for his personal and business endeavors? Again, how did this pass a peer review? Was anyone paying any attention during this so-called peer review done by Scientific Research staff?
Here are credible, human studies and articles that show lowered inflammation for omega-3 fats, fish and fish oil, disproving Peskin’s central claim (notice the replication):
http://www.ncbi.nlm.nih.gov/pubmed/22591892
http://www.ncbi.nlm.nih.gov/pubmed/25244229
http://www.ncbi.nlm.nih.gov/pubmed/25285409
http://www.ncbi.nlm.nih.gov/pubmed/25149823
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3575932/
http://www.ncbi.nlm.nih.gov/pubmed/25150074
http://www.ncbi.nlm.nih.gov/pubmed/25098909
http://www.ncbi.nlm.nih.gov/pubmed/25328170
http://www.ncbi.nlm.nih.gov/pubmed/16531187
http://www.ncbi.nlm.nih.gov/pubmed/22640930
http://researchnews.osu.edu/archive/omega3midage.htm
http://www.lef.org/magazine/2012/9/fish-oils-health-benefits/page-01
http://www.wellnessresources.com/health/articles/fish_oil_reduces_prostate_cancer_growth_in_humans/
These studies both counter Peskin’s IOWA Experiment:
http://www.ncbi.nlm.nih.gov/pubmed/24401211
http://www.ncbi.nlm.nih.gov/pubmed/22100606
Where are Peskin’s studies?
Given Peskin’s wild, unproven claims that fish oil is harmful, disease provoking or deadly from its quick oxidation under normal conditions (both at room temperature and in the body), I would expect him to provide numerous, replicated studies on modern fish-oil softgels from multiple manufacturers, testing the different softgels at different temperatures (such as 70, 80, or 90 degrees F or equivalent numbers in C), with different storage situations and expiration dates, showing their resulting peroxidation levels and expected, even proven harms to health.
I would also expect him to provide large, credible clinical trials in human subjects that replicate credible blood or urine tests that show significant increased levels of peroxidation and ROS from fish oil supplements, with all confounders tracked and accounted for (stress, diet, smoking, inactivity, poor sleep, age, gender, prescription drug use), as all can contribute to levels of oxidative stress, and including and all other FA intake. But where are Peskin’s studies?
Yet, Peskin provides no credible studies of fish oil softgel supplements or other replicated, credible human trials. Peskin ignores and excludes all the links I have included in this rebuttal, including many more study links in human that undercut his peroxidation claims below.
For some broader perspective, here is a link to a Pubmed search for fish oil benefits in human trials. There are 13 pages, and over 250 citations (Peskin ignores all of this vast research material because it overwhelms his false, manipulative claims):
http://www.ncbi.nlm.nih.gov/pubmed/?term=fish+oil+benefits+human+trials
Peskin’s claims, assertions and citations read more like a work of science fiction then a work of science. His review is filled with unsupported theories, claims (in spite of his claims of proof everywhere), and serial exaggeration, all loosely strung together with often irrelevant side meanderings and obtuse or contradictory citations with little credible support or details. Can you see why Peskin’s unscientific review should never have been published?
Peskin claims that fish oil becomes oxidized at room temperature and in the body but offers no real scientific proof or credible testing of that claim. The following links are to a range of human studies that actually tested fish oil peroxidation and oxidative stress in human subjects. Not only did they find no significant adverse effects or harms from fish oil/algae-based oils, many of these studies had beneficial outcomes that conflict with Peskin’s claims of harm, even at doses around 4 grams/day (Peskin claims these are overdose, even toxic amounts):
http://www.ncbi.nlm.nih.gov/pubmed/24225668
http://www.ncbi.nlm.nih.gov/pubmed/23952918
http://www.ncbi.nlm.nih.gov/pubmed/22103753
http://www.ncbi.nlm.nih.gov/pubmed/20540666
http://www.ncbi.nlm.nih.gov/pubmed/14583341
http://www.ncbi.nlm.nih.gov/pubmed/20303788
http://www.ncbi.nlm.nih.gov/pubmed/22136711 (See full study link below)
http://www.ncbi.nlm.nih.gov/pubmed/24077434
http://www.ncbi.nlm.nih.gov/pubmed/16278686
http://www.ncbi.nlm.nih.gov/pubmed/23010452
http://www.ncbi.nlm.nih.gov/pubmed/10451477
http://www.biomedcentral.com/1471-2318/13/41/abstract
Full study for above abstract #22136711:
http://journals.cambridge.org/action/displayFulltext?type=6&fid=8640341&jid=BJN&volumeId=108&issueId=02&aid=8640340&bodyId=&membershipNumber=&societyETOCSession=&fulltextType=RA&fileId=S0007114511005484
As you can see, these studies show replicated effects, and many show the opposite effects for Peskin’s claims of fish oil dangers (no dangers or harms, multiple benefits, including lower inflammation and less oxidative stress). The research is probably 10:1 or 20:1 in favor of fish oils/omega-3 fats. That’s an indication that good studies are being replicated and junk ones like Peskin relies on are not being replicated. In short, there is little support for Peskin’s claims and much that contravenes them.
Why does Peskin’s review ignore all these studies and most of the science behind omega-3 fats? (I’m sure there are more.) As I said earlier, his work reflects his bias, beliefs and business interests. His work is driven by those motivations, not science or truth. What’s more, Peskin never shows us what supplement manufacturers do to address the claims he makes, again reflecting his sweeping, blinding bias.
What fish oil manufacturers have done for a decade
I’m including this information to offer a better perspective on current (and past) industry practices. Peskin’s review does not include current or past industry practices, which also undercut his claims of oxidation. Some go back more than a decade, to the early 2000s.