Do Omega-3s Oil Your Joints?

Fish Oil And Osteoarthritis

Author: Dr. Stephen Chaney

Osteoarthritis is not just painful. It is one of the leading causes of disability in this country. And because the joint pain associated with osteoarthritis limits activity levels, it is linked to:

  • Obesity
  • The diseases associated with obesity (diabetes and heart disease).
    • Osteoarthritis increases the risk of heart disease by 50%.
  • Premature death associated with the increased prevalence of obesity, diabetes, and heart disease.
    • Osteoarthritis increases the risk of all-cause mortality by 55%.

If osteoarthritis were rare, these statistics would just be an interesting side note. But osteoarthritis is the most common form of arthritis. It affects more than 32 million Americans. And it is costly. It costs the American economy:

  • $65 billion in health care costs.
  • $17 billion in lost wages.
  • $136 billion in total costs.

Conventional therapy for osteoarthritis is treatment with anti-inflammatory drugs, but they have side effects. They may even increase the risk of premature death in some individuals.

What about natural anti-inflammatory nutrients and phytonutrients? Two that have received a lot of press in recent years are omega-3s (fish oil) and curcumin.

A recent meta-analysis (NK Senftleber et al, Nutrients, 9: 42, 2017) of 42 clinical studies on the effects of omega-3s on various types of arthritis found that:

  • There is moderate quality evidence that omega-3s reduce the pain associated with rheumatoid arthritis. Basically, this means that there is strong, but not definitive, evidence that omega-3s reduce the pain of rheumatoid arthritis. Other general conclusions with respect to rheumatoid arthritis were:
    • The best results were obtained from fish oil preparations with an EPA/DHA ratio of >1.5, suggesting that EPA is more beneficial than DHA.
    • Early studies suggested that the optimal dose of omega-3s was ≥2.6 g/day for ≥12 weeks.
  • There was low quality evidence for an effect of omega-3s on osteoarthritis. Only 5 clinical trials have been published on the topic and the results of those studies are conflicting.

The data for an effect of curcumin on osteoarthritis pain are even more limited. There is some evidence it might be beneficial, but the studies are small and are conflicting.

In this week’s issue of “Health Tips From the Professor” I discuss an exploratory study (JC Kuszewski et al, Rheumatology Advances In Practice 4: 1-9, 2020) on the effect of omega-3s and curcumin on osteoarthritis pain.

How Was The Study Done?

Clinical StudyYou are probably wondering, “What is an “exploratory study?” Let me start by providing you with a little perspective from my years of heading a cancer research laboratory at the University of North Carolina:

Clinical studies are expensive. And if you are trying to study an approach that has not already proven to be successful, the money needed to fund the study can be hard to come by. It is a “Catch 22” situation. You need to conduct an “exploratory study” to show your project is likely to succeed before the funding agency will give you money to fund your project.

But where do you get the money to fund your exploratory project? One way that investigators overcome that barrier is to use data from a previous study that was originally designed for a different purpose. The study I will describe today is an example of that approach.

The study utilized data collected from a clinical trial designed to measure the effect of omega-3s and curcumin on brain function in older adults. The study recruited 152 older adults (average age = 65) who were overweight to obese (average BMI = 31) and sedentary (˂55 min/week of physical activity) from New South Wales, New Australia.

The participants were randomly divided into 4 groups:

  • Placebo group. [Note: The fish oil placebo contained 20 mg of fish oil so it would match the odor of the fish oil supplement, and the curcumin placebo contained yellow food dye so it would match the color of the curcumin supplement.]
  • Fish oil group (2,000 mg DHA & 400 mg EPA per day).
  • Curcumin group (160 mg/day curcumin).
  • Fish oil + curcumin group.

Participants were followed for 16 weeks. At the beginning and end of the study participants filled out questionnaires assessing (among other things):

  • The severity of their chronic osteoarthritis pain.
  • Disabilities caused by osteoarthritis in the participant’s daily life (physical distress, sleep disturbances, psychological distress, loss of productivity, physical limitations, physical deconditioning due to reduction in physical activity, and financial hardship).
  • Their physical and mental wellbeing during the past 4 weeks.
  • Their mood during the past 7 days.

Do Omega-3s Oil Your Joints?

fish and fish oilThe results were as follows:

  • Omega-3 supplementation reduced chronic osteoarthritis pain by 42%.
  • Omega-3 supplementation reduced disability associated with osteoarthritis by 40%.
    • The reduction in pain and disability in participants supplemented with fish oil was greatest in those who reported the highest pain/disability at the beginning of the study.
    • The reduction in pain was associated with an improved perception of physical and mental wellbeing.
    • The reduction in pain was also associated with a decrease in depression and other mood disturbances.
  • Curcumin did not affect pain or osteoarthritis burden either alone or paired with omega-3s.

The authors concluded, “Our findings indicate potential for fish oil supplementation to reduce mild osteoarthritis pain and burden in sedentary overweight/obese older adults…,which was associated with improved wellbeing.”

What Are The Pros And Cons Of This Study?

pros and consPros:

The results for the effects of omega-3s on osteoarthritis were highly significant. In addition, the questionnaires used were well designed to capture the intensity and location of pain, mood, and feelings of wellbeing.

Cons:

This was an exploratory study using data collected from a study designed to measure the effect of omega-3s and curcumin on brain health in older adults. It was not ideally designed to measure the effect of omega-3s and curcumin on osteoarthritis.

If the original study had been intended for investigating the effect of these supplements on osteoarthritis, it would have been designed differently:

  • Participants would have been recruited into the study based on the presence and intensity of osteoarthritis pain.
  • The diagnosis of osteoarthritis would have been confirmed by X-rays.
  • Participants would have been admitted into the study only if they had moderate to severe osteoarthritis pain. Most of the participants in this study had only mild osteoarthritis pain. That may have limited the ability of this study to find an effect of curcumin on osteoarthritis pain.
  • The design of the omega-3 supplement would have been different.
    • Because the original study was designed to determine the effect of omega-3s on brain health, the omega-3 supplement chosen had more DHA than EPA.
    • Had the study been designed to determine the effect on omega-3s on an inflammatory disease like osteoarthritis, the omega-3 supplement would have had more EPA than DHA.
  • The curcumin supplement was also not ideally designed for this study. The curcumin supplement used in this study contained only 160 mg of curcumin and contained no other ingredients. Well-designed curcumin supplements usually contain around 500 mg curcumin standardized to 95% curcuminoids plus piperine to enhance the absorption of the curcumin.

In the words of the authors, “Further studies are warranted to evaluate the benefits of fish oil, alone or as an adjunct to pharmacotherapy, in patients diagnosed with osteoarthritis who suffer moderate-to-severe pain…” In other words, they now intend to use the data from this exploratory study to apply for funds to conduct a larger study specifically designed to measure the effects of omega-3s on osteoarthritis pain.

The study limitations described above, severely restricted the ability of the study to detect any beneficial effect of curcumin on osteoarthritis pain. The effect of curcumin on osteoarthritis pain is probably less than the effect of omega-3s, but it would be premature to conclude that it has no benefit. However, they obtained no data from their “exploratory study” to justify a follow-up study on the effect of curcumin on osteoarthritis pain.

Fish Oil And Osteoarthritis

omega-3 fish oil supplementThis study suggests that 2.4 grams/day of omega-3s may be equally effective at reducing osteoarthritis pain and the effects that osteoarthritis pain has on both physical health and psychological health. However, because this study has several limitations, the evidence cannot be considered definite.

If you have either rheumatoid or osteoarthritis, I recommend trying omega-3 supplementation. Based on the studies described above, you might want to aim for 2-3 g/day of omega-3s with an EPA/DHA ration of 1.5 or greater.

As with any natural approach, this will work better for some people that for others. However, don’t forget that omega-3s are also important for heart health, healthy blood pressure, brain health, and a healthy pregnancy (https://www.chaneyhealth.com/healthtips/omega-3s-during-pregnancy-are-healthy/). If they also happen to reduce your arthritis pain, that is an extra benefit.

As usual, I recommend a holistic approach. You should also:

  • Keep active.
  • Aim for a healthy weight.
  • Add antioxidant and polyphenol supplements.

These lifestyle changes should allow you to reduce or eliminate any pain medication you may be taking.

Finally, if you are on blood thinners, consult with your physician before adding omega-3 supplements to your diet. My preference is to incorporate omega-3s and reduce other medications, but that is a discussion you need to have with your doctor.

The Bottom Line

A recent meta-analysis has concluded there is moderate quality evidence that omega-3s reduce the pain associated with rheumatoid arthritis. Basically, this means that there is strong, but not definitive, evidence that omega-3s reduce the pain of rheumatoid arthritis. Other general conclusions with respect to rheumatoid arthritis were:

  • The best results were obtained from fish oil preparations with an EPA/DHA ratio of >1.5, suggesting that EPA is more beneficial than DHA.
  • Earlier studies suggested that the optimal dose of omega-3s was ≥2.6 g/day for ≥12 weeks.

However, there have been few studies on the effect of omega-3s on osteoarthritis. A new exploratory study looked at the effect of 2.4 g/day of omega-3s for 16 weeks on the pain and disability associated with osteoarthritis. It found:

  • Omega-3 supplementation reduced chronic osteoarthritis pain by 42%.
  • Omega-3 supplementation reduced disability associated with osteoarthritis by 40%.
    • The reduction in pain and disability in participants supplemented with fish oil was greatest in those who reported the highest pain/disability at the beginning of the study.
    • The reduction in pain was associated with an improved perception of physical and mental wellbeing.
    • The reduction in pain was also associated with a decrease in depression and other mood disturbances.

The authors concluded, “Our findings indicate potential for fish oil supplementation to reduce mild osteoarthritis pain and burden in sedentary overweight/obese older adults. Further studies are warranted to evaluate the benefits of fish oil, alone or as an adjunct to pharmacotherapy, in patients diagnosed with osteoarthritis who suffer moderate-to-severe pain…”

If you have either rheumatoid or osteoarthritis, I recommend trying omega-3 supplementation. Based on the studies described above, you might want to aim for 2-3 g/day of omega-3s with an EPA/DHA ration of 1.5 or greater.

As with any natural approach, this will work better for some people that for others. However, don’t forget that omega-3s are also important for heart health, healthy blood pressure, brain health, and a healthy pregnancy. If they also happen to reduce your arthritis pain, that is an extra benefit.

As usual, I recommend a holistic approach. You should also:

  • Follow an anti-inflammatory diet.
  • Keep active.
  • Aim for a healthy weight.
  • Add antioxidant and polyphenol supplements.

These lifestyle changes should allow you to reduce or eliminate any pain medication you may be taking.

Finally, if you are on blood thinners, consult with your physician before adding omega-3 supplements to your diet. My preference is to incorporate omega-3s and reduce other medications, but that is a discussion you need to have with your doctor.

For more details read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

It’s Buyer Beware In The Food And Supplement Industries

How Can You Identify High Quality Products?

When it comes to the food and supplement industries a paraphrase of the famous introduction to “A Tale Of Two Cities” comes to mind; “It is the best of worlds, it is the worst of worlds.”

There are companies who value your health more than their bottom line. They insist on the highest quality ingredients, verify the purity of their ingredients, and run extensive quality controls on their final product. It’s an expensive process, but you are worth it.

I wish I could tell you that all companies cared enough about your health to produce products that are pure and potent. Unfortunately, I cannot.

Some products don’t contain the amount of active ingredient claimed on the label. Some products contain potentially toxic contaminants. These errors are usually due to poor manufacturing processes and/or lack of proper quality controls.

Even worse, some products are adulterated. That means the manufacturer substituted a cheaper ingredient for the active ingredient. That cannot be accidental. Adulteration is a willful act to deceive the consumer.

I also wish I could tell you the USDA and the FDA are protecting you by making sure food and supplement products are pure and potent. Unfortunately, I cannot.

It’s not that they aren’t trying. They are simply overwhelmed.

  • There are hundreds of charlatans in the marketplace.
  • It often takes 2 to 5 years of litigation to put bad actors out of business.
  • And, as soon as they put one out of business, another one pops up. It’s like that “Whack A Mole” game at the county fair.

Normally, I see reports of poor quality products every few months. But when five product horror stories crossed my desk in a few weeks, it is time to speak up. This week I will share reports on quality control and adulteration issues with:

  • Turmeric supplements.
  • Lavender essential oils.
  • Bitter orange supplements.
  • Avocado oil.
  • CBD products.

Adulteration Of Turmeric Supplements

Turmeric supplements are “hot” right now. Their sales have almost doubled in the last couple of years. Whenever a product becomes this popular, unscrupulous manufacturers are tempted to jump into the market. Looking to make a quick buck they substitute inactive, less expensive ingredients for the active ingredients – a process called “adulteration”.

To better understand how turmeric supplements are adulterated, let’s look at how turmeric supplements are made. The active ingredients in turmeric supplements are a class of compounds called curcuminoids that come from the root of the Curcuma longa plant.

1) The simplest way to create a turmeric supplement is to simply grind the root into a powder and put the resulting turmeric powder into a capsule or tablet.

    • However, turmeric powder is often adulterated by substituting the less expensive Curcuma zeodoria root (from wild turmeric) for the Curcuma longa

2) The more potent turmeric supplements extract the active curcuminoids from turmeric powder.

    • However, turmeric extracts are often adulterated by substituting synthetic curcumin for the natural extract.

Fortunately, the American Botanical Council has created a program called Botanical Adulterants Prevention Program (BAPP) to identify bad players in the botanicals (meaning anything coming from plants) market. In a recent bulletin on turmeric adulteration, they reported:

  • In one test of turmeric powder, all the samples tested had more Curcuma zeodoria powder than Curcuma longa
  • In another test of turmeric powder, 4 out of 6 samples were adulterated with Curcuma zeodoria
  • In a test of turmeric extracts, 4 out of 5 samples were adulterated with synthetic curcumin.

Is Curcuma zeodoria powder as safe and effective as Curcuma longa powder? Nobody knows.

  • Curcuma zeodoria root has a different mix of curcuminoids than Curcuma longa root, and some concerns have been raised about the safety of Curcuma zeodoria

Is synthetic curcumin as safe and effective as natural turmeric extract? Nobody knows.

  • The FDA views synthetic versions of natural botanical compounds as different from the botanical itself, Thus, if a supplier correctly identified their extract as containing synthetic curcumin, they would be required to file an NDI notification with FDA, including proof of safety, for products containing their extract to be legally sold in the US.
  • The use of synthetic curcumin may replace the other curcuminoids found in natural turmeric extracts. In other words, you would not be getting the full spectrum of curcuminoids you would find in a natural extract standardized to 95% curcuminoids.

Note: The American Botanical Council Bulletin did not address turmeric products that are available on the marketplace. They reported on the major suppliers of the raw materials that manufacturers purchase to make their turmeric products. This has two important implications for consumers like you and me:

  • Many companies base their label claims on the specifications provided by the supplier of their raw ingredients. However, unless they run independent quality control tests on the raw ingredients, they actually have no idea what is in their product.
  • That means when comparing turmeric products, we should not rely on label claims or price alone. We should ask about the company’s quality control process, particularly whether they run independent quality control tests on the ingredients they use.

Adulteration Of Lavender Essential Oil

Lavender oil has been around for hundreds of years. It has long been prized for its calming effect. It has traditionally been used in aromatherapy for relief of stress, anxiety, depression, and to improve sleep.

With the recent “essential oil” craze, it has been reclassified as an essential oil with an impressive list of additional “benefits” – such as relieving headaches, getting rid of acne and eczema, reducing menstrual cramps, and reducing inflammation to name a few.

As you might expect, the market for lavender essential oil is exploding. It is expected to almost double between 2016 and 2024.

However, lavender oil is hard to come by. The lavender flowers are steamed to release the volatile components, and the oil is then distilled. Only a tiny fraction of the lavender plant ends up in the final product. You might suspect that manufacturers would be tempted to cut corners. You would be correct.

Once again, the American Botanical Council’s Botanical Adulterants Prevention Program (BAPP) comes to the rescue. Recently BAPP tested lavender essential oils in the marketplace. Their newly-released bulletin reported that 82% of lavender products on the market were adulterated.

  • Some of the adulterated products used oils from related plant species.
  • Some products used oils from unrelated plant species like rosemary.
  • Other products used synthetic oils.

All the adulterated products used oils that were less expensive than genuine lavender oil. To the untrained consumer the adulterated products may smell like lavender oil, but there is no evidence that the oils substituted for lavender oil have the same benefits as lavender oil.

This is not simply a quality control issue. It was not accidental. You don’t start with plant species other than lavender and expect to end up with lavender oil. And you really don’t start with synthetic oils and expect to end up with natural lavender oil. This is deception, pure and simple.

Poor Quality Control Of Bitter Orange Supplements

Bitter orange is another name for the Seville Oranges you may have seen in your local market. Unripe Seville Oranges are quite bitter, and this is the form used in supplements.

Traditionally, bitter oranges have been used as a digestive aide. More recently, some unscrupulous manufacturers have advertised bitter orange as a fat burning supplement and have marketed it as a sports nutrition and weight management supplement.

Any supplement marketed as “fat burning” attracts a lot of attention. Once again, sales have skyrocketed, and manufacturers have been tempted to cut corners. This attracted the attention of the USDA, who recently published a study assessing the quality of supplements containing bitter orange.

The USDA purchased 59 products available in the US that either contained bitter orange as the primary ingredient or as one of the major ingredients in a proprietary formula. They tested these products using state-of-the-art analytical techniques. What they found wasn’t pretty.

  • Only 5 of the products had the amount of active ingredient claimed on the label. This could be a quality control issue, but it is not reassuring to you, the consumer.
  • Some of the products had higher amounts of minor compounds found in the bitter orange than they did of the active ingredient. It is hard to imagine how this occurred unless those manufacturers used what was left over after other companies had extracted the active ingredient. And there is no research on the effects of these minor compounds in humans.
  • 7 of the products had synthetic ingredients that had never seen a bitter orange. Once again, there is no evidence these compounds are either safe or effective.

Poor Quality & Adulterated Avocado Oil

Avocado

Avocados are in. They are prized as a source of antioxidants and healthy monounsaturated fats. Avocado oil has all the benefits of raw avocados, plus it has an extremely high smoke point, making it ideal for high temperature cooking.

It’s no wonder that sales of avocado oil have soared by 52% in the last couple of years alone. Once again, there will be manufacturers who are tempted to cut corners.

Fortunately, scientist at University of California, Davis recently published a study on the quality of avocado oil. Unfortunately, they found that most of the avocado oil sold in the US was oxidized, mislabeled, or misbranded.

The scientists purchased 14 brands of avocado oil from local markets and purchased an additional 8 brands online. Here is what they found:

  • 82% of the 22 brands they tested were either oxidized or mixed with other oils. Specifically:
    • 15 of the brands were oxidized, which compromises both the taste and the health benefits of avocado oil.
    • 6 of the brands were adulterated with cheaper oils, including sunflower, safflower, and soybean oil.
    • 3 of the brands contained little or no avocado oil. They were mixtures of other oils. This is even worse than simple adulteration. These products should not have even been labeled as avocado oil.
      • Interestingly, 2 of the 3 brands with no avocado oil were labeled “extra virgin” avocado oil, which is supposed to indicate the highest quality oil. Did I mention “buyer beware”?

CBD Horror Stories

I don’t need to tell you that the CBD industry has taken off in recent years. Most of the claims for CBD products are unproven, but that is another story for another time.

Even more worrisome are quality control issues for CBD products. In fact, it is so worrisome that congress asked the FDA to study quality controls in the CBD industry and report back to them, which they did last month.

Let me start with a little history. Congress has asked the FDA to set safety, efficacy (product claims), and quality standards for CBD products.

1) The FDA is farthest along with product claims. They have rejected most product claims for CBD products and have initiated legal actions against several companies that have refused to stop making these product claims.

2) With respect to safety they have specified that CBD products should contain less than 0.3% THC (marihuana) but have not yet completed safety studies on other CBD ingredients.

3) With respect to quality controls, they have started by surveying the quality of CBD products currently available in the US. They tested 147 products, and the results weren’t pretty. As described in their report to congress:

    • 9 CBD products contained no CBD.
    • 18 products were less potent than advertised. They contained less than 80% of the amount claimed on the label.
    • 38 products were more potent than advertised. They contained more than 120% of the amount claimed on the label.
    • 72 products (49% of the total) contained impermissible levels of THC.

How Can You Identify High Quality Products?

As I said in my book “Slaying The Supplement Myths” there are ethical supplement companies that care about your wellbeing and produce high quality products. However, there is also a dark underbelly of the food and supplement industries.

In the article above I have shared examples of products that:

  • Contained little or no active ingredient.
  • Contain less or more of the active ingredient than claimed on the label.
  • Contain potentially harmful contaminants.
  • Are adulterated by substituting cheaper ingredients which may not be effective for the active ingredient.

At this point you are probably asking, “How do I protect myself? How do I make sure that I am not wasting my money and jeopardizing my health when I buy a supplement? I cover the answer to this question in my book, “Slaying The Supplement Myths“. Here is a shortened version:

  • Ignore the slick marketing.
  • Don’t base your decision on price alone. That can be a trap.
  • Do your research. Ask questions. Only choose reputable companies that do quality
    controls on both the raw ingredients and the finished product.

The problem, of course, is that every company claims to run stringent quality control tests. My
suggestion is to ask them about their quality control process. Here are the questions to ask (you will find more in my book):

1) Do you run tests to confirm the purity of your raw ingredients, or do you accept the claims of your suppliers?

2) How many quality control tests do you run on your final product? If it is a single nutrient product, the number should be in the dozens. If it is a multivitamin, the number should be in the hundreds. For more complex products, you should expect a thousand or more quality control tests.

3) Do you run quality controls on every batch…or, put another way…How many quality controls do you run each year? Those should run into the tens of thousands.

4) What kind of analytic methods do you use?

These are tough questions, but they are the right questions to ask before you pick a supplement company. After all, you are entrusting your health to their products.

The Bottom Line

There are ethical food and supplement companies that care about your wellbeing and produce high quality products. However, there is also a dark underbelly of both the food and supplement industries.

In the article above I have shared examples of products that:

  • Contained little or no active ingredient.
  • Contain less or more of the active ingredient than claimed on the label.
  • Contain potentially harmful contaminants.
  • Are adulterated by substituting cheaper, less effective ingredients for the active ingredient.

I shared reports of quality control and adulteration horror stories with:

  • Turmeric supplements.
  • Lavender essential oils.
  • Bitter orange supplements.
  • Avocado oil.
  • CBD products.

I also shared how to find companies that make high quality products you can trust.

For more details, read the article above.

To find which supplements I recommend, click here.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

 

Are Curcumin Benefits Bogus?

How Research Scientists Can Be Fooled

Author: Dr. Stephen Chaney

 

curcumin benefits tumericAre curcumin benefits bogus?

Curcumin is considered the active ingredient of turmeric, which has been used as a traditional medicine on the Indian subcontinent for thousands of years.

I don’t need to tell you that curcumin and turmeric are hot right now. If you read the blogs and Facebook posts, you are led to believe that curcumin and/or turmeric will reduce inflammation; cure cancer and Alzheimer’s Disease; treat erectile disfunction, baldness, and hangovers; and even boost fertility. I haven’t come across any claims they will help you leap tall buildings with a single bound, but maybe I missed that Facebook post.

Where there is smoke, there is bound to be fire. There are dozens of curcumin and turmeric supplements and oils on the market. The companies selling them tell you their claims are based on published scientific studies. But, what if curcumin/turmeric research is bogus? What if the claims are false? What if the products don’t work?

 

How Supplement Companies Mislead You

curcumin benefits misleadingEveryone claims that their products are backed by research studies proving they work, but many of those claims ring hollow. In past issues of “Health Tips From the Professor” I have shared the many ways in which supplement companies try to mislead you with bogus research claims. For example:

  • Some claims of “proof” are completely bogus. They are made up.
  • Some claims are based are what those in the supplement industry call “white papers.”  Simply put, those are impressive looking studies appearing on their website or appearing in their ads that have never been peer-reviewed and published. If they have not gone through peer review and been accepted for publication, you have no idea whether they are valid or not.
  • Some claims are based on what I call “borrowed science.”  Simply put, the company is simply quoting research done on ingredients in their product, not research done on their product. They have no evidence that their product works.
  • Some claims are based on studies published in what I call “advertising journals.”  Simply put, an advertising journal does not submit the studies for peer review. If you are willing to pay their fee, they will publish your study. No questions asked! Again, without peer review you have no idea whether the study is valid.

I have advised you to look for studies done by reputable scientists and published in peer-reviewed scientific journals. In most cases, this is sufficient. But, what if even reputable scientists can be fooled? What if they misinterpreted the experiments they published?

 

How Research Scientists Can Be Fooled About Curcumin Benefits

curcumin benefits researchIt turns out that natural compounds like curcumin are very difficult to work with. They can be deceptive. The claims about the benefits of curcumin and turmeric are a perfect example of how even reputable scientists can be fooled into reporting misleading information. This was highlighted in a recent review, (K.M. Nelson et al, Journal of Medicinal Chemistry, 60: 1620-1637, 2017 ), of hundreds of scientific papers on curcumin.

Curcumin has recently been categorized by medicinal chemists as a natural compound that fits into both the PAINS and IMPS classifications. Before you say: “What are you talking about,” let me sort that statement out for you.  Medicinal chemists specialize in studying the chemical and pharmacological properties of natural compounds and their derivatives. Basically, they start with a natural compound like curcumin and determine whether it might be useful as a drug or a supplement.

PAINS is an acronym for pan-assay interference compounds. In simple terms, this means the compound is a pain to work with (Who says scientists don’t have a sense of humor?) because it interferes with most of the assays used to determine whether it is beneficial or toxic. In the case of curcumin, it binds to proteins, chelates metals, and interferes with fluorescent assays. It causes protein aggregation, membrane disruption, and structural decomposition of cells.

Basically, the authors of the review are saying that most reports of curcumin benefits are based on assays that were inaccurate because the scientist conducting the studies were unaware that curcumin interfered with the assays they were using. They were fooled because they did not fully understand the compound they were working with. They did not know it was a PAINS. Since 2009, at least 15 articles on curcumin have been retracted and dozens have been revised after publication.

The authors said: “While these failures would normally end further research on its use as a therapeutic, they have apparently not deterred researchers [and I would add companies] interested in its development.” Over 100 clinical studies and millions of research dollars have been invested in testing the beneficial effects of curcumin in humans. However, in the words of the authors: ”To our knowledge, curcumin has not been shown to be conclusively effective in a randomized placebo-controlled trial for any indication.”

That has led to its second classification as an IMP (invalid metabolic panacea). Again, you have to love the sense of humor of the scientists who came up with these acronyms.

 

Are Curcumin Benefits Bogus?

 

curcumin benefits misinformationAccording to this review, you can forget about the curcumin benefits you have been hearing about. It turns out that many of the research studies on which those claims have been based are misleading. The scientists who published the study were ethical. They did their best. They simply did not understand that curcumin was a PAINS to work with (pun intended).

Let me very briefly walk you through what the reviewers said about curcumin research.

 

  • In vitro and cell culture experiments produced misleading results because curcumin interferes with the assays used to gauge its biological activity.
  • Publication of these results led to a deluge of blogs and Facebook posts proclaiming the benefits of curcumin. These were repeated so often people started to believe they must be true. Another nutrition myth was born.
  • Unscrupulous manufacturers sensed money to be made. Soon a flood of supplements and oils containing curcumin or turmeric hit the market. Manufacturers claimed their products had miraculous benefits based on the published research (much of which was incorrect).
  • Meanwhile scientists started to meticulously evaluate the probability that curcumin might be a good drug or supplement candidate by looking at its bioavailability and stability. The results of those experiments were not promising.
  • Less than 1% of curcumin is absorbed into the bloodstream. The rest is excreted into the feces, and there is no evidence that it has any beneficial effects on gut microflora.
  • Once it enters the bloodstream, it has a half-life of less than 5 minutes.
  • The breakdown products of curcumin are also unstable and/or have low biological activity.
  • These results should have been enough to halt further interest in curcumin research. However, by that point the claims for curcumin benefits (based in misleading in vitro experiments) had taken on a life of their own. More than 120 clinical trials of curcumin have been conducted at a cost of over 150 million dollars.
  • No double-blinded, placebo controlled clinical trial of curcumin has been successful.

The authors concluded: “Unfortunately, no form of curcumin, or its closely related analogs, appears to posses the properties required for a good drug candidate…The in vitro interference properties of curcumin do, however, offer many traps that can trick unprepared researchers into misinterpreting the results of their investigations. With respect to curcumin/cucuminoids and in vitro studies and clinical trials, we believe there is rather ‘much ado about nothing’.”

The curcumin saga is a cautionary tale. The internet abounds with amazing claims about the benefits of other herbs and spices. Many of the active ingredients of those herbs and spices are also PAINS compounds that interfere with the very biological assays used to assess their benefits. My advice is to take the claims about the miraculous benefits of herbs and spices with “a grain of salt.”  In fact, the most beneficial effect of those herbs and spices is probably the salt they replace in the foods you eat.

 

The Bottom Line

 

Curcumin and turmeric are “hot” right now. The internet is filled with claims about their amazing benefits. There is a flood of supplements and oils containing curcumin or turmeric on the market.

However, a recent review of curcumin has thrown cold water on its supposed benefits. According to the review:

  • Most of the benefit claims for curcumin are based on in vitro and cell culture assays. It turns out that curcumin interferes with these assays giving misleading results. In the words of the authors of the review: “The in vitro interference properties of curcumin offer many traps that can trick unprepared researchers into misinterpreting the results of their investigations.”
  • Curcumin is a very unlikely candidate for a beneficial drug or supplement because:
    • Less than 1% of curcumin is absorbed into the bloodstream. The rest is excreted into the feces, and there is no evidence that it has any beneficial effects on gut microflora.
    • Once it enters the bloodstream, it has a half-life of less than 5 minutes.
    • The breakdown products of curcumin are also unstable and/or have low biological activity.
  • Curcumin has not been shown to be conclusively effective in a randomized placebo-controlled trial for any indication.
  • The reviewers concluded: “With respect to curcumin/cucuminoids and in vitro studies and clinical trials, we believe there is rather ‘much ado about nothing’.”

The curcumin saga is a cautionary tale. The internet abounds with amazing claims about the benefits of other herbs and spices. Many of the active ingredients of those herbs and spices are also compounds that interfere with the very biological assays used to assess their benefits. My advice is to take the claims about the miraculous benefits of herbs and spices with “a grain of salt.”  In fact, the most beneficial effect of those herbs and spices is probably the salt they replace in the foods you eat.

For more details about why the “benefit” of curcumin are likely bogus, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Health Tips From The Professor