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Eating fish up to two to three times per week appears to have a beneficial effect both for healthy people and for those at risk of cardiovascular disease. Dietary fish oils have been shown equally as effective.

Controlled-intervention trials have proven that dietary fish oils favourably modify various risk factors for heart disease, independent of their ability to lower blood cholesterol. Dietary supplementation with omega-3 fish oil capsules has shown the potential to reduce both the progression of cardiovascular disease and related mortality, including sudden cardiac death.

Omega-3 Scours Out Arteries

Cold-water fish contains omega-3 polyunsaturated fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), which accumulate in various sites, including blood platelets and the heart. This fatty acid accumulation in platelets decreases platelet stickiness and reduces the build-up that can eventually lead to heart disease or heart failure.

EPA and DHA also have the ability to reduce circulating levels of blood triglycerides. This is a significant finding, as high levels of triglycerides are associated with a heightened risk of heart disease. One study showed an approximate six- to eight-per-cent reduction of blood triglyceride levels with each gram of EPA and DHA in as little as two to three weeks. Another double-blind placebo-controlled trial using four grams of EPA and DHA demonstrated a 26-per-cent reduction in triglyceride levels in postmenopausal women in as little as 28 days.

Proven Effective

Since 1980, we have known that disease patterns for the Greenland Inuit, when compared with those for the population of Denmark, exhibit a significantly lower rate of death from acute heart attack despite only moderate differences in blood cholesterol levels. The high-fat traditional Inuit diet provides several grams of omega-3 fatty acids (EPA and DHA) daily in the form of marine mammals, wildfowl, and various fish.

The higher fish intakes of the Japanese population relative to that of North America have also been associated with considerably lower rates of heart disease and hardening of the arteries, even though blood cholesterol levels in the Japanese population are only moderately lower.

Consumption of these fatty acids can also reduce deaths related to cardiac disease, particularly sudden cardiac death, because intakes of EPA and DHA at about four g per day have potential to calm irregular heartbeat. Since low heart rate variability is used to predict increased risk of heart disease, it is also interesting to consider that heart rate variability in heart attack survivors may be increased with adequate EPA and DHA.

A European study reported in 1999 looked at the effect of EPA and DHA on coronary atherosclerosis—hardening and narrowing of the coronary arteries. It determined that patients with cardiovascular disease who were given 1.5 g per day over a two-year period had moderately less progression and more discernible regression of coronary artery disease than patients on a placebo. As well, fewer clinical heart attacks and strokes were present in the omega-3 group.

Some Potential to Reduce Cancer

Epidemiological data from the Multiple Risk Factor Intervention Trial in the United States has indicated that progressively higher intakes of fish-derived omega-3 fatty acids (up to about 665 mg per day) over 10.5 years, in addition to progressively reducing death related to heart disease and total overall death, showed no associated increase in death from cancer.

A recent review of the existing evidence indicated that an increase in the consumption of fish may also contribute to lower colorectal cancer and breast cancer risks. However, avoiding fried or processed fish containing partially hydrogenated fats (trans-fatty acids) and salted or pickled fish is important to attain these positive results.

Kippers for Breakfast?

Most North Americans eat about one fish serving every 10 days, which means their combined EPA and DHA intake approaches 130 mg per day, markedly lower than Japanese intakes and only a small fraction of the amount Greenland Inuit consume. Fish consumed two and one-half to three times per week would provide a combined intake of about 500 mg EPA and DHA per day, which is about four times current North American consumption rates.

A US National Institutes of Health workshop held in 1999 recommended a combined average EPA and DHA intake of 650 mg per day for healthy adults. More recently, the American Heart Association has released guidelines that recommend we eat one fatty fish meal or take a fish-oil supplement each day.

Grandma was right about cod liver oil. Omega-3 supplements offer alternative as well as complementary options and strategies for cardiovascular care.

Adapted from Canadian Medical Association Journal, March 2002. Lisa Petty, RHN, is a holistic nutritionist who specializes in teaching and writing about anti-aging strategies as they relate to serious health issues. She is currently working on book that illustrates the connection between feeling great and looking fabulous.

Source: alive #256, February 2004