Fish and omega 3s: sometimes more is more
By now most of us are aware of the benefit of including omega-3 fatty acid-rich fish in our diets once or twice per week to help protect against cardiovascular and other disease. Now the findings of a study published in the January 17, 2006 issue of Circulation, the journal of the American Heart Association, show that consuming more fish and, consequently, more omega-3s, leads to an even greater reduction in the risk of coronary heart disease.
Researchers in Japan followed 41,578 men and women aged 40 to 59 who did not have cardiovascular disease or cancer upon enrollment, from 1990-1992 to 2001. Food frequency questionnaires completed at the beginning of the study and in 1995 provided information on weekly fish intake, which was analyzed for omega-3 content.
Over the follow-up period there were 196 nonfatal and 62 fatal coronary events. When individuals whose fish consumption was in the top one-fifth of participants at eight times per week were compared with those whose intake was in the lowest fifth at once per week, they were found to have a 37 percent lower risk of incident coronary heart disease and a 56 percent lower risk of heart attack. The risk reduction was mainly found for nonfatal coronary events.
When the effect of omega-3 fatty acid intake on cardiovascular risk was analyzed, coronary heart disease risk was lowered by 42 percent among those whose intake was the highest at 2.1 grams per day or more compared to those whose intake was the lowest at 300 milligrams per day. There was a 65 percent reduction in the risk of heart attack among those whose intake was in the top fifth compared to those whose intake was lowest. Nonfatal coronary events were similarly reduced.
In their discussion of the protective mechanism of omega-3 fatty acids in atherosclerosis, the authors explain that they reduce platelet aggregation, as well as decrease the production of leukotrienes which reduces the proliferation of endothelial cells.
“High consumption of fish was associated with reduced risk of coronary heart disease, more specifically, myocardial infarction and nonfatal coronary heart disease, compared with a modest fish consumption,” the authors conclude. “Our results suggest that a high fish intake may add a further beneficial effect for the prevention of coronary heart disease among middle-aged persons.”
The most common form of heart disease is caused by atherosclerosis. It is generally referred to as coronary heart disease or hardening and/or thickening of the arteries. Atherosclerosis involves the slow buildup of deposits of fatty substances, cholesterol, body cellular waste products, calcium, and fibrin (a clotting material in the blood) in the inside lining of an artery. The buildup that results (referred to as plaque) can partially or totally block the flow of blood through the artery. This can lead to the formation of a blood clot (thrombus) on the surface of the plaque. If either of these events occurs and blocks the entire artery, a heart attack or stroke may result.
Omega-3 fatty acids, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), from fish, flax, or perilla oils, are essential for optimal health. Most Western diets contain predominantly omega-6 fatty acids, in proportions greatly exceeding the omega-3 fatty acids. The so-called “bad” saturated fatty acids and their metabolites (those fats that are solid at room temperature) compete with beneficial EPA and DHA fatty acids. Increasing dietary alpha-linolenic acid and omega-3 fatty acids, while limiting dietary polyunsaturated fat and calorie intake, have important cardiac benefits, including reduction of risk of heart attack and mortality by as much as 70% (Guize et al. 1995).
Scientific studies demonstrate that alpha-linolenic acid (from flax or perilla oil) reduced the incidence of atherosclerosis, stroke, and second heart attacks. When perilla or flax oil is consumed, it requires the enzyme delta-6 desaturase to convert the alpha-linolenic acid into EPA and DHA. Many individuals (particularly those over 50 years of age, who show declining activity of this enzyme) should consider using high-potency fish oil because these products directly provide EPA and DHA. Compared with no fish consumption, a lower risk of death was associated with fish consumption. High proportions of omega-3 fatty acids found in serum lipids were associated with a substantially reduced risk of death (Erkkila et al. 2003).
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