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July 29, 2008

High omega-3 diet of Japanese linked with significantly lower heart disease risk compared to Americans

High omega-3 diet of Japanese linked with significantly lower heart disease risk compared to Americans

The number of deaths from coronary heart disease among Japanese men is less than half that of American men. Whether this effect is due to genetic, dietary or other factors has not been confirmed. In the first international study of its kind, published in the August 5, 2008, issue of Journal of the American College of Cardiology, University of Pittsburgh Graduate School of Public Health assistant professor of epidemiology Akira Sekikawa, MD, PhD, and colleagues evaluated data from 868 men aged 40 to 49 enrolled in the ERA JUMP (Electron-Beam Tomography, Risk Factor Assessment Among Japanese and U.S. Men in the Post-World War II Birth Cohort) Study. Two hundred eighty-one of the current study’s subjects were from Japan; 306 were Caucasian men from Pennsylvania; and 281 were Japanese-American men living in Hawaii. Blood tests measured total fatty acids, and the omega-3 fatty acids eicosapentaenoic, docosahexaenoic, and docosapentaenoic acids, which are commonly obtained by consuming fish. Ultrasound examination assessed carotid artery intima-medial thickness (IMT), which is used to evaluate atherosclerosis. Coronary artery calcification (CAC) in the heart’s arteries, which also identifies heart disease, was assessed via electron-beam CT scanner.

Although total fatty acid levels were similar among all subjects, the percentage of fish-based omega-3 fatty acids was twice as high among Japanese men compared with Americans of both European and Japanese descent. Japanese men had significantly less atherosclerosis, as indicated by lower average intima-media thickness and coronary artery calcification. Among Japanese men, intima-media thickness values declined with rising omega-3 fatty acid levels, a phenomenon that was not observed in either American group.

"The death rate from coronary heart disease in Japan has always been puzzlingly low," Dr Sekikawa observed. "Our study suggests that the very low rates of coronary heart disease among Japanese living in Japan may be due to their lifelong high consumption of fish. Our study clearly demonstrated that whites and Japanese-Americans have similar levels of atherosclerosis, which are much higher than in the Japanese in Japan. This indicates that much lower death rates from coronary heart disease in the Japanese in Japan is very unlikely due to genetic factors."

"Our study suggests that very high levels of omega-3 fatty acids have strong properties that may help prevent the buildup of cholesterol in the arteries," Dr Sekikawa stated. "Increasing fish intake to two times a week for healthy people is currently recommended in the U.S. Our study shows much higher intake of fish observed in the Japanese [approximately 3 ounces daily] may have strong anti-atherogenic effect."

“While we don't recommend Americans change their diets to eat fish at these quantities because of concerns about mercury levels in some fish, increasing intake of omega-3 fatty acids in the U.S. could have a very substantial impact on heart disease,” he added.

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Health Concern Life Extension Highlight

Coronary artery disease

Symptoms associated with atherosclerosis depend on the stage of the disease. In the early stages, which may last for decades, it rarely has any symptoms. In the later stages, the symptoms are caused by the obstruction of blood flow.

Blood testing is recommended for all adults. A comprehensive blood test will measure levels of LDL, HDL, VLDL, and triglycerides, as well as levels of C-reactive protein, homocysteine, and fibrinogen. Life Extension recommends blood testing at least annually. More frequent testing might be recommended to monitor progress after a patient begins a heart-healthy supplementation program.

People who have suffered a heart attack or stroke or who have symptoms indicative of coronary artery ischemia (such as chest pain) should see a physician. They may be required to undergo additional testing to determine the health of their coronary arteries. Additional tests include the following:

  • Angiography. During this test, a catheter is inserted through a large artery, usually in the groin, and guided into the heart, where it is used to deliver contrast material into the coronary arteries. This contrast material is visible under x-ray. The test allows physicians to identify the location and degree of vascular occlusion.
  • Electrocardiogram. This is an electronic readout of heart function that can reveal ischemic damage as a result of restricted blood flow.
  • Intima-media thickness. This test uses ultrasound imaging to estimate the thickness of the intima, or inner layer of the arteries. An increase in intima-media thickness over time indicates that atherosclerotic vascular disease is worsening. This technique can also be used to measure the effectiveness of cardiovascular intervention therapies.
  • Computed tomography scanning. This technique can assess the degree of calcification in the coronary arteries, which correlates strongly with atherosclerosis. Because of the risks associated with radiation exposure, Life Extension does not recommend computed tomography scanning unless absolutely necessary.

Elevated plasma omega-3 fatty acids associated with reduced nonfatal heart attack risk

In the July, 2008 American Journal of Clinical Nutrition, Harvard researchers report their finding of a lower nonfatal heart attack risk associated with increased blood plasma levels of the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosapentaenoic acid (DPA), an intermediary between EPA and docosahexaenoic acid (DHA).

The researchers utilized data from 32,826 women who participated in the Nurses' Health Study between 1989 and 1990. Information obtained from dietary questionnaires was used to calculate omega-3 fatty acid intake. Blood samples were analyzed for omega-3 fatty acids EPA, DHA, DPA, and ALA in plasma and red blood cells.

Over six years of follow-up, nonfatal heart attack was diagnosed in 146 subjects, who were each matched for age and other factors with two control subjects . Women whose plasma levels of EPA were among the highest 25 percent of the 434 cases and controls were found to have a 77 percent lower heart attack risk than those whose levels were in the lowest quarter. Those whose DPA levels were highest experienced a 60 percent lower risk. Subjects with higher plasma concentrations of EPA, DHA, and DPA tended to have increased high density lipoprotein (HDL) cholesterol and lower triglyceride levels.

When red blood cell omega-3 fatty acid levels were evaluated, only nonsignificant associations with nonfatal heart attack risk were observed.

Although a protective effect against fatal coronary heart disease and sudden cardiac death had been associated with omega-3 fatty acids in prior research, their effect in nonfatal heart attack has not been established. "This prospective study provides new evidence that plasma concentrations of EPA and DPA are associated with a lower incidence of nonfatal MI among US women," the authors conclude.

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