Want Heart Health? Go Fish
By Bill Todd
Forty years ago, your family doctor might have recommended a
spoonful of cod liver oil daily, "for your health." Common wisdom
at the time was that cod liver oil is loaded with vitamin D in
a form your body can use. Most milk is fortified with vitamin
D now, so cod liver oil has fallen out of favor. (The nasty taste
But fish oil has been making a comeback. Advertisements for fish
oil tout health benefits for conditions as varied as arthritis,
heart disease, and colitis. What's the truth? When you're considering
whether to add fish oil to your diet, follow your heart.
Researchers noticed that certain social groups that eat fish
regularly are much healthier than Americans, especially in the
incidence of heart disease. Nutritionists began looking at Greenland
Eskimos (Inuit) in the 1950s to determine why they were so healthy,
and their efforts finally began to focus on the amount and type
of fat the groups were consuming.
It turns out that certain kinds of fish are a rich source of
a type of fat known as omega-3 fatty acids. The beneficial compounds
in fish oil are called eicosapentaenoic acid (EPA) and docosahexaenoic
acid (DHA). These compounds have the ability to affect characteristics
of blood cells, making platelets less "sticky," which reduces
the risk of blood clots. This is good news for practically everyone;
blood clots cause most heart attacks and 80 to 90 percent of strokes.
In addition, omega-3 fatty acids can have a positive effect on
heart rhythm. The EPA and DHA reduce the risk of a condition called
ventricular fibrillation. This rhythm disturbance can cause a
fatal heart attack. A recent Italian study published in the journal
Lancet looked at 11,000 men for more than three years.
They found that a daily dose of 1 gram of EPA/DHA reduced the
risk of death by almost 20 percent, with the risk of cardiovascular-related
death being reduced by 30 percent. The researchers attributed
the benefit to fish oil's effect on heart rhythm.
An added bonus is that omega-3 oils are also good for your lipid
profile, that is, the amount and ratio of triglycerides to cholesterol
in your bloodstream. Triglyceride levels are especially critical
for women and for people with diabetes. A high triglyceride level
in these people puts them at increased risk for cardiovascular
Fish oil has many benefits, but there are a couple of side effects
you should be aware of. First is the chance that fish oil could
cause a slight increase in your LDL cholesterol level. If your
total cholesterol and your ratio of HDL to total cholesterol are
within normal ranges, this shouldn't be a concern, but if your
cholesterol is high or has not been determined, consult with your
physician before adding fish oil to your diet.
The second area is cause for a bit more attention. Because fish
oil reduces the "stickiness" of your blood, making clots less
likely, it can also make you bleed more easily. Some patients
even dropped out of clinical trials because of nosebleeds. Another
consequence of easy bleeding is a type of stroke called a hemorrhagic
stroke. The low rate of heart disease among the Inuit is combined
with a higher risk of stroke. If you are taking vitamin E or a
blood thinner, such as aspirin or the prescription medication
warfarin (Coumadin), check with your physician before increasing
your consumption of fish oil.
How much is enough?
You don't need to become a seal, eating a diet of all-fish-all-the-time.
One or two servings of fatty fish a week seems to convey the health
benefits. If you don't like fish, consider taking a daily supplement
of 2-3 grams. Look for a supplement that contains both DHA and
EPA; you get slightly different benefits from each. Regardless
of how you choose to get your omega-3 fatty acids, your heart
will be hooked.
Fish vary greatly in their oil content. Here are the ones to
Variety of fish
Grams of omega-3 fatty acids per 100
grams (3.5 oz) of uncooked fish
Anchovies and salmon (Atlantic or pink) are your best bets. The
other varieties have a higher omega-3 content, but they also contain
high levels of undesirable fat. Sardines, for example, contain
another 12 grams of fat along with the omega-3 fatty acids. Atlantic
salmon contains only another 4.2 grams, anchovies another 3.5
grams, and pink salmon another 2.5 grams.