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Fish consumption and risk of major chronic disease in men. Virtanen JK, Mozaffarian D, Chiuve SE, Rimm EB. Am J Clin Nutr. 2008 Dec;88(6):1618-25. PMID: 19064523 doi:10.3945/ajcn.2007.25816 Conclusions: Modest fish consumption was associated with a lower risk of total cardiovascular disease, consistent with cardiac mortality benefits but not with total cancer or overall major chronic disease; n-6 fatty acid consumption did not influence these relations.

Fish consumption shifts lipoprotein subfractions to a less atherogenic pattern in humans. Li Z, Lamon-Fava S, Otvos J, Lichtenstein AH, Velez-Carrasco W, McNamara JR, Ordovas JM, Schaefer EJ. J Nutr. 2004 Jul;134(7):1724-8. PMID: 15226460 The effect of fish consumption on plasma lipoprotein subfraction concentrations was studied in 22 men and women (age > 40 y). Subjects were provided an average American diet (AAD, 35% of energy as fat, 14% as saturated fat, and 35 mg cholesterol/MJ) for 6 wk before being assigned to a National Cholesterol Education Program (NCEP) Step 2 high-fish diet (n = 11, 26% of energy as fat, 4.5% as saturated fat, and 15 mg cholesterol/MJ) or a NCEP Step 2 low-fish diet (n = 11, 26% of energy as fat, 4.0% as saturated fat, and 11 mg cholesterol/MJ) for 24 wk. All food and drink were provided to study participants. Consumption of the high-fish NCEP Step 2 diet was associated with a significant reduction in medium and small VLDL, compared with the AAD diet, whereas the low-fish diet did not affect VLDL subfractions. Both diets significantly reduced LDL cholesterol concentrations, without modifying LDL subfractions. Both diets also lowered HDL cholesterol concentrations. However, the high-fish diet significantly lowered only the HDL fraction containing both apolipoprotein (apo) AI and AII (LpAI:AII) and did not change HDL subfractions assessed by NMR, whereas the low-fish diet significantly lowered the HDL fraction containing only apo AI (LpAI) and the large NMR HDL fractions, resulting in a significant reduction in HDL particle size. Neither diet affected VLDL and LDL particle size. Our data indicate that within the context of a diet restricted in fat and cholesterol, a higher fish content favorably affects VLDL and HDL subspecies

Intake of fish and n3 fatty acids and risk of coronary heart disease among Japanese: the Japan Public Health Center-Based (JPHC) Study Cohort I. Iso H, Kobayashi M, Ishihara J, Sasaki S, Okada K, Kita Y, Kokubo Y, Tsugane S; JPHC Study Group. Circulation. 2006 Jan 17;113(2):195-202. Epub 2006 Jan 9. PMID: 16401768 doi: 10.1161/CIRCULATIONAHA.105.581355 Conclusions- Compared with a modest fish intake of once a week or &20 g/d, a higher intake was associated with substantially reduced risk of coronary heart disease, primarily nonfatal cardiac events, among middle-aged persons

Fish oil-derived fatty acids, docosahexaenoic acid and docosapentaenoic acid, and the risk of acute coronary events: the Kuopio ischaemic heart disease risk factor study. Rissanen T, Voutilainen S, Nyyssönen K, Lakka TA, Salonen JT. Circulation. 2000 Nov 28;102(22):2677-9. PMID: 11094031 Methods and Results-We studied this association in the Kuopio Ischaemic Heart Disease Risk Factor Study, a prospective population study in Eastern Finland. Subjects were randomly selected and included 1871 men aged 42 to 60 years who had no clinical coronary heart disease at baseline examination. A total of 194 men had a fatal or nonfatal acute coronary event during follow-up. In a Cox proportional hazards' model adjusting for other risk factors, men in the highest fifth of the proportion of serum DHA+DPA in all fatty acids had a 44% reduced risk (P=0.014) of acute coronary events compared with men in the lowest fifth. Men in the highest fifth of DHA+DPA who had a low hair content of mercury (2.0 µg/g). There was no association between proportion of eicosapentaenoic acid and the risk of acute coronary events. Conclusions-Our data provide further confirmation for the concept that fish oil-derived fatty acids reduce the risk of acute coronary events. However, a high mercury content in fish could attenuate this protective effect.

Cardiac benefits of fish consumption may depend on the type of fish meal consumed: the Cardiovascular Health Study. Mozaffarian D, Lemaitre RN, Kuller LH, Burke GL, Tracy RP, Siscovick DS; Cardiovascular Health Study. Circulation. 2003 Mar 18;107(10):1372-7. PMID: 12642356 doi: 10.1161/01.CIR.0000055315.79177.16 Conclusions- Among adults aged >=65 years, modest consumption of tuna or other broiled or baked fish, but not fried fish or fish sandwiches, is associated with lower risk of IHD death, especially arrhythmic IHD death. Cardiac benefits of fish consumption may vary depending on the type of fish meal consumed.

Effect of fish oil on heart rate in humans: a meta-analysis of randomized controlled trials. Mozaffarian D, Geelen A, Brouwer IA, Geleijnse JM, Zock PL, Katan MB. Circulation. 2005 Sep 27;112(13):1945-52. Epub 2005 Sep 19. PMID: 16172267 doi: 10.1161/CIRCULATIONAHA.105.556886 Conclusions- In randomized controlled trials in humans, fish oil reduces HR, particularly in those with higher baseline HR or longer treatment duration. These findings provide firm evidence that fish oil consumption directly or indirectly affects cardiac electrophysiology in humans. Potential mechanisms such as effects on the sinus node, ventricular efficiency, or autonomic function deserve further investigation.

Scientists in Canada reviewing the research so far on links between different diets and heart disease found strong evidence that diets high in vegetables and nuts, and those that follow a Mediterranean pattern rich in fruit, vegetables and fish were strongly associated with lower heart disease risk than those that rely on food with a high glycemic index or high in trans-fatty acids. High glycemic index food includes rice, pasta and refined carbohydrates like white bread, and foods high in trans-fatty acids include fried foods, baked goods and snacks.

Fish oil-fed mice have impaired resistance to influenza infection. Schwerbrock NM, Karlsson EA, Shi Q, Sheridan PA, Beck MA. J Nutr. 2009 Aug;139(8):1588-94. Epub 2009 Jun 23. PMID: 19549756 doi:10.3945/jn.109.108027 These results suggest that the antiinflammatory properties of fish oil feeding can alter the immune response to influenza infection, resulting in increased morbidity and mortality.

"Fatty acids can help children in exams and improve their behaviour in class and at home, a study suggests. Overweight children who took fatty acid dietary supplements showed dramatic improvements in concentration, reading, memory and mental agility. The advances that their brains made in three months would normally take three years, researchers found."

"New research from Queen Mary, University of London and Harvard Medical School has revealed precisely why taking fish oils can help with conditions like rheumatoid arthritis."

Incremental effects of eicosapentaenoic acid on cardiovascular events in statin-treated patients with coronary artery disease. Matsuzaki M, Yokoyama M, Saito Y, Origasa H, Ishikawa Y, Oikawa S, Sasaki J, Hishida H, Itakura H, Kita T, Kitabatake A, Nakaya N, Sakata T, Shimada K, Shirato K, Matsuzawa Y; JELIS Investigators. Circ J. 2009 Jul;73(7):1283-90. Epub 2009 May 8. PMID: 19423946 Conclusions: EPA is effective for secondary prevention of CAD, especially in individuals with prior MI, and should be added to conventional treatment.

Fish consumption and depressive symptoms in the general population in Finland. Tanskanen A, Hibbeln JR, Tuomilehto J, Uutela A, Haukkala A, Viinamäki H, Lehtonen J, Vartiainen E. Psychiatr Serv. 2001 Apr;52(4):529-31. PMID: 11274502 After the analysis adjusted for potential confounders, the likelihood of having depressive symptoms was significantly higher among infrequent fish consumers than among frequent consumers.

Alpha-linolenic acid and risk of nonfatal acute myocardial infarction. Campos H, Baylin A, Willett WC. Circulation. 2008 Jul 22;118(4):339-45. Epub 2008 Jul 7. Erratum in: Circulation. 2008 Sep 16;118(12):e492. PMID: 18606916 doi: 10.1161/CIRCULATIONAHA.107.762419 Conclusions - Consumption of vegetable oils rich in {alpha}-linolenic acid could confer important cardiovascular protection. The apparent protective effect of {alpha}-linolenic acid is most evident among subjects with low intakes.

Cardiovascular risk and alpha-linolenic acid: can Costa Rica clarify? Harris WS. Circulation. 2008 Jul 22;118(4):323-4. Epub 2008 Jul 7. Review. PMID: 18606912 doi: 10.1161/CIRCULATIONAHA.108.791467

The Diet-Heart Hypothesis: Subdividing Lipoproteins Two posts ago, we made the rounds of the commonly measured blood lipids (total cholesterol, LDL, HDL, triglycerides) and how they associate with cardiac risk. It's important to keep in mind that many things associate with cardiac risk, not just blood lipids. For example, men with low serum vitamin D are at a 2.4-fold greater risk of heart attack than men with higher D levels. That alone is roughly equivalent to the predictive power of the blood lipids you get measured at the doctor's office. Coronary calcium scans (a measure of blood vessel calcification) also associate with cardiac risk better than the most commonly measured blood lipids. Lipoproteins Can be Subdivided into Several Subcategories In the continual search for better measures of cardiac risk, researchers in the 1980s decided to break down lipoprotein particles into sub-categories. One of these researchers is Dr. Ronald M. Krauss. Krauss published extensively on the association between lipoprotein size and cardiac risk, eventually concluding (source): The plasma lipoprotein profile accompanying a preponderance of small, dense LDL particles (specifically LDL-III) is associated with up to a threefold increase in the susceptibility of developing [coronary artery disease]. This has been demonstrated in case-control studies of myocardial infarction and angiographically documented coronary disease. Krauss found that small, dense LDL (sdLDL) doesn't travel alone: it typically comes along with low HDL and high triglycerides*. He called this combination of factors "lipoprotein pattern B"; its opposite is "lipoprotein pattern A": large, buoyant LDL, high HDL and low triglycerides. Incidentally, low HDL and high triglycerides are hallmarks of the metabolic syndrome, the quintessential modern metabolic disorder. Krauss and his colleagues went on to hypothesize that sdLDL promotes atherosclerosis because of its ability to penetrate the artery wall more easily

Prevalence and correlates of subclinical atherosclerosis in Alaska Eskimos: the GOCADAN study. Cutchins A, Roman MJ, Devereux RB, Ebbesson SO, Umans JG, Zhu J, Weissman NJ, Howard BV. Stroke. 2008 Nov;39(11):3079-82. Epub 2008 Jul 10. PMID: 18617652 doi: 10.1161/STROKEAHA.108.519199 Conclusions- Alaska Eskimos have similar traditional risk factors for carotid atherosclerosis as other ethnic and racial populations but have higher prevalences of atherosclerosis, possibly attributable to higher rates of smoking.

A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Mente A, de Koning L, Shannon HS, Anand SS. Arch Intern Med. 2009 Apr 13;169(7):659-69. Review. PMID: 19364995 Conclusions The evidence supports a valid association of a limited number of dietary factors and dietary patterns with CHD. Future evaluation of dietary patterns, including their nutrient and food components, in cohort studies and randomized trials is recommended

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