Bypass patients may benefit from fish oils

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Bypass patients may benefit from fish oils JoAnn Guest Jun 21, 2005 17:14

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MUNICH, GERMANY. There is considerable evidence that supplementation

with fish oils helps prevent or slow down atherosclerosis. Some studies

have shown that fish oil supplementation may help prevent restenosis

(reclosing) f the arteries after angioplasty, but more recent studies

have found no such effect. A recent study found that coronary bypass

patients who supplemented their diet with 4 grams/day of an 83% fish oil

concentrate had less reclosings (sistal anastomosis occlusions) of their

bypass grafts than did the controls. After one year the patients taking

fish oils had a reclosing (occlusion) rate of 27% while the control

patients had a reclosing rate of 33% (a 23% relative improvement).

 

Eating fatty fish once or more each week or supplementing with fish oils

(0.5 g/day) has been found to increase the survival of heart attack

patients by 29%. A recent experiment showed that cardiac transplant

patients who supplemented with 5 grams/day of fish oils after their

operation had normal endothelium-dependent coronary vasodilation when

tested after three weeks whereas it was abnormal in matched control

patients. It is not known whether fish oil supplementation will increase

the survival time for heart transplant patients. [34 references] von

Schacky, Clemens. n-3 fatty acids and the prevention of coronary

atherosclerosis. American Journal of Clinical Nutrition, Vol. 71

(suppl), January 2000, pp. S224-27S

 

Fish oils help prevent sudden cardiac death

AALBORG, DENMARK. Sudden cardiac death (SCD) is now the most common

cause of death in the Western world. SCD is often caused by ventricular

arrhythmias in patients with heart disease, but may also occur among

previously healthy people. the risks of arrhythmias and SCD are closely

tied in with heart rate variability (HRV) with a high variability index

corresponding to a lower risk. It would also appear that the risk of SCD

can be substantially reduced by an increased consumption of fish. Some

very recent research has shown that survivors of a first heart attack

can avoid having a second one by supplementing with fish oils. An

obvious question is whether there is a connection between heart rate

variability and fish oil intake.

 

Danish researchers at the Aalborg Hospital are convinced that there is

indeed a very close connection - at least in men. Their recently

released study involved 25 women and 35 men who were generally healthy

and took no medications. The participants were randomized into three

groups. Group 1 was given 10 fish oil capsules daily providing a total

of 6.6 grams of n-3 polyunsaturated fatty acids (3.0 g eicosapentaenoic

acid [EPA] and 2.0 g docosahexaenoic acid [DHA]; group 2 was given three

fish oil capsules (0.9 g EPA and 0.8 g DHA) plus seven olive oil

capsules daily, and group 3, the control group, was given 10 olive oil

capsules daily. The study participants gave fasting blood samples and

had their HRV measured with a Holter recorder for 24 hours at the start

of the study and after 12 weeks of supplementation.

 

The researchers found that fish oil supplementation significantly

increased the concentration of EPa and DHA in both blood platelets and

granulocytes and that this increase was highly dose-dependent. they also

found a significant, dose-dependent reduction in triaclyglycerols, but

no significant changes in total, LDL or HDL cholesterol levels. The

24-hour Holter recordings showed a correlation between heart rate (pulse

rate) and blood level of EPA and DHA with a higher level corresponding

to a lower pulse rate in both men and women. There was also a very

significant association between DHA level in men and SDNN. SDNN (the

standard deviation of all normal R-R intervals during the 24-hour Holter

recording) is an important index of HRV with higher values indicating

greater heart rate variability. The researches conclude that

supplementation with fish oils, especially DHA, may help prevent

arrhythmias and sudden cardiac death in healthy men. They found no

association between EPA/DHA levels in women and HRV, but urge further

studies to confirm this seeming lack of effect. Christensen, Jeppe

Hagstrup, et al. Heart rate variability and fatty acid content of blood

cell membranes: a dose-response study with n-3 fatty acids. American

Journal of clinical Nutrition, Vol. 70, september 1999, pp. 331-37

 

Fish oils protect against death from heart disease

SANTA MARIA IMBARO, ITALY. There is clear evidence that a diet rich in

oily fish confers considerable protection against heart disease. What is

clear is whether concentrated fish tissue oils in capsule form confer

similar benefits. A very large group of Italian researchers (Gruppo

Italiano per Lo Studio della Sopravivenza nell'lnfarto miocardico) has

just completed a major study which shows the benefits of fish oil

supplementation in patients who have survived a first heart attack.

their study involved over 11,000 heart attack survivors who were

randomly assigned to one of four groups. Group one received a one-gram

gelatine capsule containing about 580 mg of eicosapentaenoic acid (EPA)

and 290 mg of docosahexaenoic acid (DHA) as ethyol esters every day.

Group two received 300 mg of synthetic vitamin E daily; group three both

fish oil and vitamin E; and group four served as the control group. All

participants ate a largely Mediterranean diet and continued to take

their prescribed medications (beta-blockers, aspirin, and ACE

inhibitors). After 3.5 years of follow-up it was clear that the

participants who had received fish oil of fish oil plus vitamin E had

lowered their risk of dying of having another heart attack or a stroke

by 10 to 15 per cent. the group who had taken vitamin E alone derived no

statistically significant benefit from doing so. (Editor's note: The 300

mg of synthetic vitamin E used in the study corresponds to about 150 IU

of natural vitamin e. This would be much less effective that the 200-400

IU/day of natural vitamin E used in studies which have shown a benefit

of vitamin E in regard to heart disease and stroke). The researchers

conclude that daily supplementation with fish oils (equivalent of

consuming 100 grams of fish per day) is beneficial for patients who have

survived a first heart attack. They suggest that the role of vitamin E

needs further exploration. (Editor's note: Other studies have shown that

vitamin E protects fish oils from going rancid so it is a good idea to

take a combination of the two). NOTE: This study was funded in part by

Bristol-Myers Squibb, Pharmacia-Upjohn, Societa Prodotti Antibiotici,

and Pfizer. dietary supplementation with n-3 polyunsaturated fatty acids

and vitamin E after myocardial infarction: results of the

GISSI-Prevenzione trial. The Lancet, Vol. 354, August 7, 1999, pp.

447-55 Brown, Morris. Do vitamin E and fish oil protect against

ischaemic heart disease. The Lancet, Vol. 254, August 7, 1999, pp.

441-42 (commentary)

 

Fish oils reverse atherosclerosis.

MUNICH, GERMANY. German medical researchers have just released the

results of a major study which proves that fish oil supplementation is

highly beneficial to patients suffering from atherosclerosis. Their

randomized, double-blind, placebo-controlled clinical trial involved 162

patients with confirmed atherosclerosis. Half the patients were given

six grams of fish oils per day for three months while the other half

were given six grams per day of placebo capsules containing a fatty acid

composition resembling that of the average European diet. After three

months the dosages were reduced to three grams/day for a further 21

months. Angiograms were taken at the start of the trial and at the end

of the two-year study period. At the end of the treatment twice as many

of the patients in the fish oil group (16) showed regression of their

atherosclerotic deposits when compared to the placebo group. Three

patients in the placebo group suffered a non-fatal heart attack during

the 2-year period as compared to only one in the fish oil group. All

told there were seven patients in the placebo group who had a

cardiovascular event (heart attack or stroke) as compared to only tow in

the fish oil group. The researcher conclude that fish oil

supplementation is beneficial for atherosclerosis patients and is safe

and well-tolerated. NOTE: This study was partially funded by Pronova

A.S., a Norwegian fish oil producer. von Schacky, Clemens, et al. The

effect of dietary omega-3 fatty acids on coronary atherosclerosis.

Annals of Internal Medicine, Vol. 130, April 6, 1999, pp. 554-62

 

Eat Fish and Live Longer

BOSTON, MASSACHUSETTS. There is a growing consensus that regular fish

consumption protects against heart disease. There is, however, still

controversy as to whether this protection applies to all forms of heart

disease and it is also not clear how fish exerts its protective effect.

Some studies have found that fish consumption protects only against

sudden cardiac death while others have found that it protects only

against nonsudden death. Now researchers at the Harvard Medical School

and the Brigham and Women's Hospital weigh in with a comprehensive new

study which concludes that even modest fish and shellfish consumption

protects against sudden cardiac death in men and significantly reduces

total mortality. The study involved over 20,000 male American physicians

who were between the ages of 40 and 48 years in 1982 when the study

commenced. Food frequency questionnaires were administered after 12 and

18 months and again in 1988. By December 1995 133 of the participants

had died from a sudden cardiac event (death occurring within one hour

from onset of symptoms). Analysis of the collected data showed that the

men who consumed fish once or more each week had a 62 per cent lower

risk of dying form a sudden cardiac event that did the men who ate fish

less that once a month. This lower risk applied after adjusting for all

other known risk factors. The estimated dietary intake of marine n-3

fatty acids also correlated well with the risk of sudden cardiac death

with an intake of more that 300 mg/month providing significant

protection. the extent of protection did not increase significantly with

greater fish or marine n-3 fatty acid intake indicating that eating fish

once a week is sufficient to provide worthwhile protection.

 

Fish consumption was not associated with the risk of nonsudden death,

total myocardial infarction or total deaths from cardiovascular

diseases. There was , however, a 30 percent decrease in the overall

mortality among the men consuming fish once or more each week as

compared to the men eating fish less that once per month. the

researchers speculate that fish consumption may exert its protective

effect by preventing fatal arrhythmias. they suggest that the n-3 fatty

acids found in fish and shellfish (eicosapentaenoic acid and

docosahexaenoic acid) are responsible for the antiarrhythmic properties

and point out that alpha-linolenic acid, and n-3 fatty acid found in

flax oil and nuts, also has antiarrhythmic properties. they did no

investigate the benefits of fish oil supplements and purposely excluded

777 physicians from the study who were taking fish oil supplements. the

researchers conclude that eating fish once per week may substantially

reduce the risk of sudden cardiac death. In an accompanying editorial

Dr. Daan Kromhout of the Dutch National Institute of Public Health

concurs with this conclusion and adds that patients already suffering

from cardiac disease should be advised to eat fish twice a week. Albert,

christine M., et al. Fish consumption and risk of sudden cardiac death.

Journal of the American Medical Association, Vol. 279, January 7, 1998,

pp. 23-28 Kromhout, Daan. Fish consumption and sudden cardiac death.

Journal of the American Medical Association, Vol. 279, January 7, 1998,

pp. 65-66 (editorial)

 

Eating fish prevents death of heart attack patients

AALBORG, DENMARK. A low degree of heart rate variability (HRV) is a very

strong predictor of sudden death among survivors of a heart attack

(myocardial infraction). Danish researchers now report that a high fish

consumption increases the concentration of n-3 polyunsaturated fatty

acids (PUFAs) in cell membranes and that this increase is associated

with a significant beneficial increase in HRV. Their study involved 52

patients who ate fish once a week had an 18 percent higher HRV than

non-fish eaters. Fish eaters were also found to have a higher content of

DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid) in their

blood platelets. Patients with more than 3.14 per cent DHA in their

platelets were found to have a 43 per cent higher HRV than patients with

a DHA content of less than 2.26 per cent. The researchers also

discovered that a high ratio of arachidonic acid to DHA in the platelets

corresponds to a significantly lower HRV. Other research has shown that

the consumption of just one fatty fish meal per week reduces the risk of

primary cardiac arrest by 50 per cent. Hagstrup Christensen, Jeppe, et

al. Fish consumption, n-3 fatty acids in cell membranes, and heart rate

variability in survivors of myocardial infraction with left ventricular

dysfunction. American Journal of Cardiology, Vol. 79, June 15, 1997, pp.

1670-73

 

Fish consumption protects against fatal heart attacks

CHICAGO, ILLINOIS. Researchers at the Northwestern University Medical

school have just released the results of a 30-year study which shows

that eating fish regularly protects against the risk of dying from a

heart attack (myocardial infarction). The study involved 1822 men aged

40 to 55 years at the start of the study in 1957. During the 30-year

follow-up 1042 men died. 293 of them from a heart attack. Sixty-eight

per cent of the study participants were blue-collar workers, 58 per cent

were smokers, and 85 per cent drank alcohol. After adjusting for all

other variables known to affect the risk of heart disease and heart

attack in particular, the researchers found that men who consumed about

one kg (two lbs) of fish per month had a 40 per cent lower rate of death

from heart attacks than did men who did not eat fish. Men who ate only

500 g (one lb) of fish per month also had a significantly lower risk of

fatal heart attack. The difference in mortality was almost exclusively

due to the much lower rate of non-sudden death from heart attack amongst

the high fish consumers. The researchers found no significant

relationship between fish consumption and death from other

cardiovascular causes; they did, however, confirm that cholesterol

level, cigarette smoking, dietary cholesterol intake, and age were all

independently related to the risk of incurring a fatal heart attack.

Daviglus, Martha L., et al. Fish consumption and the 30-year risk of

fatal myocardial infarction. New England Journal of Medicine, Vol. 336,

April 10, 1997, pp. 1046-53

 

fish oils protect against arrhythmias

AALBORG, DENMARK. Research has shown that heart attack survivors who

increase their intake of oily fish considerably improve their chance of

long-term survival. Now Danish researchers report that daily

supplementation with fish oil capsules may have a similar effect. Their

experiment involved 49 patients who had been discharged from hospital

after suffering a heart attack. The study participants were randomly

allocated to receive 5 grams per day of fish oil as a mixture of

eicosapentaenoic acid and docosahexaenoic acid or a similar amount of

olive oil as a placebo for a 12-week period. A 24-hour recording

(Holter) of their heart rate was obtained at the start and end of the

study. At the end of the experiment the patients in the fish oil group

exhibited a marked increase in the variability of their heart rate as

compared to the controls. It is believed that greater heart variability

is desirable in heart attack patients as it protects the heart against

often fatal ventricular arrhytmias. the researchers conclude that fish

oils may have an antiarrhythmic effect which could account for the

better survival among heart attack patients who increase their intake of

them. Christensen, Jeppe Hagstrup, et al. Effect of fish oil on heart

rate variability in survivors of myocardial infraction. British Medical

Journal, Vol. 312, March 16, 1996, pp. 677-78

 

Fish oils help prevent cardiac arrest

SEATTLE, WASHINGTON. Cardiac arrest is a serious, usually fatal

condition in which the heart stops pumping. Cardiac arrest most commonly

occurs in connection with ventricular fibrillation and its primary cause

is a heart attack. Researchers at the University of Washington now

report that the risk of cardiac arrest can be significantly lowered by

an increased intake of seafood rich in eicosapentaenoic acid (EPA) and

docosahexaenoic acid (DHA). their study involved 334 patients who had

suffered cardiac arrest during the period of 1988 to 1994 and 493

controls matched for age and sex. None of the study participants had had

any indication of heart disease prior to the beginning of the study.

Interviews with survivors or their spouses were used to determine the

participant's fish intake in the month preceding the cardiac arrest. The

researchers found that the intake of just one portion of fatty fish per

week lowered the risk of cardiac arrest by an impressive 50 per cent

after adjusting for age, smoking, family history of heart attacks,

hypertension, diabetes, obesity, physical activity, education, and

cholesterol level. The researchers believe that consumption of fish

increases the level of EPA and DHA in the membranes of the red blood

cells which in turn reduces platelet aggregation and coronary spasm.

This belief was confirmed by finding that blood samples taken from 95

cardiac arrest patients and 133 controls showed that a high blood

content of EPA and DHA (five per cent of total fatty acids) corresponded

to a 70 per cent reduction in the risk of cardiac arrest when compared

to study participants with a low EPA and DHA content in their blood (3.3

per cent of total fatty acids). Other studies have shown that patients

who have already suffered a heart attack can reduce their risk of future

life threatening arrhythmias and sudden cardiac death by increasing

their intake of fish, fish oils or linolenic acid (flax seed oil). The

researchers conclude that a modest intake of EPA and DHA from seafood

may reduce the risk of ventricular fibrillation and death from coronary

heart disease. NOTE: fresh salmon is one of the best sources of fish

oils; it contains twice as much per serving as does albacore tuna and

six times more EPA and DHA than a serving of cod. Siscovick, David S.,

et al. Dietary intake and cell membrane levels of long-chain n-3

polyunsaturated fatty acids and the risk of primary cardiac arrest.

Journal of the American Medical Association, Vol. 274, No. 17, November

1, 1995, pp. 1363-67

 

Omega-3 fatty acids help protect against heart disease

SAN FRANCISCO, CALIFORNIA. Researchers a the Veterans Affairs Medical

Center report that docosapentaenoic acid and docosahexaenoic acid (a

main component of fish oil) provide significant protection against the

development of coronary heart disease (CHD). Their study involved over

6,000 middle-aged men who had samples of their blood taken between 1973

and 1976. During the next seven years, 94 of these men had a heart

attack or died suddenly due to heart disease. The 94 men with heart

disease tended to have a higher serum level of the saturated fatty acid

palmitic acid and conclude that a high level of this acid increases the

risk of CHD by 68 per cent. Palmitic acid is the main saturated fatty

acid in most diets. this acid is known to cause an increase in both

total cholesterol and low-density cholesterol levels; the researchers,

however, found that the detrimental effect of a high intake of palmitic

acid persisted even after allowing for its cholesterol-increasing

effect. The researchers also determined that almost 50 per cent lower

risk of developing heart disease than did men with lower levels. The

researchers also found that men with CHD tended to have a higher serum

level of omega-6 fatty acids derived from linoleic acid, but were unable

to confirm previous reports that these acids are linked to an increased

risk of CHD. Simon, Joel A., et al. Serum fatty acids and the risk of

coronary heart disease. American Journal of Epidemiology, Vol. 142, No.

5, September 1, 1995, pp. 469-76

 

Fish oils reduce blood pressure

BALTIMORE, MARYLAND. The daily consumption of fish oils (omega-3)

polyunsaturated fatty acids) can significantly lower blood pressure in

people suffering from hypertension. The benefit of the fish oils is

comparable to that obtainable by sodium reduction and weight loss. A

group of medical researchers at the Johns Hopkins Medical School

evaluated the results of 17 clinical trials involving supplementation

with fish oils for periods of three months or less. They found that the

consumption of 3 grams per day of fish oil (6-10 capsules) or more led

to impressive reductions in the blood pressure of hypertensive

individuals. Systolic pressure was lowered by an average of 5.5 mm Hg

and diastolic pressure was lowered by 3.5 mm Hg. The effect was found to

be more pronounced at higher blood pressures and no significant effects

were noted in people with normal blood pressure. Twenty-eight percent of

the participants in the trials reported side effects such as a fishy

taste or belching.

 

The doctors suggest that fish oil supplementation may be a valuable

therapy in patients with borderline hypertension who would otherwise be

candidates for conventional drug therapy. They point out that the

effects of long term (> 3 months) supplementation are unknown and that

lower dosages than 3 g/day may be desirable and perhaps as effective.

NOTE: Systolic pressure is the first (highest) reading given for a blood

pressure measurement, diastolic is the second (lowest) reading, i.e.

120/80. Appel, Lawrence j. et al. Does supplementation of diet with

" fish oil " reduce blood pressure. Archives of Internal Medicine, Vol.

153, June 28, 1993, pp. 1429-38

 

Fish oils fight atherosclerosis

COPENHAGEN, DENMARK. Medical doctors at two copenhagen hospitals have

confirmed that regular consumption of fish prevents narrowing of the

arteries due to atherosclerosis. The doctors performed 40 autopsies and

determined that the degree of atherosclerosis present in the coronary

arteries was inversely proportional to the amount of docosahexaenoic

acid found in the adipose (fatty) tissue. They conclude that fish

consumption reduces the risk of coronary heart disease. Seidelin, Kaj N.

et al. n-03 fatty acids in adipose tissue and coronary artery disease

are inversely related. American Journal of clinical Nutrition, Vol. ,

june 1992, pp. 1117-9

 

Fish is good for you

TROMSO, NORWAY. Norwegian researchers now offer conclusive evidence that

eating fish, particularly fatty fish like mackerel, herring, and salmon

will significantly reduce the risk of heart disease. As little as one

serving of 300 grams per week will provide the benefit. Fish are rich in

eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and it is

these polyunsaturated fatty acids which provide protection. It is

suggested that the minimal dietary requirement for EPA and DHA should be

about 200 mg/day and this amount can be obtained from eating fish once a

week. Nordoy, Arne. Is there a rational use for n-3 fatty acids (fish

oils) in clinical medicine. DRUGS, 42(3), 199, pp. 331-42

 

A regular diet containing fish oils improves fat tolerance

PORTLAND, OREGON. An experiment involving seven healthy human subjects

was carried out to determine if the composition of a background diet fed

for four weeks would influence the rise in triglyceride level

experienced after consuming a fatty test meal. The three background

diets contained 30-40% of calories as fats, polyunsaturated vegetable

oils, and salmon oils respectively. Fasting triglyceride levels in the

three regimes were 72+-19, 76+-11 mg/dl respectively. It was found that

the rise in plasma triglyceride level after a test meal containing 50

grams of fat was significantly lower for subjects who had been on the

fish oil background diet. This relationship held true independent of the

type of fat in the test meal (saturated, vegetable oil, or fish oil).

The results suggest that long term (but not acute) fish oil consumption

my improve improve fat tolerance. Harris, William S., et al. Reduction

of postprandial triglyceridemia in humans by dietary n-3 fatty acids.

Journal of Lipid Research, Volume 29, No. 11, November 1988, pp.

1451-1460

 

Consuming freshwater fish may lower risk of heart disease

KUOPIO, FINLAND. A 15-week experiment involving 62 students was carried

out to determine if a regular diet of freshwater fish affect coronary

heart disease risk factors. The students were divided into three groups:

a fish eating group who made no other changes to their diet, a fish

eating group who also decreases their overall fat intake and a control

group (19) students who ate a typical western diet. The special diet

consisted of one fish meal a day (in addition the regular diet) and

provided about 0.25 g/day of eicosapentaenoic acid and 0.55 g/day of

docosahexaenoic acid. Serum cholesterol was found to decrease in fish

eaters who also decreased their lipid intake but not in the other

groups. Blood triglyceride levels decreased significantly in the fish

eating groups, but not in the control group. Levels of apolipoproteins

A1 and B were lowered in both fish eating groups as was the formation of

thromboxane B2 during incubation of whole blood. In the fish eating

groups, the proportion of omega-3 fatty acids increased significantly in

erythrocyte ghosts and platelets at the expense of omega-6 fatty acids.

the results of the study support the contention that moderate fish

consumption has a protective effect against coronary heart disease.

Agren, J.J., et al. Boreal freshwater fish diet modifies the plasma

lipids and prostanoids and membrane fatty acids in man. LIPIDS, Vol. 23,

No. 10, October 1988, pp. 924-929

 

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