Home Up Arthritis Asthma Brain Breast Milk Cancers Crohn's Disease Dermatological Heart Pregnancy Psychiatry Background Info Flax



Randomized Studies on the Impact of Various Factors on Cardiac Events

Fish Oil, But Not Vitamin E Prevents Death, Sudden Death, and Heart Death: In the Italian GISSI-Prevenzione, 11,323 patients were invited to follow Mediterranean dietary habits, and were treated with up-to-date preventive pharmacological interventions. Long-term omega-3 PUFA 1 g daily, but not vitamin E 300 mg daily, was beneficial for death and for combined death, non-fatal myocardial infarction, and stroke. All the benefit, however, was attributable to the decrease in risk for overall, cardiovascular, cardiac, coronary, and sudden death. In GISSI-Prevenzione, long-term administration of omega-3 PUFA (1 g daily) significantly decreased the risk of overall (-20%), cardiovascular (-30%), and sudden death (-45%). Omega-3 and coronary heart disease Marchioli R, Minerva Cardioangiol. 2003 Sep;51(5):561-76

Fish Oil But Not Vitamin E Decreased Death After MI: A randomized study of 11324 heart attack victims given vitamin E 300mg, fish oil, both, or placebo found fish oil decreased MI death and overall death by 17% and 14% while Vitamin E had no impact. Lancet 8/99 354:447

Fish Decreased CHD Death: Once a Week Enough: JAMA 2002 Apr 10;287(14):1815-21. 85,000 nurses followed 16 years. After adjustment for age, smoking, and other cardiovascular risk factors, the multivariable relative risks (RRs) of CHD were 0.79 (95% confidence interval [CI], 0.64-0.97) for fish consumption 1 to 3 times per month, 0.71 (95% CI, 0.58-0.87) for once per week, 0.69 (95% CI, 0.55-0.88) for 2 to 4 times per week, and 0.66 (95% CI, 0.50-0.89) for 5 or more.

Fish Didn't Help Angina Patients at All: 3,114 Welsh angina patients were randomized to advice to eat oily fish twice a week or no such advice.  Those not liking fish were given maxEPA fish oil capsules. After six months, cardiac death was 29% higher with the fish advice and sudden death 54% higher with the worst impact in the maxEPA patients. Lack of benefit of dietary advice to men with angina: results of a controlled trial. Burr ML, Ashfield-Watt PA, Dunstan FD, Fehily AM, Breay P, Ashton T, Zotos PC, Haboubi NA, Elwood PC. Eur J Clin Nutr. 2003 Feb;57(2):193-200

Meta-Analysis Favorable: meta-analysis suggests that dietary and non-dietary intake of n-3 polyunsaturated fatty acids reduces overall mortality (RR 0.8), mortality due to myocardial infarction (RR=0.7), and sudden death in patients with coronary heart disease (RR=0.7). 11 randomized studies of 15,800 patients used. Switz., Am J Med 2002 Mar;112(4):298-304

20% Lower Mortality with Once a Week Fish due to fewer Heart Attacks: In a 10-year follow-up of 18,000 Chinese prospectively studied found a 20% reduction in total mortality associated with weekly fish/shellfish intake was observed in the study population (relative risk = 0.79). These prospective data suggest that eating fish and shellfish weekly reduces the risk of fatal myocardial infarction in middle-aged and older men. There was no effect on strokes or ischemic heart disease. Am J Epidemiol 2001 Nov 1;154(9):809-16

Fish Oil Decreased Death in DB Better than Mustard Oil: DB PC 360 patients 18 hr s/p MI x 1 year. Fish oil 1.08 DHA vs. Mustard oil 2.9 g/d ALA vs. placebo. Cardiac events were 24%, 28%, and 35% respectively. Nonfatal infarctions were 13%, 15%, and 25%. Cardiac deaths not significant decreased for mustard but fish oil did with only 11% vs. 22% for placebo. Both Rx groups decr arrhythmias, angina, and ventricular enlargement. Only modest changes lipids but evidence of decr in oxidative stress which may be part cause of improvement. Singh, India, Cardiovasc Drug Ther 7/97;485-91

Randomized Advice Increased Fish, Decreased Death: UK DART-study 2,033 men after heart attacks were divided into three groups. One group advised to decrease saturated fats and increase unsaturated, one advised increase fish, one advised increase fiber. No benefit in fat advice group. Fish advice group had a decrease in overall death of 29% in two years! Benefit started to become apparent after 80th day. Fish advice group told eat fatty fish twice a week (200-400g) or given MaxEPA caps to take three times a day. Benefit not altered by correction for confounding variables. 22% of fish group used capsules. There was little spontaneous tendency to eat fatty fish in groups not given fish advice. Fish advice produced a fourfold difference at 2 years in EPA intake. Amount of fish actually consumed by fish advice group = 300 g/wk (10 ounces). ML Burr, Lancet ’89;2:757

Randomized Lyon Canola-Mediterranean Diet Decreased Death: 605 heart attack patients under 70 were randomized to a control diet or diet with less saturated fat, cholesterol and linoleic acid but more oleic and alpha-linolenic acids by using a canola old margarine with only 5% trans fats. Bread, fruits, vegetables, fish consumption all increased and meat decreased and no change in butter or cream with little change in poultry. Mortality over 5 years was 60% lower due to decrease in cardiac deaths. De Lorgeril, France, Lancet 343:1454 1994

Fish Oil in Two of Three Studies Find Decreased Restenosis: Decreased in DB study by Grigg, Circ ’87;76:Suppl4:IV-214 & Schmitz, Clin Res 87;35:6A, but not Slack, J Am Coll Cardiol ’87;9:64a.

Seven Countries Study Finds Decreased Mortality with Higher Fish: Reference only and a cohort study so probably only an epidemiologic study. Arch Mal Coeur Vaiss 10/98;91 Spec No 5:27

Epidemiologic Studies

Fish Lowers Heart Rate, BP, Triglycerides, Increases HDL: 9,758 French and Irish men, 50-59 years old, without coronary heart disease (CHD) with fish consumption, as follows: (1) less than once per week (n=2662), (2) once per week (n=4576), (3) twice per week (n=1964), and (4) more than twice per week (n=556). Triglycerides (P<0.0001), systolic blood pressure (P<0.006), and diastolic blood pressure (P<0.0001) were lower and HDL cholesterol levels (P<0.004) were higher in fish consumers than in nonconsumers. Similarly, heart rate decreased across the categories of fish intake (P<0.0001). After risk factor adjustment, heart rate remained lower among fish consumers (P<0.0001). Lower heart rate may help explain the lower risk of sudden death among fish consumers. Fish consumption is associated with lower heart rates. Dallongeville J, Yarnell J, Ducimetiere P, Arveiler D, Ferrieres J, Montaye M, Luc G, Evans A, Bingham A, Hass B, Ruidavets JB, Amouyel P. Circulation. 2003 Aug 19;108(7):820-5. 

Fish, Plasma Omega-3 Strongly Linked to Low Heart Death in Heart Patients: 415 coronary artery disease patients followed up for 5 years during which 36 patients died, 21 had myocardial infarctions, and 12 had strokes. Highest tertile of fatty acids vs. lowest tertile for death RR 0.33 for ALA, 0.33 for EPA, and 0.31 for DHA (P for trend = 0.063, 0.056, and 0.026, respectively). Compared with no consumption, consumption of fish tended to be associated with a lower risk of death [1-57 g/d, RR = 0.50; > 57 g/d, RR = 0.37). Finland. n-3 Fatty acids and 5-y risks of death and cardiovascular disease events in patients with coronary artery disease. Erkkila AT, Lehto S, Pyorala K, Uusitupa MI. Am J Clin Nutr. 2003 Jul;78(1):65-71

Fish Consumption Dramatically Cuts Death Rate; 5+ per Week Best: 5,103 nurses with diabetes followed an average of 9 years. There were 141 CHD deaths, 221 nonfatal myocardial infarctions and 468 deaths from all causes. Compared with women who seldom consumed fish, the relative risks (RRs) of CHD adjusted for established coronary risk factors were 0.70 for fish consumption 1 to 3 times per month, 0.60 for once per week, 0.64 for 2 to 4 times per week, and 0.36 for 5 or more times per week (P=0.002). Higher consumption of fish was also associated with a significantly lower total mortality (multivariate RR=0.48). Higher consumption of long-chain omega-3 fatty acids was associated with a trend toward lower incidence of CHD (RR=0.69) and total mortality (RR=0.63). Fish and long-chain omega-3 fatty acid intake and risk of coronary heart disease and total mortality in diabetic women. Hu FB, Cho E, Rexrode KM, Albert CM, Manson JE. Circulation. 2003 Apr 15;107(14):1852-7. Harvard

Baked, Broiled, Boiled Fish; Not Fried, Fish Sandwiches, or Salted; 3+ per Week: 3,910 adults over 64 were followed for 9.3 years. Tuna or other broiled or baked fish had 49% lower risk of total IHD death and 58% lower risk of arrhythmic IHD death among persons consuming 3 or more times per week compared with less than once per month. Fried fish/fish sandwich consumption had trends toward higher, not lower risk. 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

1st Study!=Decreased Eskimo CHD Deaths Linked to Fish: Eskinos were found to have one-tenth the CHD mortality as Danes or U.S. despite high fat and cholesterol in diet. Danes had twice as much saturated fat and more n-6 fatty acids in their diets. Eskimos had 5-10 g/day of omega-3 fatty acids such as EPA and DHA which came from marine phytoplankton and passed up the food chain. Eskimos had high HDL and low LDL. Dyerberg and Bang, Am J Clin Nutr ’75;28:958-66; Bang, Acta Med Scand ’76:200:69-73

Metanalysis Says Fish Only Helps High Risk: A meta-analysis found 11 prospective cohort studies of value. No benefit found in two large (N=65,000) very well done studies with low risk populations. Eur J Clin Nutr 8/99 53:585

WWII Fish Consumption Increased, Heart Disease Decreased in Norway: Bang in Acta Med Scand ’81;210:245-8 noted that ischemic heart disease death fell in Norway within one year of sudden change in diet with increased fatty fish. Mortality rose again within a year of end of World War II.

Fish Decreased Heart Disease in Norway: Norway eating fish, especially fatty fish like mackerel, herring, and salmon decreased risk of heart disease. Arne Nordoy, DRUGS ’91;42:331-42.

Fish Decreased Cardiac Death: Inverse relationship fish consumption and 20-yr mortality from CHD in the Zutphen dietary study of 852 middle-aged men without CAD. As little as 35 g/d fish decreases CAD mortality by 50%. Kromhout, NEJM ’85;312:1205.

Fish Decreased CHD Death & Overall Mortality: Western Electric Study data. No increase in cancer death. Shedelle, NEJM ’85;313:820.

Mediterranean Diet Decreased Heart & CA Death In France: 605 random to Mediterranean diet or AHA for 4 yr. Lyon (France) Heart Diet. 14 vs. 38 deaths with 56% decrease overall after controlling for smoking, etc. with 61% decrease in CA death. Diet ALA rich.

Fish Decreased MI Death In Chicago: Northwestern Univ 30 year f/u of 1822 men 40-55 with 1042 dying, 293 of heart attack (MI). 58% smokers, 85%drinkers, 68% blue collar. Eating 2.2 pounds fish/mo decreased MI death. Even 1.1 pounds/mo helped. No benefit other cardiovascular death from fish. Martha Daviglus, NEJM 336:1046-53 4/10/97.

Fish Decrease Heart Attack Death in Denmark: High fish consumption increase n-3 PUFAs in cell membrane which is associated with higher heart rate variability (HRV) which is very strong predictor of less sudden death among survivors of MI. 52 MI patients followed. Those eating fish once a week had 18% higher HRV and higher DHA and EPA. A high ratio of AA to DHA in platelets corresponded to a lower HRV. Hagstrup Christensen, Am J Cardiol 79:1670-3, 6/15/97

Linolenic Intake Decreases Death: Harvard Health Professionals prospective study of over 43,000 found RR 0.4 for high linolenic acid intake. Highest quintile sat fats RR 2.21 vs. lowest quintile. This drops to 1.7 when corrected for fiber intake. BMJ 7/13/96;313:84

Eating Fish Protects Japanese Fishing Villagers: Epidemiologic study compared to inland farming villages with lower fish consumption and higher CAD mortality and more cerebrovascular accidents. A Hirai, In Loverburg, Nutr Prevention of Cardiovasc Disease. NY:Acad Press ’84;231-9.

Eskimos Low MI, asthma, DM, psoriasis and allergies: Thought due to high fish intake. Ricardo Uauy-Dagach, Nutr Rev 54:S102-8 11/96

Fish Oil Best Way Lower Triglycerides and VLDL: Phillipson, NEJM ’85;312:1210-6. Fish oils suppress hepatic triglyceride and apolipoprotein B synthesis WS Harris, Metab ’84;33:1016. The VLDL and LDL after fish oil is more dense and smaller and thereby less harmful.

Fish in Dutch Decreased MI Death: Middle-aged men eating 30 g/day of fish or more had a 50% decrease heart disease mortality. Ditto.

Fish in Swedish Study Finds Benefit But not two others: Epidemiological study in Sweden found decreases in coronary artery disease from large amount of fish but not in two other studies. Norell, Br Med J ’86;293:426 but not in Curb, NEJM ;85;313:821, and Vollset, NEJM ’85;313:820-1

Fish Prevents Heart Attacks in U.S.: In a University of Washington study of 334 patients after a heart attack vs. 493 controls, one fatty fish meal per week lowered recurrent heart attack risk 50% after adjust for age, smoking, family history, HBP, DM, obesity, physical activity, & cholesterol. High RBC content EPA and DHA corresponded to 70% decreased risk of heart attack vs. low content. Recommend increased fish, fish oil, or flax seed oil. David Siscovick, JAMA 11/1/95;274:1363-7

DHA in Diet Decreases Atherosclerosis: Copenhagen doctors found in 40 autopsies that degree of atherosclerosis in coronary arteries inversely proportional to DHA in adipose tissue. Kaj Seidelin, Am J Clin Nutr 6/92:55:1117

Fish Once a Week Enough: Omega-3 Gives 81% Decrease in Death from Sudden Heart Attack in Men: Men with high blood levels omega-3. NEJM 4/11/02 JoAnn Manson, Harvard. The US Physicians Health Study evaluated 20,551 US male physicians aged 40-84 without cardiovascular disease followed for 11 years. Consumption of at least one fish meal per week reduced the risk of sudden cardiac death by 52% (p=0.03), when compared with those consuming fish once a month. All levels of fish consumption up to one meal per week were associated with a decreased risk of sudden death. At levels of consumption greater than one fish meal per week the risk reduction did not change indicating a threshold effect. Blood levels of long-chain n-3 fatty acids were inversely related to risk of sudden death both before and after adjustment for potential confounders (p=0.007, for trend). As compared with men whose blood levels of long-chain n-3 fatty acids were in the lowest quartile, the relative risk of sudden death was significantly lower among men with levels in the highest quartile (adjusted relative risk, 0.19)

Fish 5/week 50% Decr Dying Heart Attack in Women: JAMA 4/10/02, Manson, Harvard.

Controlling for Sat Fats, Smoke Elim Fish Benefit: In the Seven Country study with 12673 middle-aged men with 25yr f/u, the favorable assoc of incr alc and incr fish with decr CHD death disappeared after controlling for satur fat intake, flavonoids, and smoking. Fiber and anti-oxidants not related to decr CHD death. Int J Epid ’96;25:753

Palmitic Bad, n-3 Good: VA San Francisco study 6000 men with 7 yr f/u with 94 MI or sudden heart death vs 94 healthy controls. Blood showed high palmitic acid incr risk 68% and high n-3 lower risk

n-3 in Adipose Tissue Inverse to CAD: Autopsy study found higher n-3 levels in adipose tissue associated with lowe risk of CAD death. Seidelin, Am J Clin Nutr ’92;55:1117-9

Arrhythmias and Heart Rate

Fish Oil Decreased Heart Rate, Improves Diastolic Ventricular Filling: DB PC study of 223 adults of refined EPA vs. refined DHA vs corn oil found no diff in BP but heart rate decreased by 2 beats/min in both n-3 groups and ventricular diastolic filling improved in both groups. Grimsgaard, U Tromso, Am J Clin Nutr 7/98;68:52

Fish Oil Decreased Danish Arrhythmias in DB: 49 pt post MI randomized to 5 g fish oil or olive oil placebo 12 week study. Fish oil group marked increase in variability of heart rate which is desirable protecting against ventricular arrhythmias. Christensen, Br Med J 3/16/96;312:677-8

Fish Oil Prevent V Fib in Acute MI: Riemersma, J Intern Med ’89;225(suppl 1):111-16; Also Sellmayer, Am J Cardiol ’95;76:974

Fish Oil Helps Heart Rate Variability: DB PC 55 pt s/p MI found fish oil with 5.2g EPA/DHA in 12 weeks increased heart rate variability. Christensen, Ugeskr Laeger 9/97;159:5525

Fish Oil & Heart Rate Variability: Christensen, BMJ 3/16/96;312:677 DB fish oil PC 55 pt 5.2g/d n-3 vs. olive oil. N-3 had a favorable increase in heart rate variability. This increases v fib threshold and protects against ventricular arrhythmias.

Fish Oil/Fish Reduce Sudden Death: take one capsule of a fish oil concentrate daily or eat two meals of oily fish (salmon, mackerel, or tuna) a week. According to research conducted by Dr. Roberto Marchioli of Italy's Consorzio Mario Negri Sud and reported in the journal Circulation, in just three months the fish oil supplements lowered the risk of fatal arrhythmia. 11,000 patients, all of whom had suffered a heart attack within the previous three months, participated in the study. While all of them received the same preventive care and ate a Mediterranean-style diet rich in fruits, vegetables, olive oil, and fish, some of them were given 1 gram of fish oil supplements daily. Those who took the fish oil supplements appeared to be at a 41 percent lower risk of death from any cause after only three months of treatment, and after four months of treatment, they had a significantly reduced risk of sudden cardiac death.

Lipid Profile

Fish Oil For Hypertriglycerides: Helps severe hypertrigly insufficiently controlled by diet and fibrates (NJ Stone, Circ 94:2337, ’96). Ed. Note: Fibrates of absolutely no value on longevity. Indeed, Atromid-S increases death rates!

Fish Oil Best for Type IV & Type V Hyperlipoproteinemias: Canned mackerel was clearly better than sunflower seed oil or linseed oil in decreasing total cholesterol and triglycerides although these were also effective. The same has been found in other studies for type IIa and type V and for plasma free fatty acids. Peter Singer, Germany, Nutr ’92;8:133-5

n-3 Ethyl Esters Decrease Hypertriglycerides, Cholesterol, Increase HDL: DB PC 935pts with hypertriglyceridemia Rx 6 months DB 3 g/d n-3 etyl esters vs. placebo with n-3 decrease triglyceridemia and 4% decr cholesterol and 9% increase HDL. Sirtori, U Milano, Atherosclerosis 4/98;137:419. No increase problem with glucose control. Am J Clin Nutr 6/97;65:1874

Fish Oil Decreased Post-Prandial Triglycerides: DB PC study 47 healthy middle-aged males with four fish oil caps per day found only one change in measurable lipid risk facts in four week study. Marckmann, Denmark, Arterioscler Thromb Vasc Biol 12/97;33:3384

Fish Oil Decreased TG with increases in lipoprotein lipase and hepatic lipase activity: DB PC olive oil vs. 5 caps double-concentrated fish oil/70kg/d. Normals TG down 18% an hyperTG pts down 35%. Wm Harris, Am J Clin Nutr ’97;66:254-60

Fish Oil Adds to Simvastin: DB PC of 41 males simvastin alone vs both vs placebo found adding fish oil further decr triacyglyserols, total cholesterol, and apolipoprotein E. Norday, Tromso, J Intern Med 2/98;243:163; Same results in a U Chicago study.

Amer Heart Assoc’s Strange Opposition to Fish Oil: In a press release 4/22/97 the AHA advised people to eat fish regularly but "does not recommend [fish oil’s] general use" www.americanheart.org. The study triggering the release was published in the AHA journal Arteriosclerosis, Thrombosis, and Vascular Biology 4/97;17:688-94 by Ken Rogers of Univ W. Ontario & Duke Univ who fed 32 Yucatan miniature pigs a high fat diet for 8 months, then killed 8 to document clogging of arteries. Then 8 pigs had fish oil added to diet, 8 had a "control" oil whose fats were high in 18:2n6 without any n-3 fatty acids, i.e., a similar polyunsat:sat ratio but n-6 instead of n-3 and 8 had no supplement. Both oils caused similar decreases in fatty build-up in coronary arteries. AHA said fish oil made LDL particles more susceptible to oxidation and oxidized LDL is more likely to accumulate in blood vessel walls. However, the researchers had already documented that there was no greater buildup with the fish oil than for the control oil, so the AHA concern appears misplaced and purely speculative. Indeed, since the study documented clear benefit from fish oil and since fish oil is readily available for purchase, but the control oil is not, it seems best to eat fish or fish oil with no evidence of any difference between the two. While the researchers stated that none of the coronary arteries showed a significant reduction in the percentage of vessel surface with arteriosclerosis, in fact there was a dramatic 70% less staining in the fish oil and n-6 groups than in the low-fat diet only group. This tremendous difference apparently did not reach statistical significance because of the very small number of pigs involved in the study!

DHA Lowers Triglycerides: DB PC with pt with hypertriglyderides (150-400) and high LDL-C (130-220) Rx with 1.25g/d DHA vs. 2.5g/d DHA vs. placebo for 6 weeks found DHA in plasma phospholipids increased 2- to 3-fold depending on intake. Triglycerides decreased 17% to 21%. HDL increased 6% and LDL-C increased up to 13%. Davidson, Chicago, J Am Coll Nutr 6/97;16:236

Fish Oil, Not Flax, Lower TG in NIDDM: DB PC fish vs flax vs olive for 3 months found decrease in hypertriglyceridemia with fish only only. Flax increased ALA and slight increased EPA but no increase in DHA. Goh, U Alberta, Diabetology 1/97;40:45. Fish and flax oil were given at doses to equalized n-3 fatty acids at 35mg/kg/d of EPA+DHA or ALA respectively

Fish Oil, Not Flax, Lowers TG in Equal Doses: DB PC cross-over study of 26 adults using 35mg/kg/d EPA+DHA in fish oil vs. 35mg/kg/d ALA in flax oil vs. olive oil found fish oil decr TG and incr plasma EPA and DHA while flax oil had no signif effect of TG and only a slightly increasing effect on plasma EPA and DHA level. Layne, U Alberta, J Nutr 9/96;126:2130

Fish Oil, Not Flax Lowers TG in DM: Type II DM 11 pts DB cross-over of 3 months of fish vs flax oil at 35mg/kg/d n-3s each after three months of olive oil. No different in diabetic serum measures but decr in TG in fish oil group. McManus, U Alberta, Diabetes Care, 5/96;19:463

Flax Oil Does Help: In a Russian study without much information available, patients with coronary heart disease, HBP, and hyperlipidemia were treated with flax oil and improved clinically as well as showing better lipid profile. EPA and DHA in RBC did go up. Rozanova, Vopr Pitan ’97;(5):15

Fish Oil & Garlic Lower Chol: Univ Guelph 50 men with high cholesterol (>200 mg/dL or 5.2 mmol/L) rendom to 4 grous for 12 week: two placebos, 900mg garlic (Kwai), 12g fish oil (12 caps with 180 EPA 120 DHA), or both. After 12 wk, combo had 12% decrease total cholesterol, 9.5% decr LDL, 34% decrease triacylglycerol and better HDL:LDL ratio. Garlic by self did not lower TG but fish oil by self increase LDL. Adam Adler, Am J Clin Nutr 2/97;65:445-50

Flax Seed, Eggs No Impact on Lipids: Leghorms raised on flaxseeds increase ALA content by 2000% and DHA content by 70%. Humans eating four eggs/d for 2 week had no change in TG or lipid profile. Ferrier, U Guelph, Am J Clin Nutr 7/96;62:81. Ed: The huge increase in ALA and small increase in DHA suggests that chickens may have some diff, just like humans, in converting ALA into DHA.

Algae DHA Lowers TG, Improves Lipids in Vegetarians: DB PC 24 vegetarians rx 6 wk DHA 1.62g/d found over 200% incr DHA in serum and platelet phospholipids and over 100% increase in EPA in serum and platelet phospholipids. AA and docosapentanoic acid (22:5n-3) decreased moderately. TG, HDL:chol ratio and HDL:LDL ratios improved. Conquer, U Guelph, J Nutr Julie A Conquer & Bruce J Holub, Dept Human Biol and Nutr Sci, Guelph ONT N1G2W1. Note that efficiency of conversion of ALA to DHA in healthy adults via desaturation and elongation is about 5% (Emken, Biochim Biophys Acta 1213:277-88, ’94). Vegans and vegetarians have lower DHA than omnivores (Reddy, ‘94 Eur J Clin Nutr 48:358). This is despite consuming as much or more n-3 from plant sources as ALA relative to omnivores, i.e. 3.6 vs. 2.7 g/d. (Pan, studied buddhist vegetarians, Am J Clin Nutr 58:354). DHASCO capsules from David Kyle of Martek Biosciences, Columbia, MD. Neuromin’s dha, raw material, www.martekbio.com 410-995-0821

AA-DHA Oil Lowers TG, Chol: DB PC 32 healthy males in four groups receiving from 0 to 6.5g/d AA:DHA in oil in ratio of 1.25:1.00. Oil made by combining an AA containing fungal oil with a DHA containing microalgae oil. Over 8 weeks TG levels and plasma linoleic decrease and cholesterol levels, AA (18%) and DHA (55%) levels incr. Innis, U Brit Columbia, Am J Clin Nutr 8/96;64:159

Helps TG & VLDL but Not Insulin Sensitivity: Very small 16 pt DB study 2.7g/d n-3 fish oil for 1 month then 1.7g/d four months lowered TG and VLDL without affect on insulin sensitivity and no loss of glucose control. Rivellese, Naples, Diabetes Care 11/96;19:1207.

Fish Oil Lowers TG: DB 40 pt 3.6g/d n-3 vs soy oil led to 27% decr TG with n-3 and 20% incr with soy. Silva, U Coimbra, Int J Cardiol 11/96;57:75

No Effect in Small Study with Normal Lipidemic: 24 healthy normal lipidemic adults Rx low dose fish oil 1.5-1.8g/d without effect detected on lipid profile. Hamazaki, Toyama, J Nutr 11/96;126:2784

Freshwater fish Help TG & Chol: 15 wk Finnish study 62 sudents randomized to fish, fish with decr fat, and control. One fish meal/day=.25g EPA and .55g DHA. Chol and TG decr both fish groups. Also decr thromboxane B2 and apolipoproteins A1 and B. and incr n-3 in blood and decr n-6. JJ Agren 10/88 LIPIDS 23:924-9


Only Fish Oil, Not Primrose or Sunflower or Soy, Helps Endothelium: A PC DB for 173 normal adults. The effects of dietary fatty acid supplementation on endothelial function and vascular tone in healthy subjects. Khan F, Elherik K, Bolton-Smith C, Barr R, Hill A, Murrie I, Belch JJ. Cardiovasc Res. 2003 Oct 1;59(4):955-62

Improving Arterial Function: Compliance or elasticity of arteries imp index of circ func and decr with incr CV risk. Fish and fish oil improve. 15 obese given four week diet of sat/high fat or alpha-linolenic acid/low fat with 20 g ALA fr flax oil margarine or diet of oleic/low fat. Compliance markedly better with ALA diet tho incr LDL oxidizability and decr HDL and insulin sensitivity. Arterioscler Thromb Vasc Biol 1997 Jun; 17(6):1163-70. Nestel PJ, Baker Med, Australia.

Fish Oil Helps Small Arteries: 16 hyperlipemic pts and 12 controls DB PC study 10 MaxEPA caps/d found improved endothelium in peripheral small arteries. Improvement correlated with incr EPA in RBCs. Goode, Manchester, Circ, 96:2802

Omega-3 Dramatically Reduces Sudden Death: In Harvard’s 17 year follow-up of physicians, sudden death due to heart was much reduced in the 3rd and 4th quartiles, i.e., the highest blood omega-3 levels with 72% and 81% reduced risk (RR of 0.28 and 0.19). NEJM 4/10/02

Lean Meat OK: Aborigines on very low-fat kangaroo meat diet improved cardiovasc risk factors. Meat high in AA, precursor of platelet thromboxane which promotes clotting. Study 10% fat diet with 500g beef/d x 2wk then three groups with 20% energy extra from beef fat, olive oil, or safflower oil. All groups had an incr in arachidonic acid. EPA increased in the beef fat and olive oil groups and linoleic acid decreased with the opposite changes in the safflower oil gropu. AA is modulated by eicosanoids produced by EPA reducing clotting. Therefore linoleic intake more important to determining plasma AA than is dietary AA. Says high n-6:n-3 ratio incr heart disease, NIDDM, and inflam diseases and recommends a 7:1 instead of 15:1 ratio. Sinclair, www.mla.com (meat and livestock Australia)

Heart Transplants Do Better: DB fish oil vs corn oil 4 days after transplant for 1 year found fish oil beneficially lowered blood pressure and preserved microvasc endothelial function.without affecting cyclosporine levels. Andreassen, Norway, J Am Coll Cardiol 5/97;2:1324

Prevents Restenosis After Angio: O’Connor, Am J Prev Med ’92;8:186

Decreases Angina: Salachas, Angiol ’94;45:1023

Eat Fish for Healthy Baby: 8,000 Danish women during pregnancy to determine if seafood had an impact on early births. "Low consumption of fish was a strong risk factor for pre-term delivery and low birth weight," Pre-term deliveries fell from 7.1 percent in women who never ate fish to 1.9 percent in expectant mothers who ate fish at least once a week. BMJ 2/20/02

Flax Oil Helps Arterial Elasticity: 15 obese fed 4 week crossover 20g flax oil in margarine or high sat fat or high oleic control. Big improvement in arterial compliance despite incr in LDL oxidizability and lower HDL. No change total cholesterol, BP, blood glucose. Nestel, Arterioscl Thrombo Vasc Biol 6/97;17:1163

Flax vs. Fish Oil Similar on Clotting factors tho Another Study Disagrees: 46 healthy adults DB flax with 5.9g/d ALA or fish oil 5.2g/d EPA/DPA 12 weeks. No diff collagen-induced platelet aggregation, Thromboxane production, bleeding time, fibrinogen, and various other. Riitta Freese, U Helsinki, Am J Clin Nutr ’97;66:591-8. One other study found the opposite, i.e. fish oil 10 times more efficient at increasing bleeding time. Adam, Klin Wochenschr ’86;64:274.

Thomas E. Radecki, M.D., J.D.