Polyunsaturated Fatty Acids and Cardiovascular Events: A Fish Tale

Autor: J. Thomas Bigger, Tarek El-Sherif
Rok vydání: 2001
Předmět:
Zdroj: Circulation. 103:623-625
ISSN: 1524-4539
0009-7322
Popis: The Eskimo diet has a high fat content, but this group has a low incidence of deaths from coronary heart disease.1 Because the Eskimo diet contains large amounts of long-chain polyunsaturated fatty acids (PUFAs),2 many studies have been conducted to determine whether high dietary PUFAs may reduce death from coronary heart disease. These studies, which have focused on two n-3 PUFAs that are relatively abundant in fish, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), include many prospective epidemiological studies, a few case-control studies, and 2 secondary prevention trials.3 4 5 6 7 8 9 10 11 12 13 Most of the prospective population studies showed a statistically significant inverse relationship between fish consumption and the risk of death from coronary heart disease. The dose-response relationship was complex in these studies: the reduction in coronary risk was greatest when adding a modest amount of dietary fish to populations that previously had low fish intake. Increasing fish intake still more did not incrementally decrease risk. Many of these studies measured n-3 PUFA incorporation into the cell membranes of platelets, granulocytes, adipose tissue, or erythrocytes. Overall, there was a significant correlation between fish intake and the level of n-3 PUFA in cell membranes. The overall consistency in the observational studies is excellent and signals a survival benefit from dietary n-3 PUFA. The epidemiological data suggest that the benefit of dietary fish is centered on a reduction in sudden cardiac death. A case-control study in Seattle compared 334 victims of out-of-hospital primary cardiac arrest with 493 population-based controls.11 Compared with no dietary intake of EPA, ≥5.5 g of n-3 PUFA per month was associated with a 50% decrease in the risk of primary cardiac arrest. The US Physician’s Health Study studied the effect of dietary fish on sudden cardiac death …
Databáze: OpenAIRE