Large study links fish-rich diets to the Asian nation's low heart disease levels 03/06/2014
Why do doctors recommend fish oil?
The answer lies in mountains of lab, animal, epidemiological, and clinical evidence … but rests most heavily on four large human studies.
The DART Study followed 2,033 British men who'd suffered a heart attack for two years. The results showed that higher intakes of fatty fish reduced the risk of death from any cause by 29 percent, and prompted recommendations that everybody should consume two servings of fatty fish per week.
Italy's GISSI-Prevenzione clinical trial tested the effects of omega-3 fish oil in 8,488 recent heart attack survivors, and showed that taking one gram of EPA + DHA per day for 3.5 years reduced the risk of death from any cause by 14 to 20 percent, and the risk of heart-related death by between 17 to 30 percent.
(A follow-up to the GISSI-Prevenzione trial also found that EPA and DHA were more cost effective than some statins at reducing all-cause deaths following the initial heart attack.)
The GISSI-HF trial involved 6,975 Italian heart failure patients placed on traditional treatment for heart failure, and showed that taking one gram of EPA + DHA per day for up to 4.5 years reduced the risk of death from any cause by an average of nine percent, the risk of heart-related death or hospitalization by eight percent.
Finally, the JELIS study followed 18,645 Japanese patients being treated with statins for high cholesterol for five years and showed that taking 1.8 grams of omega-3 EPA per day reduced the risk of major coronary events by 19 percent, versus statin therapy alone.
Japan's JELIS study also found that EPA reduced the risk of a secondary major coronary event by 27 percent, the risk of heart attack by 23 percent, and the risk of a first heart attack by 53 percent among patients with high triglyceride and low HDL cholesterol levels.
Omega-3 EPA supplements also substantially reduced the risk of unstable angina, non-fatal coronary events (e.g., heart attacks) and stroke.
Omega-3 levels were twice as high in the Japanese men.
Japanese men had a significantly lower rate of CAC compared to white men.
- El-Saed A, Curb JD, Kadowaki T, Okamura T, Sutton-Tyrrell K, Masaki K, Seto TB, Takamiya T, Choo J, Edmundowicz D, Evans RW, Fujiyoshi A, Nakamura Y, Miura K, Shin C, Kuller LH, Ueshima H, Sekikawa A. The prevalence of aortic calcification in Japanese compared to white and Japanese-American middle-aged men is confounded by the amount of cigarette smoking. Int J Cardiol. 2013 Jul 15;167(1):134-9. doi: 10.1016/j.ijcard.2011.12.060. Epub 2012 Jan 10.
- El-Saed A, Sekikawa A, Zaky RW, Kadowaki T, Takamiya T, Okamura T, Edmundowicz D, Kita Y, Kuller LH, Ueshima H. Association of lipoprotein-associated phospholipase A2 with coronary calcification among American and Japanese men. J Epidemiol. 2007 Nov;17(6):179-85.
- Kitamura A, Iso H, Naito Y, Iida M, Konishi M, Folsom AR, Sato S, Kiyama M, Nakamura M, Sankai T, et al. High-density lipoprotein cholesterol and premature coronary heart disease in urban Japanese men. Circulation. 1994 Jun;89(6):2533-9.
- Sekikawa A, Curb JD, Ueshima H, El-Saed A, Kadowaki T, Abbott RD, Evans RW, Rodriguez BL, Okamura T, Sutton-Tyrrell K, Nakamura Y, Masaki K, Edmundowicz D, Kashiwagi A, Willcox BJ, Takamiya T, Mitsunami K, Seto TB, Murata K, White RL, Kuller LH; ERA JUMP (Electron-Beam Tomography, Risk Factor Assessment Among Japanese and U.S. Men in the Post-World War II Birth Cohort) Study Group. Marine-derived n-3 fatty acids and atherosclerosis in Japanese, Japanese-American, and white men: a cross-sectional study. J Am Coll Cardiol. 2008 Aug 5;52(6):417-24. doi: 10.1016/j.jacc.2008.03.047.
- Sekikawa A, Miura K, Lee S, Fujiyoshi A, Edmundowicz D, Kadowaki T, Evans RW, Kadowaki S, Sutton-Tyrrell K, Okamura T, Bertolet M, Masaki KH, Nakamura Y, Barinas-Mitchell EJ, Willcox BJ, Kadota A, Seto TB, Maegawa H, Kuller LH, Ueshima H; for the ERA JUMP Study Group. Long chain n-3 polyunsaturated fatty acids and incidence rate of coronary artery calcification in Japanese men in Japan and white men in the USA: population based prospective cohort study. Heart. 2013 Dec 18. doi: 10.1136/heartjnl-2013-304421. [Epub ahead of print]
- Sekikawa A, Ueshima H, Kadowaki T, El-Saed A, Okamura T, Takamiya T, Kashiwagi A, Edmundowicz D, Murata K, Sutton-Tyrrell K, Maegawa H, Evans RW, Kita Y, Kuller LH. Less subclinical atherosclerosis in Japanese men in Japan than in White men in the United States in the post-World War II birth cohort. Am J Epidemiol. 2007 Mar 15;165(6):617-24. Epub 2007 Jan 22.
- University of Pittsburgh (UP). Eating Fish with High Levels of Omega-3 May Explain Very Low Levels of Heart Disease in Japan Compared to the U.S. Accessed at http://www.upmc.com/media/newsreleases/2008/pages/jacc-sekikawa.aspx