Fish and Omega-3 Fatty Acids AHA Recommendation Omega-3 fatty acids benefit the heart of healthy people, and those at high risk of — or who have — cardiovascular disease. We recommend eating fish (particularly fatty fish) at least two times a week. Fish is a good source of protein and doesn’t have the high saturated fat that fatty meat products do. Fatty fish like mackerel, lake trout, herring, sardines, albacore tuna and salmon are high in two kinds of omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). To learn about omega-3 levels for different types of fish — as well as mercury levels, which can be a concern — see our Encyclopedia entry on Fish, Levels of Mercury and Omega-3 Fatty Acids. We also recommend eating tofu and other forms of soybeans, canola, walnut and flaxseed, and their oils. These contain alpha-linolenic acid (LNA), which can become omega-3 fatty acid in the body. The extent of this modification is modest and controversial, however. More studies are needed to show a cause-and-effect relationship between alpha-linolenic acid and heart disease. The table below is a good guide to use for consuming omega-3 fatty acids. Summary of Recommendations for Omega-3 Fatty Acid Intake
Patients taking more than 3 grams of omega-3 fatty acids from capsules should do so only under a physician’s care. High intakes could cause excessive bleeding in some people. Background In 2002, the American Heart Association released a scientific statement, “Fish Consumption, Fish Oil, Omega-3 Fatty Acids and Cardiovascular Disease,” on the effects of omega-3 fatty acids on heart function (including antiarrhythmic effects), hemodynamics (cardiac mechanics) and arterial endothelial function. The link between omega-3 fatty acids and CVD risk reduction are still being studied, but research has shown that omega-3 fatty acids
What do epidemiological and observational studies show? Epidemiologic and clinical trials have shown that omega-3 fatty acids reduce CVD incidence. Large-scale epidemiologic studies suggest that people at risk for coronary heart disease benefit from consuming omega-3 fatty acids from plants and marine sources. The ideal amount to take isn’t clear. Evidence from prospective secondary prevention studies suggests that taking EPA+DHA ranging from 0.5 to 1.8 grams per day (either as fatty fish or supplements) significantly reduces deaths from heart disease and all causes. For alpha-linolenic acid, a total intake of 1.5–3 grams per day seems beneficial. Randomized clinical trials have shown that omega-3 fatty acid supplements can reduce cardiovascular events (death, non-fatal heart attacks, non-fatal strokes). They can also slow the progression of atherosclerosis in coronary patients. However, more studies are needed to confirm and further define the health benefits of omega-3 fatty acid supplements for preventing a first or subsequent cardiovascular event. For example, placebo-controlled, double-blind, randomized clinical trials are needed to document the safety and efficacy of omega-3 fatty acid supplements in high-risk patients (those with type 2 diabetes, dyslipidemia, hypertension and smokers) and coronary patients on drug therapy. Mechanistic studies on their apparent effects on sudden death also are needed. Increasing omega-3 fatty acid intake through foods is preferable. However, coronary artery disease patients may not be able to get enough omega-3 by diet alone. These people may want to talk to their doctor about taking a supplement. Supplements also could help people with high triglycerides, who need even larger doses. The availability of high-quality omega-3 fatty acid supplements, free of contaminants, is an important prerequisite to their use. Related AHA publications: Related AHA Scientific Statements Detailed Research Environmental Protection Agency’s National Listing of Fish and Wildlife Advisories Food and Drug Administration’s list of mercury content of selected fish See also: Cholesterol Diabetes Mellitus Dietary Recommendations for Healthy Children Fat Fat Substitutes Fats and Oils High Blood Pressure Obesity Step I , Step II and TLC Diets Sudden Cardiac Death Trans fats now listed on food labels Triglycerides Vitamin and Mineral Supplements |
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