Importance of Omega-3 Fatty Acids in Reducing Cardiovascular Disease
Reporter and Curator: Dr. Sudipta Saha, Ph.D.
UPDATED on 7/24/2018
Omega-3 fats Supplements Effect on Cardiovascular Health: EPA and DHA has little or no effect on Mortality or Cardiovascular Health
Reporter: Aviva Lev-Ari, PhD, RN
The available evidence for cardiovascular effects of n-3 polyunsaturated fatty acid (PUFA) consumption has been reviewed here, focusing on long chain (seafood) n-3 PUFA, including their principal dietary sources, effects on physiological risk factors, potential molecular pathways and bioactive metabolites, effects on specific clinical endpoints, and existing dietary guidelines. Major dietary sources include fatty fish and other seafood. n-3 PUFA consumption lowers plasma triglycerides, resting heart rate, and blood pressure and might also improve myocardial filling and efficiency, lower inflammation, and improve vascular function. Experimental studies demonstrate direct anti-arrhythmic effects, which have been challenging to document in humans. n-3 PUFA affect a myriad of molecular pathways, including alteration of physical and chemical properties of cellular membranes, direct interaction with and modulation of membrane channels and proteins, regulation of gene expression via nuclear receptors and transcription factors, changes in eicosanoid profiles, and conversion of n-3 PUFA to bioactive metabolites. In prospective observational studies and adequately powered randomized clinical trials, benefits of n-3 PUFA seem most consistent for coronary heart disease mortality and sudden cardiac death. Potential effects on other cardiovascular outcomes are less-well-established, including conflicting evidence from observational studies and/or randomized trials for effects on nonfatal myocardial infarction, ischemic stroke, atrial fibrillation, recurrent ventricular arrhythmias, and heart failure. Research gaps include the relative importance of different physiological and molecular mechanisms, precise dose-responses of physiological and clinical effects, whether fish oil provides all the benefits of fish consumption, and clinical effects of plant-derived n-3 PUFA. Overall, current data provide strong concordant evidence that n-3 PUFA are bioactive compounds that reduce risk of cardiac death. National and international guidelines have converged on consistent recommendations for the general population to consume at least 250 mg/day of long-chain n-3 PUFA or at least 2 servings / week of oily fish.
Source References:
http://content.onlinejacc.org/article.aspx?articleid=1146941
http://www.ncbi.nlm.nih.gov/pubmed/17047219
http://www.ncbi.nlm.nih.gov/pubmed/18614744
http://www.ncbi.nlm.nih.gov/pubmed/19364995
http://www.ncbi.nlm.nih.gov/pubmed/16172267
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I find reference 16172267 to be quite insufficient. There is clear evidence of the benefit of omega-3 PUFAs, but the statement of fish and seafood, is not equivalent. What seafoods in the way of shellfish? There is no table showing the concentrations of n-3 PUFA in various fish and shellfish. There is also no mention of the benefit of deriving n-3 PUFA from Flax seed, either whole or ground. Yet, in the Framingham study, Eduardo Siguel, MD, PhD, a pioneer in the study of n-3 PUFA, had an executive who was inoperable for bypass who had plaque regression on 10 g/day of flax seed.
There has been, what to me is superfluous, a for-some-time discussion about the superiority of n-3 PUFA from fish over that from Flax seed. Of course, now one can buy Krill oil, which is extracted from the ocean plant life that the fish eat. They don,t make the n-3 omega.
50 years ago, it was taught that there are 3 essential fatty acids – linoleic, linolenic, and arachidonic acid. Arachidonic acid is not essential, perhaps conditionally essential, since it is made from linoleic acid. The whole thinking about this changed perhaps 25 years ago.
Lineoleic acid is from the fat in “meat”. It is pro-inflammatory. Linolenic acid is “anti-inflammatory”. Then you have the “parents” and the children”. They are measured by GC/MS. I was asked to set up a laboratory some 20 years ago to measure these for health benefit. I wasn’t interested then or now, but my friend Frank Konstantinides, has a laboratory of nutrition in St. Paul, very successful for maybe 15 years now.
At another time, I’ll have to take out the data I have on the subject. The only important therapeutic point is the ratio of n-3/n-6 omega consumed in the diet.
Dr. Saha.
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