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      Issues of Fish Consumption for Cardiovascular Disease Risk Reduction

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          Abstract

          Increasing fish consumption is recommended for intake of omega-3 ( n-3) fatty acids and to confer benefits for the risk reduction of cardiovascular disease (CVD). Most Americans are not achieving intake levels that comply with current recommendations. It is the goal of this review to provide an overview of the issues affecting this shortfall of intake. Herein we describe the relationship between fish intake and CVD risk reduction as well as the other nutritional contributions of fish to the diet. Currently recommended intake levels are described and estimates of fish consumption at a food disappearance and individual level are reported. Risk and benefit factors influencing the choice to consume fish are outlined. The multiple factors influencing fish availability from global capture and aquaculture are described as are other pertinent issues of fish nutrition, production, sustainability, and consumption patterns. This review highlights some of the work that needs to be carried out to meet the demand for fish and to positively affect intake levels to meet fish intake recommendations for CVD risk reduction.

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          Fish and omega-3 fatty acid intake and risk of coronary heart disease in women.

          Frank Hu (2002)
          Higher consumption of fish and omega-3 fatty acids has been associated with a lower risk of coronary heart disease (CHD) in men, but limited data are available regarding women. To examine the association between fish and long-chain omega-3 fatty acid consumption and risk of CHD in women. Dietary consumption and follow-up data from 84 688 female nurses enrolled in the Nurses' Health Study, aged 34 to 59 years and free from cardiovascular disease and cancer at baseline in 1980, were compared from validated questionnaires completed in 1980, 1984, 1986, 1990, and 1994. Incident nonfatal myocardial infarction and CHD deaths. During 16 years of follow-up, there were 1513 incident cases of CHD (484 CHD deaths and 1029 nonfatal myocardial infarctions). Compared with women who rarely ate fish (<1 per month), those with a higher intake of fish had a lower risk of CHD. 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 times per week (P for trend =.001). Similarly, women with a higher intake of omega-3 fatty acids had a lower risk of CHD, with multivariable RRs of 1.0, 0.93, 0.78, 0.68, and 0.67 (P<.001 for trend) across quintiles of intake. For fish intake and omega-3 fatty acids, the inverse association appeared to be stronger for CHD deaths (multivariate RR for fish consumption 5 times per week, 0.55 [95% CI, 0.33-0.90] for CHD deaths vs 0.73 [0.51-1.04]) than for nonfatal myocardial infarction. Among women, higher consumption of fish and omega-3 fatty acids is associated with a lower risk of CHD, particularly CHD deaths.
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            Cardiovascular effects of marine omega-3 fatty acids.

            Philip C. Calder, Anthony C. Davidson, B. Schmidt … (2010)
            Much evidence shows that the marine omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid have beneficial effects in various cardiac disorders, and their use is recommended in guidelines for management of patients after myocardial infarction. However, questions have been raised about their usefulness alongside optimum medical therapies with agents proven to reduce risk of cardiac events in high-risk patients. Additionally, there is some evidence for a possible pro-arrhythmic effect in subsets of cardiac patients. Some uncertainly exists about the optimum dose needed to obtain beneficial effects and the relative merit of dietary intake of omega-3 polyunsaturated fatty acids versus supplements. We review evidence for the effects of omega-3 polyunsaturated fatty acids on various cardiac disorders and the risk factors for cardiac disease. We also assess areas of uncertainty needing further research. Copyright 2010 Elsevier Ltd. All rights reserved.
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              Fish consumption and risk of sudden cardiac death.

              U Ajani, Charles Hennekens, J Manson … (1998)
              Dietary fish intake has been associated with a reduced risk of fatal cardiac end points, but not with nonfatal end points. Dietary fish intake may have a selective benefit on fatal arrhythmias and therefore sudden cardiac death. To investigate prospectively the association between fish consumption and the risk of sudden cardiac death. Prospective cohort study. The US Physicians' Health Study. A total of 20 551 US male physicians 40 to 84 years of age and free of myocardial infarction, cerebrovascular disease, and cancer at baseline who completed an abbreviated, semiquantitative food frequency questionnaire on fish consumption and were then followed up to 11 years. Incidence of sudden cardiac death (death within 1 hour of symptom onset) as ascertained by hospital records and reports of next of kin. There were 133 sudden deaths over the course of the study. After controlling for age, randomized aspirin and beta carotene assignment, and coronary risk factors, dietary fish intake was associated with a reduced risk of sudden death, with an apparent threshold effect at a consumption level of 1 fish meal per week (P for trend=.03). For men who consumed fish at least once per week, the multivariate relative risk of sudden death was 0.48 (95% confidence interval, 0.24-0.96; P=.04) compared with men who consumed fish less than monthly. Estimated dietary n-3 fatty acid intake from seafood also was associated with a reduced risk of sudden death but without a significant trend across increasing categories of intake. Neither dietary fish consumption nor n-3 fatty acid intake was associated with a reduced risk of total myocardial infarction, nonsudden cardiac death, or total cardiovascular mortality. However, fish consumption was associated with a significantly reduced risk of total mortality. These prospective data suggest that consumption of fish at least once per week may reduce the risk of sudden cardiac death in men.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Nutrients
                Journal ID (iso-abbrev): Nutrients
                Journal ID (publisher-id): nutrients
                Title: Nutrients
                Publisher: MDPI
                ISSN (Electronic): 2072-6643
                Publication date (Electronic): 28 March 2013
                Publication date Collection: April 2013
                Volume: 5
                Issue: 4
                Pages: 1081-1097
                Affiliations
                [1 ]Grand Forks Human Nutrition Research Center, Agricultural Research Service, United States Department of Agriculture, Grand Forks, ND 58201, USA; E-Mails: lisa.jahns@ 123456ars.usda.gov (L.J.); matthew.picklo@ 123456ars.usda.gov (M.J.P.)
                [2 ]Department of Food Science and Nutrition, University of Minnesota, Minneapolis, MN 55108, USA
                [3 ]Office of National Programs, Agricultural Research Service, United States Department of Agriculture, Beltsville, MD 21769, USA; E-Mail: jeff.silverstein@ 123456ars.usda.gov
                [4 ]Department of Chemistry, University of North Dakota, Grand Forks, ND 58203, USA
                Author notes
                [* ] Author to whom correspondence should be addressed; E-Mail: susan.raatz@ 123456ars.usda.gov ; Tel.: +1-701-795-8294; Fax: +1-701-795-8240.
                Article
                Publisher ID: nutrients-05-01081
                DOI: 10.3390/nu5041081
                PMC ID: 3705336
                PubMed ID: 23538940
                SO-VID: f07e5c3a-5978-49b0-8d85-95f8433c6239
                Copyright © © 2013 by the authors; licensee MDPI, Basel, Switzerland.
                License:

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0/).

                History
                Date received : 10 January 2013
                Date revision received : 10 February 2013
                Date accepted : 13 March 2013
                Categories
                Subject: Review

                ScienceOpen disciplines: Nutrition & Dietetics
                Keywords: cardiovascular disease,dha aquaculture ,epa,fish,omega-3 fatty acids
                Data availability:
                ScienceOpen disciplines: Nutrition & Dietetics
                Keywords: cardiovascular disease, dha aquaculture , epa, fish, omega-3 fatty acids

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