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Fish Oil Cuts Risk of Sudden Death

Fish Oil Cuts Risk of Sudden Death

JAMA April 10, 2002;287:1815-1821
The New England Journal Of Medicine April 11, 2002;346:1113-1118

People who eat several servings of fish each week may lower their risk of heart disease and death, two national studies report.

In one study, men without heart disease were 81% less likely to experience sudden death when their blood levels of omega-3 fatty acids were high regardless of their age, smoking habits, or the amount of other types of fatty acids in their blood.

Omega-3 fatty acids, which are found in fatty fish such as salmon and mackerel, may lower the risk of developing an irregular heart rhythm and reduce blood cholesterol and clotting -- all risk factors for heart disease.

The findings point to a way for individuals to lower their risk of sudden death from heart attack.

The results suggest that increasing intake of omega-3 fatty acids by either supplements or by diet may substantially reduce the risk of sudden death, even among those without a history of heart disease.

More than 50% of people who die suddenly of cardiac causes have no signs or symptoms of heart disease.

In the first study, published in the New England Journal of Medicine researchers looked at the experience of about 22,000 male doctors who enrolled in the Physicians' Health Study in 1982. They were all free of heart disease at the time, and about 15,000 volunteered a blood sample.

Over the next 17 years, 94 of the men who had given blood samples and who had not subsequently been diagnosed with heart disease died suddenly. The researchers chose about 180 surviving members of the study and compared them with those victims. In particular, they compared the bloodstream concentrations of substances called omega or n-3 fatty acids, found primarily in fish oils.

On average, the men who died suddenly had lower amounts of n-3 fatty acids than the ones who did not. When the researchers divided all the men into four groups based on the concentration of n-3 fatty acids in their blood, the men in the highest quarter had only a fifth the risk of sudden death as those in the lowest quarter.

In the second study, which appears in JAMA, researchers studied the experience of 85,000 female nurses. Like the physicians, they volunteered to be questioned and followed over many years as part of the Nurses' Health Study, which began in 1976.

The researchers used dietary information gathered in five interviews between 1980 and 1994 to estimate fish intake. They also calculated the approximate amount of n-3 fatty acids consumed, based on the type of fish the women listed in their diet questionnaires.

The researchers found that the more frequently a woman ate fish, the less likely she was to suffer a heart attack or to die of any cardiac cause. Specifically, those who ate fish once a week had a 30 percent lower risk of heart attack or death as those who never ate fish. Eating fish five times a week was only slightly more beneficial; those women had a 34 percent lower risk.

Although ocean-living, cold-water oily fish such as salmon, swordfish and tuna offer the largest, easily accessible sources of n-3 fatty acids, there are others. Flax seed oil, canola oil and English walnuts all contain significant amounts of the oils.

A European study published in 1999 showed that fish oil supplements reduced the risk of sudden death in people who had previously survived a heart attack. The n-3 fatty acids appear to have a specific antiarrhythmic effect, possibly by stabilizing the membranes of heart muscle cells.

The oils also have a blood-thinning effect, like aspirin. In some observational studies, fish consumption has been associated with a lower risk of stroke. There have been anecdotal observations that fish oil supplements may have antidepressant effects as well.

The findings support a growing body of research indicating that omega-3 fatty acids may reduce the risk of heart disease and death.

The New England Journal of Medicine April 11, 2002;346:1113-1118

JAMA April 10, 2002;287:1815-1821


If you live in the Chicago area you will certainly want to mark your calendars for one of the leading world experts in Omega-3 nutrition to speak to the public for only $10. Her book, The Omega Diet, is one of the best ones out there on omega-3 fats for health. You can read more about the lecture by reviewing her lecture page.

If you have been reading the newsletter for awhile, you will know that omega-3 oils is something I have been promoting for some time now. Last month I posted an excellent review on this topic that was published in the Canadian Medical Journal.

Omega three fats are essential to your health. You can certainly get them from cod liver oil or fish oil.

Please remember that nearly all fish are contaminated with mercury and should ideally be avoided. You will want to identify a clean source of fish oil.

If you already have significant sun exposure then you should not take cod liver oil as you will run the risk of overdosing on vitamin D.

You should then take fish oil capsules. The standard fish oil capsule is 180 mg of EPA and 120 mg of DHA. You should take approximately one capsule for every ten pounds of body weight, preferably in two divided doses.

So if you weigh 160 pounds you would take 8 capsules twice a day. If you have problems with belching them up, you will want to consider taking them on an empty stomach.

Probably the best value for fish oil capsules is the one we sell in our office. The Kirkland brand from Costco. They sell a 300 capsule bottle for about $7.50. Because Costco has such a high turnover, the oil is very fresh. You can tell, by puncturing one of the capsules and seeing if there is any "fishy" aftertaste. This is usually a sign of rancid fat and an indication of an inferior product.

Cod liver oil has the benefit of providing you with vitamin D and A. A reasonable dose for cod liver oil is one teaspoon for every 30-40 pounds of body weight. If you use cod liver oil during your summer you will need to be careful of vitamin D toxicity and I suggest you review the information on vitamin D testing.

When you take fish oil supplements or cod liver oil in the doses I recommend please be sure and take an one vitamin E 400 unit supplement per day as this will help serve to protect the fat from oxidation. This is less of an issue with the cod liver oil as the vitamin D itself is a very potent anti-oxidant.

You will also need extra amounts of the "fourth and unforgotten" oil soluble vitamin, vitamin K. If you are juicing plenty of green vegetables and taking the cod liver oil or fish oil with the juice you should absorb the vitamin K in the vegetable juice. However, if you have osteoporosis or osteopenia, you will want to consider adding an extra 1000 mcg ( 1 mg ) of vitamin K per day.

Generally our diet contains far to much omega 6 fats. Experts looking at the dietary ratio of omega-6 to omega-3 fatty acids suggest that in early human history the ratio was about 1:1. Currently most Americans eat a dietary ratio that falls between 20:1 and 50:1. The optimal ratio is most likely closer to the original ratio of 1:1. For most of us this means greatly reducing the omega-6 fatty acids we consume and increasing the amount of omega-3 fatty acids.

Please recognize that we get ALL the omega-6 and omega-9 fat we need from food. We do NOT need to take any supplements for these fats. Many of the omega fat supplements you see in health food stores will only serve to worsen your health, not improve it as they contain omega 6 fats which will worsen your omega-6 to omega-3 ratio.

I strongly recommend avoiding sunflower, corn, soy, safflower, canola, or products that contain these oils. That is no hydrogenated or partially hydrogenated fats, no margarine, no vegetable oil, no shortening. These oils are chock full of omega-6 fats and will only worsen your omega 6:omega 3 ratio.

Acceptable oils will be a high quality extra virgin olive oil, coconut oil, avocados, and organic butter, or better yet grass-fed organic butter.

Another way to improve your omega 6:3 ratio is to change the type of meat you are eating. You could consume more game meat like venison, or other game animals that are raised exclusively on grass type foods. However, these are hard to find and generally more expensive than beef.

Since nearly all cattle are grain fed before slaughter, if you eat most traditionally raised beef, it will typically worsen you omega 6:omega 3 ratio.

Normally a good ratio for omega 6:3 in fish is 2 or 3 to 1. The lower the better. Grassfed beef from Grassfed Organics is much higher in Omega 3 than fish, with a 6:3 ratio of 0.16 to 1. This information is from a study done at Iowa State University in August 2001.

To get the necessary Omega-3 fatty acids, you should consider eating meat that is allowed to "free-range", or in the case of cattle, to be grass-fed. Unfortunately, you cannot buy this grass-fed beef at your local grocery store.

You must also be careful as many stores will advertise grass-fed beef but it really isn't. They do this as ALL cattle are grass fed, but the key is what they are fed the months prior to being processed.

Most all cattle are shipped to giant feed lots and fed corn to fatten them up. You will need to call the person who actually grew the beef, NOT the store manager, to find out the truth.

The least expensive way to obtain authentic grass fed beef would be to find a farmer who is growing the beef who you can trust and buy a half a side of beef from him. This way you save the shipping and also receive a reduced rate on the meat.

An inexpensive, yet effective way to determine if the meat is really from a grass fed animal is to purchase the ground beef. Slowly cook the beef till done and drain and collect all the fat. Grass fed beef is very high in omega-3 fats and will be relatively thin compared to traditionally prepared ground beef.

It will also be a liquid at room temperature as it has very few saturated fats which are mostly solid at room temperature.

However, most of us live in large urban areas and do not have the time for this process. Just as it would be ideal to have an organic garden and grow your own vegetables, most of us elect not to do that for time or space reasons.

I used to have an organic garden, but my schedule just would not allow me to have that luxury anymore. So, if you are convinced, like I am, that grass-fed beef is better for you and you would like the convenience of being able to order it over the Net, you can buy grass-fed beef online, shipped overnight to your door, at Grassfed Organics.

The New England Journal Of Medicine April 11, 2002;346:1113-1118
JAMA April 10, 2002;287:1815-1821

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