In this column we will continue to look at the benefits of fish oil. Remember that these fatty acids namely EPA and DHA are found mainly in fish and are called essential fatty acids as they need to be taken specifically because the body is unable or poorly able to make these essential fatty acids.

The role of these EFA’s in heart health is of great importance and there is mounting evidence that Omega 3 fatty acid fish or fish oil supplements can not only help to prevent heart disease in healthy individuals but also reduce the incidence of cardiac events and mortality (death) in patients with existing heart disease.

Interestingly culture has historically played a role, sometimes dubbed the ‘Eskimo factor’. Research shows cultures that have traditionally supported a diet rich in fish oil – like the Asians and Alaskan American populations – have a lower prevalence of heart disease and mortality compared to European and U.S. populations where consumption of fish is lower.

Unfortunately the introduction of Western dietary practices into Asian and Native American cultures is diluting the cardio protective benefits enjoyed by these populations by both reducing the overall intake of fish oils as well as overwhelming its benefits with other deleterious dietary practices including high intakes of saturated and transfatty acids and cholesterol.

Remember saturated fats come from sources like butter, cream and cheese and transfatty acids come from hydrogenated oils that are used in baking, prepared foods and margarines.

Dr. Carl Lavie the Medical Director of Cardiac Rehabilitation and Prevention in New Orleans, believes that the benefits of fish oil are not just hype. There is tremendous and compelling evidence from very large studies, some dating back 20-30 years, that demonstrate the protective benefits of Omea 3 fish oil especially in patients with established heart disease or following a heart attack. Studies have shown up to 30% reduction in heart related death says Dr. Lavie.

The earliest damage to the coronary blood vessels that carry the blood supply to the heart muscle begins in the endothelial lining of the vessels. An inflammatory process in the blood vessels leads to a process called atherosclerosis which results in the hardening and narrowing of these vessels by deposits called plaques. Subsequent rupture of these plaques cause heart attacks. Fish oil exerts its preventative benefit by decreasing inflammation and atherosclerosis reducing the risk of sudden cardiac death and heart attack.
The DHA and EPA from fish oil also work by getting into the cell membrane and may help to improve the heart’s electrical activity that helps in treating irregular heart rhythms.

Studies have also shown great promise in the reduction of ‘triglyceride levels’ which is a risk marker for heart disease, as also modest increase in HDL (the good cholesterol). No doubt further studies in this area are eagerly awaited.

There is clear health and heart benefits associated with increasing ones intake of food that are rich in Omega 3 including oily fish like sardines, anchovies, mackerel, trout and wild salmon. As contamination of fish is becoming an increasingly environmental hazard it is wise to be aware of this fact and avoid fish from areas that could be contaminated with PCB’s, dioxins and mercury. Eating fish 2-3 times/week may not be easy for several individuals and hence patients should consult with their health practitioners to get the right amount of fish oil supplements for their needs.

Fish oils also make the blood thin and hence avoiding interaction with certain drugs or at times of an operation may be necessary. Fish oil quality is extremely important while supplementing as not all fish oils are equal. Purity, freshness and the dosage of EPA and DHA need to be considered carefully to get optimal benefit and avoid any harm with supplementation.

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