PRESCRIPTIONS
Protect your heart by eating omega-3 fats
By Landis Lum
Q. I had heart bypass surgery last month, and my doctor suggested I take fish oil capsules. (I hate fish.) What's the scoop?
A. Here's evidence that omega-3 fatty acids, which can be found in fish, can help: Heart disease is rare in Greenland Eskimos, but when a group of them moved to Denmark their chance of heart attack increased tenfold. In Greenland, dietary fat comes from the sea, while in Denmark (and the United States), fat comes mainly from land animals. Studies show that the fats called omega-3 fatty acids — found in fish, nuts, avocados, and olive, canola, soybean and flaxseed oils — help protect the heart.
The largest such study randomly gave 11,324 patients with heart disease either nothing, 300 milligrams of vitamin E or 850 milligrams of omega-3 fatty acids from fish (also known as EPA and DHA) per day. Vitamin E did nothing, while the EPA/DHA combination from fish oils led to a 20 percent reduction in total deaths and a 45 percent reduction in sudden deaths.
The American Heart Association advised in November 2002 in the journal Circulation that people like you who have heart disease eat about 1 gram, or 1,000 milligrams, of EPA/DHA a day, preferably from fatty fish, but that EPA/DHA supplements (usually in the form of capsules) be considered in patients who can't eat fish in such amounts.
This means 2 ounces of chinook or Atlantic salmon, 3 ounces of trout or 4 ounces of white canned-in-water tuna a day (or double these amounts three to four days a week). For seafood with less fat, it gets worse: 12 ounces a day of clams, light canned-in-water tuna, or mahi- mahi.
Fish oils seem to calm the heart muscle, not only reducing heart rate but also reducing dangerous palpitations. Many capsules have about 300 milligrams of EPA/ DHA (read the label), so you'd need to take three capsules a day if you don't eat fish. There's a low chance of fishy aftertaste or nausea, but because the supplements are not regulated by the Food and Drug Administration, their purity and dosage aren't assured.
Tests of 20 fish-oil supplements by ConsumerLab.com found no mercury, but six of 20 had substantially less EPA or DHA than they claimed. Interestingly, two of these six stated on their labels that their potency had been tested or verified. And some supplements may even contain contaminants from pesticides, especially if they're from fish liver rather than fish body.
People who don't have heart problems should eat a variety of fish (preferably oily) at least twice a week, especially if you're older than 40, overweight, or have diabetes or other heart-disease risk factors.
Dr. Landis Lum is a family practice physician for Kaiser Permanente and an associate clinical professor at the University of Hawai'i's John A. Burns School of Medicine. Write: Prescriptions, Island Life, The Honolulu Advertiser, P.O. Box 3110, Honolulu, HI 96802; e-mail islandlife@ honoluluadvertiser.com.
