Friday, December 28, 2007
omega-3
How Much Fish Is Enough?
Michael Miller, MD, FACC, FAHA
Medscape Family Medicine. 2007; ©2007 Medscape
Posted 12/19/2007
Question
Can't people get the omega-3 fatty acids they need from a diet rich in fish?
Response from Michael Miller, MD, FACC, FAHA
Associate Professor of Medicine, Epidemiology, and Preventive Medicine; Director, Center for Preventive Cardiology, Division of Cardiology, University of Maryland Medical Center, Baltimore, Maryland
The answer depends on the amount required for the potential cardiovascular benefits attributable to omega-3 fatty acids. Specifically, omega-3 fatty acids have been shown to reduce the risk of sudden cardiac death in patients with preexisting coronary heart disease (CHD)[1] and to lower triglyceride (TG) levels in subjects with hypertriglyceridemia.[2] To achieve the former, the American Heart Association recommends the equivalent of 1 gram of active omega-3 compounds (eicosapentaenoic [EPA] and docosahexaenoic acids [DHA]) ingested daily.[3] This amount can be obtained by consuming a 4-ounce serving of white albacore tuna, 2 to 3 ounces of salmon (pink or red), 2 ounces of herring, and 2 to 3 ounces of sardines daily. Alternatively, significantly higher quantities of shellfish would need to be consumed, including 8 or more ounces of crab, shrimp, and lobster daily.[3] For significant TG-lowering effects (20% reduction and greater), the amount of EPA/DHA required is considerably higher (ie, 2 to 4 grams daily) and exceedingly difficult to obtain unless a person consumes vast quantities of fish every day. Therefore, patients with CHD can get the omega-3 fatty acids needed from a diet rich in oily fish. Similarly, patients with TG levels in the borderline-elevated range (150-199 mg/dL) may reduce TG levels by approximately 10% with consumption of fish equivalent to 1 gram of EPA/DHA. However, with higher TG levels, and especially when levels exceed 500 mg/dL, a diet rich in fish is most likely to be insufficient for reducing TG levels to an acceptable range.
Supported by an independent educational grant from Reliant Pharmaceuticals
Michael Miller, MD, FACC, FAHA
Medscape Family Medicine. 2007; ©2007 Medscape
Posted 12/19/2007
Question
Can't people get the omega-3 fatty acids they need from a diet rich in fish?
Response from Michael Miller, MD, FACC, FAHA
Associate Professor of Medicine, Epidemiology, and Preventive Medicine; Director, Center for Preventive Cardiology, Division of Cardiology, University of Maryland Medical Center, Baltimore, Maryland
The answer depends on the amount required for the potential cardiovascular benefits attributable to omega-3 fatty acids. Specifically, omega-3 fatty acids have been shown to reduce the risk of sudden cardiac death in patients with preexisting coronary heart disease (CHD)[1] and to lower triglyceride (TG) levels in subjects with hypertriglyceridemia.[2] To achieve the former, the American Heart Association recommends the equivalent of 1 gram of active omega-3 compounds (eicosapentaenoic [EPA] and docosahexaenoic acids [DHA]) ingested daily.[3] This amount can be obtained by consuming a 4-ounce serving of white albacore tuna, 2 to 3 ounces of salmon (pink or red), 2 ounces of herring, and 2 to 3 ounces of sardines daily. Alternatively, significantly higher quantities of shellfish would need to be consumed, including 8 or more ounces of crab, shrimp, and lobster daily.[3] For significant TG-lowering effects (20% reduction and greater), the amount of EPA/DHA required is considerably higher (ie, 2 to 4 grams daily) and exceedingly difficult to obtain unless a person consumes vast quantities of fish every day. Therefore, patients with CHD can get the omega-3 fatty acids needed from a diet rich in oily fish. Similarly, patients with TG levels in the borderline-elevated range (150-199 mg/dL) may reduce TG levels by approximately 10% with consumption of fish equivalent to 1 gram of EPA/DHA. However, with higher TG levels, and especially when levels exceed 500 mg/dL, a diet rich in fish is most likely to be insufficient for reducing TG levels to an acceptable range.
Supported by an independent educational grant from Reliant Pharmaceuticals
# posted by roodbont @ 3:00 PM 
