Medical Associates Clinic

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GETTYSBURG MEDICAL NEWS
The Clinical View
by P.E. Hoffsten, MD
22 May 2002

THE BENEFITS OF FISH OIL

 In the 1970’s,  population studies were done in various parts of the world and it was discovered that the incidence of heart disease on Eskimos was very, very low.  Yet the Eskimo diet consisted of large amounts of fat obtained from animals native to the far north. Unbelievably, serum cholesterol’s in some of these  individuals were found to be a high as 2,000 mg%.  Note that a  normal value in the United States is 200 mg%.  Physicians in the United States become very disturbed when they find a patient with a cholesterol of 300 mg% as this is associated with a huge increase in the incidence of heart disease.  Yet here were the Eskimos with a very, very low incidence of heart disease and unbelievably increased rates of total cholesterol.

 This led scientists to investigate the contents of the Eskimo's fatty foods.  It turned out that there was a markedly increased amount of a certain type of fatty acid called an N-3 polyunsaturated fatty acid (PUFA) that is rich in the fish oil Eskimo eat.  The idea that large amounts of fish oil intake was associated with a decreased rate of heart attack was tested in other populations.  Specifically, the Mediterranean Island of Crete has a very low incidence of heart attacks.  It was found that their diets also contained large amounts of fish oil because of their fish intake but also related to the unique vegetable oil intake that they have.  This led to the so called “Mediterranean  diet”.

 Through the 1980’s, the idea that fish oil would have some impact on heart disease was further tested.  There are now four separate very large and reliable studies demonstrating that individuals that have an increased intake of fish oil as opposed to animal fat such as beef, pork, or chicken have a decreased rate of heart attack.  Initially, studies were done along the coast of the United States as compared to the midwest.  It was seen that there was more fish intake along the coast than there was in the upper midwest.  Indeed the rate of heart attacks seemed to be less in those individuals living along the ocean fronts who ate more fish than did the midwestern rural dweller.

 Recently, the mechanism of how fish oil would help with preventing heart attacks and preventing sudden death has been further studied.  It turns out that not only does fish oil decrease the incidence and severity of coronary artery disease, it also prevents sudden death when a heart attack occurs.  Thus, it makes an individual’s heart attack more survivable.

 The right amount of fish used has been recommended by the American Heart Association.  It is recommended that 35 gms or about 2 ounces of fish be consumed twice a week.  The type of fish needs to be salt-water species.  Specifically, those wonderful walleye from our local fresh water lake do not benefit as do salt-water salmon, halibut, herring, or mackerel out of the ocean.

 In South Dakota, salt-water fish consumption is quite low.  No matter which direction one would travel, we are as far away from salt water as a person can get.  Our salt-water fish rarely come to South Dakota fresh but instead are frozen and shipped in that manner.  While that may suit the palates of some individuals, it is not a high consumption item in our state.

 In order to have the benefits of the fish oil intake without changing our diet dramatically, the use of a fish oil supplement is a recommended step.  Local pharmacies have very cheap fish oil supplements that can be used to provide the fish oil that is beneficial in our diet.  The use of 3 gms per day of the fish oil is adequate to equal the fresh salt-water fish consumption recommended.  I have queried local pharmacies and the cost of the supplement is much cheaper than buying fish at the grocery store and it doesn’t take a change in your dietary preferences. Contrary to some gossip and claims, you don’t wind up smelling like a fish after a few weeks either.

 Of all the many dietary vitamin and supplement recommendations, this one is based on good scientific foundation and testing in over 40,000 people showing the rate of heart attack is lower with fish oil consumption than without.  The data in regards to stroke prevention is not as extensively studied but appears to be parallel to the benefits for heart attacks.

 In summary, it is recommended that fish oil, 3 gms per day, be consumed as a preventive for heart attacks and strokes.  A secondary benefit is an increased survival of those that do have a heart attack using the fish oil as mentioned above.