Can eating fish prevent heart disease?

Eat things that swim!

How in the world can fish help prevent heart disease? They haven’t learned how to get away from sharks!

Low rates of heart disease exist in populations that eat a lot of fish including Alaskan natives, Greenland eskimos, and fishing village people of Japan. We don’t eat that much fish in the United States compared to other populations. But when we do eat fish, our go to is shrimp. The silver and bronze medals go to salmon and canned tuna. Fourth is Tilapia, and then Pollock. So, does eating seafood, specifically cold water, oily fish, prevent heart disease?

Fish and other marine life contain high concentrations of a heart protective fat called long chain polyunsaturated fatty acids. The other common term for some of these good fats is “Omega 3’s.” The scientific names for them are eicosapentaenoic acid, docosahexaenoic acid, and possibly a third, docosapentaenoic acid. Say that really fast three times! These fats are highly prized by our bodies as building blocks for cell membranes and have also been shown to decrease inflammation, reduce triglycerides, reduce blood clotting, improve blood vessel dilation, and tickle our taste buds.

What if I’ve had a heart attack?

Unfortuately, no good studies exist that have looked at people with heart attacks who then start eating fish. Most studies look at 50-100 people. Hardly the size of a study to make recommendations to the world. The best study was done in the United Kingdom where men who had heart attacks were told to eat oily fish two times per week or take 1.5 grams of fish oil. After 2 years, the patients told to eat fish had lower death from heart disease.

Okay, I’ve not had a heart attack. Do they prevent heart disease?

Fish do prevent heart attacks. In a large review of studies of over 400,000 participants, eating fish 4 or more times per week, was associated with the largest reduction in heart attacks in men and women. For every serving (size of a deck of cards) of fish, the rate of heart attacks dropped by 5%. Interestingly eating 1 serving of seafood a week reduced ischemic strokes as well.

Do fish prevent sudden cardiac death?

Fish also prevent “sudden cardiac death.” In one study, the biggest effect was in those who ate fish 5 times weekly, however eating fish once a week was pretty close to the benefit of 5 times/week. Even eating fish 1-3 times monthly prevented sudden cardiac death. Another study showed that eating fish 2 times per week provided the maximum protective benefit from sudden death. These findings were confirmed in another study that showed that fish protected people from sudden death (incidentally this study also showed that saturated fat was NOT associated with sudden cardiac death). Another study showed that Omega 3’s from both fish AND plants were also protective from sudden cardiac death—good news if you don’t like fish!

Can I eat fish sticks? Fried fish is yummy!

Don’t bite that hook (har!). Three very prominent studies have shown that consistently eating fried fish/other foods is associated with a higher incidence of developing heart failure later in life (Study 1, Study 2, and Study 3). Frying in this case means cooking in oil.

Am I going to get mercury poisoning Dr. Lughead? What about farm raised salmon? Should I order my fish from Alaska?

Two common concerns about fish include mercury poisoning and over fishing the oceans. Farm raised fish do have different Omega 3 levels than their wild counterparts. Some farm raised fish have MORE such as salmon or trout while some have lower levels of Omega 3 like catfish (yuk!) and crawfish (double yuk!). There is no current evidence to support the idea that mercury in fish leads to more heart attacks or heart death.

Just tell me what to do!

So what’s the bottom line. 1). Eating two servings of cold water, oily fish per week will likely provide maximum benefit in preventing heart attacks, strokes, and sudden cardiac death. 2). Avoid frying fish–instead bake or broil. 3). Farm raised fish may be a good substitute for wild fish. 4). Omega 3’s from plants may be just as protective of heart conditions as Omega 3’s from fish. 5). Substitute fish for saturated fats like beef, pork, chicken, etc…