Omega-3 Fatty Acids and Cardiovascular Disease
Tim Church, M.D., Ph.D., M.P.H.

Recently, there has been a lot press on omega-3 fatty acids. It has long been hypothesized that the low rates of cardiovascular disease found in Alaskan Natives is due to their high intake of omega-3 fatty acids through their fish based diet. While the idea that omega-3 fatty acids provide health benefits is not new, the accumulation of solid research studies supporting the importance of them is exciting.

Omega-3 fatty acids are essential fatty acids, meaning your body cannot produce them and they must come from the diet. They are also often referred to as n-3 PUFAs (polyunsaturated fatty acids). There are three omega-3 fatty acids:

alpha-linolenic acid (ALA) -- found in tofu, soybean, flax seed and canola oils and nuts.
eicosapentaenoic acid (EPA) -- found in seafood, especially cold-water fish and seafood.
docosahexaenoic acid (DHA) -- found in seafood, especially cold-water fish and seafood.

The most common source of omega-3 fatty acids are fatty fish like mackerel, lake trout, herring, sardines, Alaskan char, albacore tuna and salmon. Different types of fish contain different amounts of these fats and as a general rule the colder the water the fish lives in the higher the concentration of omega-3 fatty acids. There have been a number of studies, which show that men and women who eat fish on a regular basis have substantially lower risk for heart disease than individuals who do not eat fish. Based on these and other studies, the American Heart Association recommends eating fish two times per week. There is compelling evidence that increasing omega-3 fatty acid intake is particularly important in individuals who already have cardiovascular disease.

For those people who do not eat fish, there is evidence that fish oil pills containing omega-3 fatty acids produce similar benefits to eating fish. In the GISSI trial from Italy, which was composed of 11323 individuals who have had a heart attack, a 20 percent reduction in overall mortality and a 45 percent reduction in sudden death was found in participants who took fish oil capsules compared to individuals who did not. The capsules consisted of 850 mg of omega-3 fatty acid ethyl esters (as EPA and DHA).

A number of mechanisms have been proposed as to how omega-3 fatty acids provide protection against heart disease. These include reducing blood triglycerides, reducing the clotting ability of platelets and improving the function of the blood vessels. Interestingly, omega-3 fatty acids appear to be particularly protective against deadly heart rhythm disturbances (arrhythmias), which are the principle cause of sudden cardiac death. There is data to suggest that omega-3 fatty acids protect the heart from arrhythmias by stabilizing the electrical activity of the heart muscle cells.

In addition to providing protection against cardiovascular disease, there is preliminary evidence that omega-3 fatty acids may be important in the treatment of arthritis, Alzheimer's disease, depression and cancer. While there is still more work to be done, it is clear that eating fish high in omega-3 fatty acids provides substantial health benefits particularly if you have a history of cardiovascular disease. And if you do not eat fish, taking an omega-3 supplement may be a good alternative. As always be sure to check with you physician before you make any changes in your diet, medications, or vitamin-supplement use.

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