Fish oils and Atrial Fibrillation
It is important you read this report in context that the information only pertains to preventing AF in patients who have had an AF diagnosis with fish oils. There are lots of other benefits to individuals who take omega-3 fish oils.
The study, published in the Journal of the American College of Cardiology.
“The results for atrial fibrillation are important negative findings, answering key clinical and research questions,” said Dr. Dariush Mozaffarian, an omega-3 expert at the Harvard School of Public Health, who was not involved in the study.
The new research, combined with other trials, “indicates that short-term fish oil use is unlikely to prevent recurrent atrial fibrillation,” he said.
Atrial fibrillation, in which the heart’s upper chambers beat out of step with those below. The condition is linked to strokes and heart failure.
Although doctors prescribe certain medications to treat the condition, none to date has proven particularly effective. As a result, most drug treatment focuses on preventing strokes by administering blood thinners to dissolve clots caused by the fibrillation.
Some evidence suggests that omega-3 fatty acids, found in oily fish like sardines and tuna, might reduce the risk of atrial fibrillation, although exactly how they would produce their effect is not clear.
A study published earlier this year in Circulation, for example, found that people with the most omega-3s in their blood had a 30% lower chance of developing an irregular heart beat than those with the lowest concentrations of the substances.
That 30% difference would work out to eight fewer cases of atrial fibrillation per 100 people – which would be a meaningful benefit if it could be enjoyed by those with fibrillation or at risk for it, just by consuming more omega 3s.
But the latest study suggests that it probably can’t. The trial included 586 men and women with a history of atrial fibrillation who were given a gram a day of fish oil or dummy capsules for a year. Participants also were allowed to take other drugs to control their heart rhythms, as prescribed by their doctors.
At the end of the study period, about 24% of the people who took fish oil, and 20% of those who did not, had experienced a recurrence of atrial fibrillation – a difference so small, statistically, it was likely due to chance.
The findings on atrial fibrillation echo results from a study led by Mozaffarian published in November, of patients recovering from heart surgery.
Even so, Dr. Alejandro Macchia, a cardiologist at the GESICA Foundation in Buenos Aires, who led the current study and collaborated with Mozaffarian on the previous one, said fish oil may still prove beneficial for heart health, at least in some patients.
Omega 6 not too be confused with Omega 3
This is very confusing as there is so much conflicting information and Omega 6 is not to be confused with Omega 3. This information has been extrapolated from The American Journal of Clinical Nutrition, November 28, 2012.
Despite evidence suggesting omega-6 fatty acids might protect the cardiovascular system, a large new study of men finds the fats typically found in flax seeds and some vegetable oils do nothing to prevent heart failure. ”Although we know omega-6 fatty acids could influence blood pressure in a good way, we don’t see that translate into a lower risk of heart failure,” said Dr. Luc Djousse, one of the authors of the study and a professor at Brigham and Women’s Hospital in Boston.
Omega-6 fatty acids are relatively abundant in the Western diet, and are found in many cooking oils, such as sunflower and canola oils.
The effect of omega-6s on heart health has been controversial, however, according to William Harris, a professor at the University of South Dakota‘s Sanford School of Medicine and a senior scientist at Health Diagnostic Laboratory in Richmond, VA.
“Some people like me and others at the American Heart Association say higher intake of omega-6 is good for your heart from the heart attack point of view. Another group of people are saying high omega-6 is causing inflammation, so that’s a bad thing,” said Harris, who was not part of the current study.
One heart benefit linked by past research to omega-6 consumption is lower blood pressure and because high blood pressure is a risk factor for heart failure, Djousse and his colleagues wanted to see if people who ate more omega-6s also had a lower risk of heart failure.
They used data from a long-term study of 22,000 male physicians in the U.S. At the beginning of the study the men gave a blood sample, from which the researchers determined the level of omega-6 fatty acids in the men’s bodies. Over an average follow-up period of 17 years, 788 of the participants developed heart failure.
Djoussa’s group compared these men to 788 others in the study, who were otherwise similar in age and other measures but had not experienced heart failure.
They found no differences between the two groups of men in the amount of omega-6 fats in their blood. “There’s no evidence of benefit. It’s just one of those things where it doesn’t appear to be playing a role in this particular disease,” indicated William Harris.
Djoussa said his findings suggest that researchers can shift their priorities away from looking to omega-6s as a possible way to reduce the risk of heart failure.
Another recent study by Djousse and his colleagues found that getting a lot of omega-3 fatty acids in the diet by eating fish is tied to a lower risk of heart failure.
Old Fish Wives Tails – not any more
Evidence is building that high quality fish oils containing high levels of EPA and DHA are proving very useful to Heart Failure patients
“Adding n-3 polyunsaturated fatty acids, even in patients that had a major improvement [on standard treatment], showed a further improvement in heart function and exercise capacity,” said study co-author Dr. Mihai Gheorghiade, a professor of cardiology at Northwestern University‘s Feinberg School of Medicine.
This shows that even in patients who respond to therapy, “we can make them much better,” he added. “This opens the door for the potential of a natural therapy — so-called macronutrients — in the management of heart failure.”
Gheorghiade cautioned that this study is not conclusive, but nutrients such as omega-3 fatty acids might extend life and quality of life for these patients.
The report is published in the Jan. 5 online edition of the Journal of the American College of Cardiology.
Gheorghiade’s team randomly assigned 133 heart failure patients with minimal symptoms on standard therapy, which included beta blockers, to high doses (2 grams) of omega-3 fatty acid supplements or a placebo.
After a year, those receiving the omega-3 supplement showed a 10.4 percent increase in heart function, compared with a 5 percent decrease among those taking placebo, the researchers found.
In addition, blood oxygen levels increased 6.2 percent in the omega-3 patients and decreased 4.5 percent in the placebo patients. Also, exercise time went up 7.5 percent in those receiving supplements while it went down 4.8 percent in those receiving placebo, they added.
Moreover, among those taking the supplement the hospitalisation rate was 6 percent during the year, compared with 30 percent for those on placebo.
Gheorghiade speculated that the supplements improved the metabolism of the heart. “This is one example where a nontraditional therapy may also work,” he said.
However, larger studies are needed to really see if this supplement helps prolong life, Gheorghiade said. “It’s promising, but it’s not conclusive,” he said. “But it would be a mistake not to look at the value of the macro and micronutrients in the management of heart failure.”
Gheorghiade doesn’t recommend that people take large amounts of this supplement in hopes of staving off heart disease. Whether or not one should take a supplement is a topic that patients and their doctors should discuss, he said.
Treatment needs to be tailored to individual patients, he pointed out. “This is not a cookbook,” Gheorghiade added.
Dr. W.H. Wilson Tang, an assistant professor of medicine at the Cleveland Clinic and co-author of an accompanying journal editorial, said that “studies on omega-3 fatty acid in heart failure still have not been effectively tested, based on limitations on their designs.”
Tang added, “We need to know what are potential dose and timing of intervention before we can effectively demonstrate whether an intervention works or not.”
The current study suggested that doses far higher than commonly used may have some effect not seen in the larger studies, he said.
“That being said, whether every treatment approach needs mega-trials to demonstrate effectiveness is now being increasingly challenged. The current debate is whether a relatively safe intervention such as fish oil should be recommended based on the current data — it is currently written in some guidelines but not too many doctors are actively recommending them,” Tang said.
Douglas “Duffy” MacKay, vice president for scientific and regulatory affairs at the Council for Responsible Nutrition, which represents the supplement industry, said that “all adults should get 500 milligrams of omega-3 fatty acids, from either diet or supplements, just to maintain heart health.”
The American Heart Association also recommends that people get omega-3 fatty acids for heart health, with at least two servings a week of fatty fish, such as tuna, sardines or salmon, mackerel, herring or lake trout.
Super Heart Foods for Health
Below you will find some super foods for a Healthy Heart. Please note that if you are on Warfarin then remember eat regularly not in bursts to maintain your INR in range.
Food for the heart: spinach
We should all be eating as much spinach as Popeye, according to the British Dietetic Association, who cannot speak highly enough about the health benefits of this super food. Ursula Arens, a dietician and spokesperson for the BDA, says, “We can’t bang the drum enough in praise of spinach. As a nation we eat very few dark green things and this is jam packed with nutrients”.
The dark green, leafy vegetable (and its cousins such as kale, Swiss chard, broccoli, and spring greens) is high in vitamins, minerals, and antioxidants that may protect against cardiovascular disease; it’s also a source of Omega-3 fatty acids.
Spinach is also rich in folate, which helps reduce the blood levels of the amino acid homocysteine. An emerging risk factor for developing cardiovascular disease is a high level of homocysteine.
The BDA recommends eating a portion a day of your favourite dark green, leafy vegetable and says it does not matter if you eat it raw, boiled or fried.
Food for the heart: salmon
Nutritionist Kathleen Zelman, WebMD’s director of nutrition, says she’s a “huge salmon fan”. “Salmon is widely available, affordable, fast, and easy”, she says.
Oily fish such as salmon (as well as mackerel, herring, and sardines) contain high levels of Omega-3s. This “healthy fat” is believed to reduce the risk of developing cardiovascular disease by lowering the levels of triglycerides in the body-blood fats linked to heart disease and diabetes.
Research has also found that Omega-3 fatty acids prevent blood clots by making platelets less likely to clump together and stick to artery walls. Blood vessels are also less likely to constrict, making the heart less vulnerable to life-threatening irregular heart rates.
The British Heart Foundation recommends eating at least two servings of fish (including one of oily fish like salmon) a week; a serving is between 85 grams and 170 grams.
Food for the heart: soya protein
Rich in Omega-3 fatty acids, protein, vitamins, and minerals, soya protein is a good alternative for red meat, says Ms Arens. It is also lower in fat and higher in fibre than many meat choices.
In people with high cholesterol, studies show that soya protein, when eaten with a healthy low-fat diet, lowers cholesterol. In fact, researchers found that people who ate a diet of several cholesterol-fighting foods lowered their cholesterol as much as people who took medicine.
Both the BDA and the BHF encourage eating at least 25 grams of soya protein daily. You can get your soya from soyabeans (they taste a bit like Oriental broad beans and are sold frozen in supermarkets), soya nuts, soya milk, soya flour, energy bars, fortified cereal, tempeh, and tofu.
Food for the heart: porridge
Grandma may have known what she was doing when she served up a piping hot bowl of porridge every morning, says Ms Arens. A daily serving of porridge contains only about 130 calories while delivering five grams of heart-healthy fibre that helps to lower cholesterol and keep body weight at a healthy level.
Ms Arens says, “It’s really good for you. It releases energy slowly and will fill you up for a long time, meaning you won’t nibble unhealthy snacks between meals. Just don’t add extra cream, sugar or honey”.
Porridge oats and other whole grains such as whole wheat, barley, rye, millet, quinoa, brown rice, and wild rice also help reduce the risk of diabetes, which in itself is a risk factor for heart disease, says Ms Zelman.
It’s important to use whole grains, not refined grains, says Ms Zelman, “so you get the whole package”. Refined or processed grains lose their nutrients and fibre.
You can also get your whole grains from whole grain breads and pastas.
The daily recommendation for fibre intake is between 21 and 38 grams, depending on your sex and age, according to the BDA.
Food for the heart: blueberries
Tasty blueberries are considered a “super food” because they contain high levels of antioxidants.
Ms Arens says, “Blueberries and other types of British berries, like blackberries and blackcurrants, are high in antioxidants. There’s been particular interest in blueberries helping with eyesight and reducing the rate of age-related macular degeneration”.
Antioxidants help neutralise harmful byproducts of metabolism called free radicals that can lead to cancer and other age-related diseases. Anthocyanin, the antioxidant that is thought to be responsible for this major health benefit, can also be found in blackberries, black raspberries, blackcurrants, and red grapes.
Researchers believe that the antioxidants in blueberries work to reduce the build up of “bad” LDL cholesterol in artery walls that contributes to cardiovascular disease and stroke.
Studies have shown that blueberries rank very high in antioxidant activity — number one when compared with 40 other fresh fruits and vegetables.
Ms Arens says that, when in season, we should try to eat a portion of berries a day.