Charles A. Bertrand, M.D., FACP, DIM-CD (Ret.)
Associate Clinical Professor of Medicine at New York Medical College
and at the Medical University of South Carolina


The country has gone crazy over diets, and sometimes it's difficult to tell whether eating a particular food will improve your health, have little effict, or put you in an early grave. Such is the case with fish. For example, you've probably read that eating fish will prevent heart trouble. But is that statement really true?

In order to provide a definite answer, researchers Albert, Hennekens et al recently published a report in the Journal of the American Medical Association (Jan 7, 1998). Their article, entitled "Fish Consumption and Risk of Sudden Cardiac Arrest," focused on the U.S. Physicians Health Study Group, a sample of 20,551 U.S. male physicians --between 40 and 84 -- who enrolled in 1982 and, at that time, were free of heart disease, cerebral vascular disease, and cancer.

The authors were particularly interested in two health problems: sudden cardiac death (i.e. cardiac arrest) and heart attacks (i.e. myocardial infraction, a heart attack caused by a blood clot that damages the heart muscle). For purposes of their study, the authors defined "sudden cardiac death" as "dying within one hours of the onset of symptoms."

The researchers measured the dietary intake of fish, dividing the amount eaten into several different brackets. In order to insure the validity of their fishy conclusions, they also corrected for other cardiac risk factors such as smoking and high blood pressure.

The results were mixed but encouraging. The incidence of heart attacks was about the same in subjects who ate fatty fish once a week and those who didn't. However, the authors reported a 52 percent reduction of sudden cardiac death in those who did eat fish once a week, as compared with those who ate fish less than once a month.

This was not an unexpected result. Experimental data on dogs and primates had previously suggested that n-3 fatty scids in fish might affect the membrane of cells and therefore have an anti-arrhythmic effect. Cardiac arrest is the worst form of arrythmia. The intake of fish probably prevented arrhythmic death in many animal subjects.

Given those findings, you inevitably ask: If one fish meal a week increases your chances of avoiding sudden cardiac death, will three or more fish meals further improve your odds of surviving? Researchers reported such was not the case.

The implications of this study are enormous, particularly when you consider the fact that about 250,000 people die annually as the result of sudden cardiac arrest; and half of these have no prior history of heart disease.

In many medical journals, significant findings are discussed in seperate editorials, as well as in the articles themselves. Sometimes the editors praise the article and sometimes they offer criticisms. In the companion article to this study, Dr. Dean Kramhout--who had, some 15 years ago, published research on the relationship between fish and coronary disease--agreed with the authors and concluded that patients who have never had heart trouble would be wise to eat one fatty fish meal per week. He also suggested that those with a heart condition should eat fish twice a week, though he offered no supporting evidence for his conclusion.

The advice provided on this website is intended to be general in nature and should not be relied upon for specific treatment. If you need personal medical attention please contact your physician.

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