COMMENTARY

Preventing Heart Failure: Thanks for All the Fish

Sandra A. Fryhofer, MD

Disclosures

July 20, 2011

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Sandra A. Fryhofer, MD: Hello. I'm Dr. Sandra Fryhofer. Welcome to Medicine Matters. The topic: How eating fish can lower a woman's heart failure risk. Here's why it matters.

As many as 5.7 million people in the United States currently suffer from heart failure. Heart failure sends more patients over 65 to the hospital than anything else. It consumes precious healthcare resources. That's why preventing heart failure is vitally important. A study in the journal Circulation: Heart Failure, which is the Women's Health Initiative observational study, included more than 84,000 postmenopausal women, 85% of whom were white.[1] Their average age at the beginning of the study was 63 years old. Seventeen years of data were analyzed, which included more than 1800 cases of heart failure. Dietary history was also assessed.

Researchers found that women who ate 5 or more weekly servings of broiled or baked fish had a 30% lower risk for heart failure compared with women who ate less than 1 serving a month.

There are some caveats. Not all fish were equally effective at preventing heart failure. Darker fish like salmon, mackerel, and blue fish were linked to significantly greater risk reductions compared with tuna or white fish like sole, snapper, and cod.

Preparation also mattered. For heart failure protection, the fish had to be either baked or broiled, not fried. In fact, just 1 weekly serving of fried fish was linked to a 48% higher risk. Although frying increases trans fats, which can increase heart disease risk, the study did not link trans fats to heart failure risk.

Fish are a good source of omega-3 fatty acids, including EPA, DHA, and ALA, which decrease inflammation and relieve oxidative stress. They also improve blood pressure and heart and blood vessel function.

How women prepared fish seemed to reflect their lifestyles. Compared with women who ate more fried fish, those who tended to eat broiled and baked fish had the following characteristics:

  • Were more physically active, more educated, and less likely to smoke;

  • Had less diabetes, less high blood pressure, and less pre-existing heart disease;

  • Included more fruits and vegetables in their diet; and

  • Tended to weigh less and have lower body mass indices.

Note that 5 or more servings of fish per week associated with 30% lower heart failure risk is more than twice the American Heart Association general recommendation, which is at least 2 servings of fish, preferably fatty fish, each week. By the way, a serving of fish is only 3.5 ounces.

For Medicine Matters, I'm Dr. Sandra Fryhofer.

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