Use and misuse of dietary fatty acids for the prevention and treatment of coronary heart disease.
Use and misuse of dietary fatty acids for the prevention and treatment of coronary heart disease.
Year: 2004
Authors: M de Lorgeril, P Salen.
Publication Name: Reprod. Nutr. Dev.
Publication Details: Volume 44; Page 283
Abstract:
The study of the health benefits of n-3 fatty acids has attracted considerable interest over the past few decades particularly in regard to cardio protective effect. In this review, DeLogeril reviews and summarizes key data highlighting the importance of the n-3 fatty acids alpha-linolenic acid (ALA), eicosapentenoic acid (EPA) and docosahexaenoic acid (DHA) in the primary and secondary prevention of cardiac events. In assessing the data, the benefits of consuming ALA, EPA and DHA appears to lie primarily in the prevention of sudden cardiac death (SCD). Research has indicated that consuming moderate amounts of fish may be associated with a 50% reduced risk of SCD. However, based on this same data, no risk reduction was observed for non-SCD or myocardial infarction. It appears the preventative effect of n-3 fatty acids on SCD are most likely attributed to an anti-arrhythmic effect. N3 fatty acids may also protect the heart by significantly reducing infarction in that myocardial cells rich in n-3 fatty acids may be resistant to ischemia. Furthermore, a growing body of evidence now suggests that n-3 fatty acids have an important cardioprotective role in patients with existing coronary heart disease (CHD). In addition to EPA and DHA, ALA has also been found to exert a cardioprotective effect through a direct and beneficial effect on cardiac arrhythmias. ALA can also reduce the elongation of linoleic acid (LA) to arachidonic acid (AA), the precursor for a number of pro-inflammatory eicosanoids. The prevalence and severity of eicosanoid related disorders including atherosclerotic complications and SCD have been shown to be lower following intake of ALA. The balance between n-3 and n-6 fatty acids, not absolute n-3 fatty acid intake appears to be critical in the prevention of CHD. ALA is also a feasible n-3 source for individuals who cannot, or will not, eat fish. Strong evidence supports the consumption of n-3 fatty acids for a protective effect in CHD risk, particularly in regard to SCD. The author strongly advises that cardiologists should not only recommend an increased consumption of ALA, EPA and DHA to their cardiac patients, but should view this as a medical and ethical obligation.
