Fish, nuts and beans are good for your heart! Spanish study

How good would it be to eat more fish and plant foods rich in alpha-linolenic acid?

Recently, a Spanish study published in JACC supports that these two foods can protect the heart: they help improve the prognosis of patients with myocardial infarction.

Studies have shown that serum omega-3 fatty acid levels during myocardial infarction are negatively correlated with major adverse cardiovascular events and cardiovascular disease readmission, reducing the risks of the two by 24% and 26%, respectively.

The study included 944 patients with ST-segment elevation myocardial infarction (STEMI) who underwent percutaneous coronary intervention.

The novelty of the study is that instead of relying on patient self-reports and food intake questionnaires to obtain information, the levels of eicosapentaenoic acid (EPA) and alpha-linolenic acid (ALA) were measured by detecting serum phosphatidylcholine (PC) levels, which can reflect dietary intake levels over 3 or 4 weeks.

EPA is mainly found in high concentrations in fish, but researchers say it is a bit difficult to convert serum indicators into how much fish to eat, but the best advice is to follow the American Heart Association's recommendation of eating two servings of high-fat fish per week.

As for ALA, it is found in flaxseeds, walnuts, and soybeans. Studies have shown that eating more of it is associated with a lower risk of death in high-risk patients.

The researchers said that given that some people do not like to eat fish, or considering environmental pollution and sustainability issues, the study took ALA into consideration. Studies have shown that these two sources of omega-3 fatty acids are "good partners" in preventing heart disease.

The benefits of EPA have been confirmed by the JELIS and REDUCE-IT studies as well as the EVAPORATE and CHERRY studies. For example, the REDUCE-IT study confirmed that high-purity EPA can reduce the relative risk of major adverse cardiac events in high-risk Western populations by 25%.

Why does EPA protect the heart?

Spanish researchers explained that dietary EPA helps replace omega-6 arachidonic acid in myocardial cell membrane phospholipids. When myocardial infarction occurs, local ischemia of the heart will induce the cleavage of membrane fatty acids in myocardial cell membranes, but the release of omega-6 arachidonic acid will enhance ischemic damage, while the release of omega-3 EPA will play an anti-inflammatory role. This has been confirmed in animal experiments.

Among the 944 patients in this study, during the 3-year follow-up, the rates of major adverse cardiac events (all-cause mortality or readmission due to cardiovascular disease), all-cause mortality, and cardiovascular disease readmission were 22.4%, 11.4%, and 13.8%, respectively.

source:

Iolanda Lázaro, Ferran Rueda, Germán Cediel, et al. Circulating Omega-3 Fatty Acids and Incident Adverse Events in Patients With Acute Myocardial Infarction. J Am Coll Cardiol, 2020, 76: 2089-2097.

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