Fish Oil: It Conveys Much More Than Cardiovascular Health

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Numerous studies have evaluated the effects of the omega-3 fatty acids, DHA and EPA, on cardiovascular health. Overwhelmingly, scientists and clinicians involved in such research believe that omega-3 fatty acids play various beneficial roles in preserving optimal vascular and cardiac health: Anti-Inflammatory, Anti-Thrombotic, Anti-Arrhythmic, and TG-Lowering effects are considered to be the most relevant. Recently, Smith et al. published a fascinating and novel clinical trial looking at a non-cardiovascular yet widespread adverse aspect of aging: muscle mass decline. They published their findings in the American Journal of Clinical Nutrition: Fish oil–derived n–3 PUFA therapy increases muscle mass and function in healthy older adults. All parameters evaluated improved with the administration of 3,200 mg of daily DHA+EPA. Thigh muscle volume, handgrip strength, one-repetition maximum (1-RM) lower- and upper-body strength, and average power during isokinetic leg exercises all demonstrated statistically significant improvement. Improving muscle strength as we age can have far-reaching beneficial consequences that could reduce both morbidity and mortality. Thus, these findings need to be further studied in larger and even more consequential trials. But what additional meaning can we garner from their trial?

I believe that beyond their fascinating and clinically pertinent findings there actually lies a far more evocative message. It is simply that we should be extraordinarily cautious about abandoning the evaluation of therapies (even dietary) when they make biological and physiological sense. Fish oil consumption is woefully low in the US when compared to the far more healthy Japanese population. Our life expectancies are far shorter and various cancers occur more frequently in the US. It is scientifically quite plausible that our deficiency in omega-3 fatty acids plays a significant role in our relatively diminished health. But, after the publication of a few clinical trials failed to demonstrate the cardiovascular benefit of fish and fish oil in select patient populations, some physicians truly abandoned their prior admonitions for patients to augment fish consumption. They were derailed by the controversial results of just a few trials (that many exceptional researchers consider to be flawed in the first place). This type of knee jerk reaction has no place in medicine. It is dangerous and counterproductive. To protect our patients and maintain our scientific integrity, we must always practice with open and attentive minds. Once again I implore my scientific colleagues as well as the oftentimes superficially inquisitive media to follow the science, not the hype.

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Resveratrol – the key to anti-aging?

In November 1991, a news segment on CBS’s “60 Minutes” popularized the “French paradox” – the counterintuitive notion that a French diet of cheese, chocolate, and wine could be associated with improved cardiovascular health. With the proposal that red wine might decrease the incidence of heart disease, consumption increased 44% and some wineries began lobbying for the right to label their products “health food”. While most doctors might hesitate to go that far, many agree there does seem to be something in red wine that helps your heart.  Now years later that “something” may have found a name… Resveratrol is the ingredient in red wine that made headlines in 2006 after scientists demonstrated that it kept overfed mice from gaining weight, turned them into the equivalent of Olympic marathoners, and seemed to slow down their aging process.

Resveratrol is an antioxidant, found naturally in a number of foods like grapes, berries, and peanuts.  In grapes, resveratrol is found primarily in the skins; grapes grown in cool damp regions produce it when the skin is attacked by fungus.  Resveratrol is detected primarily in red wine, which is made from red or black grapes that undergo fermentation together with the skins in order to retain the color pigments, while white wine is usually made by fermenting juice pressed from white grapes.  Of the red wines, Pinot Noir contains the highest quantities of resveratrol, perhaps partly because of the grape’s characteristic thin skin and tight clusters that make it more vulnerable to fungus.

Resveratrol has ignited the modern day quest for the Fountain of Youth.  At the fore are researchers David Sinclair and Joseph Baur at the Harvard Medical School and Rafael de Cabo at the National Institute on Aging of the NIH.  The earliest studies have shown resveratrol to prolong lifespan in non-vertebrate organisms such as yeast and fruit flies.  By studying a short-lived fish species and now mice, researchers have been able to show that the natural compound could also do so in vertebrate species, supporting the potential utility of resveratrol in human aging research.  In the study published November 2006 in Nature, resveratrol was shown to shift the physiology of middle-aged mice on a high-calorie diet towards that of mice on a standard diet and significantly increase their survival.  Resveratrol mimicked the healthful effects seen with calorie restriction and produced changes associated with longer lifespan, including increased insulin sensitivity.  As you know, insulin resistance often leads to the development of type 2 diabetes, which is a widespread and devastating condition that over time causes irreparable damage to many parts of the body, including the heart, blood vessels, eyes, nerves, and the kidneys.  The discovery that resveratrol could enhance insulin sensitivity in mice and ward off diabetes, “provides a potential new therapeutic approach for preventing or treating this condition,” said researchers.

A more recent study, conducted and supported in part by the National Institute on Aging, was published July 3, 2008, in Cell Metabolism. The findings confirm previous results suggesting that resveratrol may mimic, in mice, some of the effects of calorie restriction, shown to lessen age-related diseases.  A major finding of this study is that resveratrol prevented age-related and obesity-related cardiovascular functional decline in the mice.  In addition, the scientists found resveratrol to have a variety of positive effects on other age-related problems in mice, including, better bone health, reduced cataract formation, and enhanced balance and motor coordination. “We are learning a great deal about how resveratrol affects the health and survival of mammals,” said Sinclair.  “Continued study of calorie restriction mimetics such as resveratrol may eventually point the way to new medicines to treat diseases of aging.”

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