Joel Fuhrman - Eat To Live

128 Joel Fuhrman, M.D.

Does Fish Prevent Heart Disease?

There are two components to a heart attack or stroke. First, you must

develop atherosclerotic plaque. This plaque builds up over many

years from eating a diet deficient in unrefined plant foods. Almost all

Americans have such plaque. Autopsy studies demonstrate athero-

sclerosis even in the vast majority of American children.'^2

Once these fatty plaques accumulate and partially block a coro-

nary artery, a clot can develop in a defect or crack in the surface of

the plaque. This clot is called a thrombus, which can enlarge and

completely block the vessel, causing a heart attack, or break off and

travel upstream, obstructing a more distal coronary site. A traveling

thrombus is called an embolus. Emboli and thrombi are the cause of

almost all heart attacks and strokes.

Fish contains omega-3 fatty acids (EPA and DHA) that interfere

with blood clotting much the same way aspirin does. Once you have

significant atherosclerosis, it is helpful to take such anti-clotting

agents, especially if you continue a dangerous diet. These fish-derived

fats also have some effect on protecting the arterial walls from dam-

age from other fats. For people eating saturated fat containing animal

products, it is advisable to consume one or two weekly portions of

fatly fish, such as sardines, salmon, trout, halibut, or mackerel, and

reduce the consumption of other animal products accordingly. In-

creasing fish intake beyond one or two servings per week has not

been shown to offer additional protection."

However, the best way to prevent a heart attack or stroke is to'

follow a high-nutrient diet with little or no animal products, thereby

ensuring that such blockages don't develop in the first place. Then

eating fish won't matter. It is true that increasing blood levels of these

important fish-derived fats reduces the incidence of heart attacks sig-

nificantly.^14 However, contrary to popular belief, not only vegetarians

bul most others eating diets with adequate plant material get most of

their long-chain omega-3 fatty acids from non-fish sources.^15 In fact,

the reason the fish-derived fats, EPA and DHA, are not considered es-

sential fats is that almost all people have enzymes to convert the

plant-derived omega-3 fat rapidly into EPA and DHA.^16

Fish is a double-edged sword, especially because fish has been

shown to increase heart attack risk if it is polluted with mercury.^17

Keep in mind that even though men in Finland consume lots of fish,

their mortality from coronary heart disease is one of the highest in