Seafood Long-Chain n-3 Polyunsaturated Fatty Acids and Cardiovascular Disease: A Science Advisory From the American Heart Association

Abstract

Since the 2002 American Heart Association scientific statement "Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease," evidence from observational and experimental studies and from randomized controlled trials continues to emerge to further substantiate the beneficial effects of seafood long-chain n-3 polyunsaturated fatty acids and cardiovascular disease. A recent American Heart Association science advisory addressed the specific effect of n-3 polyunsaturated fatty acid supplementation on clinical cardiovascular events. This American Heart Association science advisory extends that review and offers further support to include n-3 polyunsaturated fatty acids from seafood consumption. Several potential mechanisms have been investigated, including antiarrhythmic, anti-inflammatory, hematologic, and endothelial, although for most, longer-term dietary trials of seafood are warranted to substantiate the benefit of seafood as a replacement for other important sources of macronutrients. The present science advisory reviews this evidence and makes a suggestion in the context of the and in consideration of other constituents of seafood and the impact on sustainability. We conclude that 1 to 2 seafood meals per week be included to reduce the risk of congestive heart failure, coronary heart disease, ischemic stroke, and sudden cardiac death, especially when seafood replaces the intake of less healthy foods.

n‐3 Docosapentaenoic Acid Intake and Relationship with Plasma Long‐Chain n‐3 Fatty Acid Concentrations in the United States: NHANES 2003–2014

“…This analysis of NHANES 2003–2014 data demonstrates that the average DPA intake in the US is very low, as is that of EPA and DHA. Even when accounting for DPA intake, the total daily long‐chain n‐3 fatty acid intake (defined as EPA + DPA + DHA) of the majority of the US population is well below the ~250–500 mg/day amount estimated to be provided by the amount of fish/seafood consumption recommended by the AHA (Arnett et al, ; Rimm et al, ) and the 2015–2020 DGA (U.S. Department of Health and Human Services and U.S. Department of Agriculture, ). Similar to previous findings for EPA and DHA in this population (Thompson et al, ), DPA intake was lower in women and younger age groups (<19 years), even when adjusting for differences in caloric needs between age groups.…”

Altered mitochondrial metabolism in the insulin‐resistant heart

“…It appears likely that FA accumulation results in increased levels of FA intermediates, such as long‐chain acylcarnitines, which underpin lipotoxic effects in heart mitochondria . Notably, however, in contrast to saturated long‐chain FAs, polyunsaturated FAs at reasonable amounts are cardioprotective rather than detrimental to the heart and mitochondrial function …”

Dietary intake of marine n‐3 polyunsaturated fatty acids and future risk of venous thromboembolism

“…Food habits may have a significant influence on health. Dietary intake of fish and marine food products is associated with several health benefits including lower risk of fatal and non‐fatal arterial CVD, and is now implemented in dietary guidelines worldwide . The beneficial effects are largely attributed to the essential long‐chained n‐3 polyunsaturated fatty acids (n‐3 PUFAs, ie, eicosapentaenoic acid [EPA], docosapentaenoic acid [DPA] and docosahexaenoic acid [DHA]) .…”