Fish consumption, contaminants and sudden unexpected death in epilepsy: many more benefits than risks

Abstract

People with epilepsy have an increased risk of dying prematurely and the most common epilepsy-related category of death is sudden unexpected death in epilepsy (SUDEP). SUDEP is mainly a problem for patients with chronic uncontrolled epilepsy. The ultimate goal of research in SUDEP is to develop new methods to prevent it and actions other than medical and surgical therapies that could be very useful. Nutritional aspects, i.e., omega-3 fatty acids deficiency, could have an interesting role in this scenario. Some animal and clinical studies have suggested that omega-3 fatty acids could be useful in the prevention and treatment of epilepsy and hence SUDEP. It has been ascertained that the only foods that provide large amounts of omega-3 are seafood (fish and shellfish); however, some fish are contaminated with methylmercury, which may counteract the positive effects of omega-3 fatty acids. Our update review summarises the knowledge of the role of fish consumption on epilepsy research.Keywords: epilepsy, omega-3, heart, sudden death, fish consumption. Consumo de peixe, contaminantes e morte súbita em epilepsia: mais benefícios do que riscos ResumoPessoas com epilepsia têm um risco aumentado de morrer de forma prematura e a causa mais comum de morte relacionada à epilepsia encontra-se na categoria de morte súbita inesperada em epilepsia (SUDEP). SUDEP é um problema significativo para pacientes com epilepsia crônica não controlada. O principal objetivo nas pesquisas em SUDEP é o desenvolvimento de métodos capazes de levar à sua prevenção e ações outras que não medicamentosas e cirúrgicas que podem ser úteis. Os aspectos nutricionais, como por exemplo, a deficiência do ácido graxo ômega-3 pode ter um papel interessante neste cenário. Alguns estudos animais e clínicos têm sugerido que os ácidos graxos ômega-3 podem ser úteis na prevenção e no tratamento da epilepsia e, consequentemente, na SUDEP. Os únicos alimentos que contêm grandes proporções de ômega-3 são os frutos do mar (peixes e mariscos). No entanto, alguns peixes podem estar contaminados com metilmercúrio, o que pode levar a um efeito contrário ao benefício trazido pelos ácidos graxos ômega-3. Aqui, resumimos o conhecimento do papel do consumo de peixe nas pesquisas em epilepsia.Palavras-chave: epilepsia, ômega-3, coração, morte súbita, consumo de peixe.

New avenues to prevent sudden unexpected death in nocturnal frontal lobe epilepsy: follow the route established by omega-3 polyunsaturated fatty acids

“…Nowadays it is well established that the human body is not able to synthesize omega-3 FAs; therefore, people should get it from a diet rich in specific types of fish to provide positive impact on the health system [32][33][34][35]. In this context, the best fish options for consumption determined by experts are anchovies, Atlantic herring, salmon, trout, and sardines [35][36][37][38][39][40][41]. Both national and international guidelines recommend having at least two servings of oily fish per week to prevent chronic diseases [42].…”

Fish consumption in individuals with Down syndrome with seizure disorder: News for prescription

“…In short order, which specific types of fish should be prescribed to individuals with DS? Considering low levels of contaminants and the amount of omega-3 FAs present in the body structure, ample data now indicate that anchovies, Atlantic herring, salmon, trout, and sardines are the best choices [32,[36][37][38][39][40][41].…”

Sudden unexpected death in children with epilepsy: Focus on dietary supplementation with omega-3 polyunsaturated fatty acids

“…On the other hand, we must not fail to highlight that other actions than medical and surgical therapies may be useful to minimize this tragic event [13,24]. In this scenario, among the proposals outlined in the SUDEP field, omega-3 fatty acid (omega-3 FA) supplementation and regular fish consumption have increasingly attracted the attention of the scientific community [25][26][27].…”

“…As well described in this book's text, the human body cannot synthesize omega-3 FAs; therefore, people should get it from a diet rich in specific types of fish to provide medical health benefits and, thereby, obtain a positive impact on the health system [30][31][32][33]. Thus, the best fish choices for consumption, considering the amount of omega-3 FAs present in the body structure and low levels of contaminants, are anchovies, Atlantic herring, salmon, trout, and sardines [27,[33][34][35][36][37][38]. Because of the major benefits provided by omega-3 FAs, national and international guidelines have converged on consistent recommendations for the general population for the prevention of some chronic diseases to consume at least 2 servings/week of oil fish [39], even knowing that natural fish consumption varies in different populations and cultures.…”