Fish Consumption and Risk of Sudden Cardiac Death

Chen, Albert; Hennekens, Charles H.; O’Donnell, Christopher J.; Ajani, Umed A.; Carey, Vincent J.; Willett, Walter C.; Ruskin, Jeremy N.; Manson, JoAnn E.

doi:10.1001/jama.279.1.23

Cited by 842 publications

(495 citation statements)

References 33 publications

Supporting

Mentioning

445

Contrasting

Unclassified

Order By: Relevance

“…In some previous studies, those with the highest fish consumption had the lowest consumption of dairy products (16,27,32) , but in some studies, the direction of the association was the opposite (17,23) . In only one previous study, the consumption of sweets was reported by fish consumption groups, and the association seemed to be negative (16) .…”

Section: Discussionmentioning

confidence: 89%

“…In addition, energy intake and the total amount of food consumed are usually smaller among women and therefore fish may be able to partially replace other types of meats in their diet. With regard to poultry consumption in previous studies, those who had the highest fish consumption had the highest consumption of poultry (17,23,27,29,49) . In the present study, this association was seen only in the general population, although the positive linear association practically disappeared especially among the women after adjusting for other food groups.…”

Section: Discussionmentioning

confidence: 90%

See 1 more Smart Citation

Fish consumption in relation to other foods in the diet

et al. 2011

View full text Add to dashboard Cite

Our aim was to investigate whether fish consumption is associated with the consumption of other healthy foods. The study population consisted of 2605 men and 3199 women from the nationally representative Health 2000 survey and 114 professional fishermen and 114 fishermen's wives (the Fishermen substudy) in Finland. Dietary data were collected using a calibrated (i.e. determined to have relative validity) FFQ. Model-adjusted means for food consumption and P values for linear trend were calculated across fish consumption tertiles. Those with the highest fish consumption had the highest consumption of vegetables, fruit and berries, potatoes, oil and wine even after adjusting for other food groups. The consumption of red meat and sausages had a tendency to decrease across fish consumption tertiles but the associations were inconsistent in the study populations. In conclusion, fish consumption had a positive linear association with the consumption of some other healthy foods such as vegetables, fruit, berries, and oil both in the general population of Finland and in a population with high fish consumption. Additional adjustment for other food groups had a clear effect on some of the studied associations. Therefore, when evaluating the health effects of fish consumption, confounding by other foods characterising a healthy diet needs to be considered.

show abstract

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 90%

Fish consumption in relation to other foods in the diet

et al. 2011

View full text Add to dashboard Cite

show abstract

“…[103][104][105] In elderly nursing home residents, supplementation with 2 g of fish oil significantly improved both high and low frequency components of HRV and SDNN, suggesting that fish oil can decrease sympathetic tone and increase parasympathetic response.…”

Section: Medical Therapies Modulating Cardiac Autonomicsmentioning

confidence: 98%

“…[99][100][101][102][103][104][105][106] These classes of drugs have also been shown to modulate the autonomic nervous system to decrease sympathetic tone and/or increase parasympathetic tone.…”

Section: Medical Therapies Modulating Cardiac Autonomicsmentioning

confidence: 99%

The Role of the Autonomic Nervous System in Sudden Cardiac Death

Vaseghi

Shivkumar²

2008

Progress in Cardiovascular Diseases

317

221

View full text Add to dashboard Cite

The cardiac autonomic nervous system consists of 2 branches-the sympathetic and the parasympathetic systems-that work in a delicately tuned, yet opposing fashion in the heart. This extrinsic control mechanism can dominate intrinsic regulatory mechanisms that modulate heart rate and cardiac output. These branches differ in their neurotransmitters (norepinephrine and acetylcholine) and exert stimulatory or inhibitory effects on target tissue via adrenergic and muscarinic receptors. Stimulation of the sympathetic branch exerts facilitatory effects on function, increasing heart rate and myocardial contractility, whereas the stimulation of the parasympathetic branch exerts inhibitory effects that decrease heart rate and contractility. The interplay between these two branches is complex and susceptible to control at several levels, from centrally mediated baroreceptors and chemoreceptors to local interneuronal interactions.Alterations in autonomic function occur in several interrelated cardiac conditions including sudden cardiac death, congestive heart failure, diabetic neuropathy, and myocardial ischemia. Although the full extent of these changes has not been elucidated, multiple autonomic remodeling mechanisms have been observed at both the neuronal fiber and myocardial cellular level that contribute to an arrhythmogenic substrate. We describe the anatomy of both systems in this review. However, the review will premdominantly focus on the sympathetic system, whose role in the modulation of cardiac arrhythmias is slightly better delineated. Cardiac Autonomic Innervation: NeuroanatomyBoth branches of the autonomic nervous system are composed of both afferent and efferent as well interneuronal fibers (Fig 1). Sympathetic innervation originates mainly in the right and left stellate ganglia. These fibers travel along the epicardial vascular structures of the heart and penetrate into the underlying myocardium similar to coronary vessels and end as sympathetic nerve terminals reaching the endocardium. Based on norepinephrine content studies, a gradient exists in sympathetic innervation from atria to the ventricles and from base to apex of the heart. Therefore, the atria are most densely innervated, but the ventricles are also supplied with a sympathetic network, most densely at the base. 1 Parasympathetic effects are carried by the right and left vagus nerves, originating in the medulla. The vagus nerve further divides into the superior and inferior cardiac nerves, finally merging with the postganglionic sympathetic neurons to form a plexus of nerves at the base of the heart, known as the cardiac plexus. In contrast to sympathetic neurons, after parasympathetic fibers cross the atrioventricular (AV) groove along the surface of the heart,

show abstract

“…• prospective cohorts -Yes [34,[51][52][53][54][55][56][57][58][59][60][61]; No [62] • case-control studies -Yes [63,64]; No [62,65] • Raising biomarker levels with fish or omega-3 FAs reduces risk -Yes [66,67]; No [68] • Strong association between biomarker and disease -Yes [34] • Biomarker independent of other known risk factors -Yes [33,34,59] • Adds predictive value to currently-available risk markers -Unknown …”

mentioning

confidence: 99%

Omega-3 fatty acids and cardiovascular disease: A case for omega-3 index as a new risk factor

Harris

2007

Pharmacological Research

229

136

View full text Add to dashboard Cite

The omega-3 fatty acids (FAs) found in fish and fish oils (eicosapentaenoic and docosahexaenoic acids, EPA and DHA) have been reported to have a variety of beneficial effects in cardiovascular diseases. Ecological and prospective cohort studies as well as randomized, controlled trials have supported the view that the effects of these FAs are clinically-relevant. They operate via several mechanisms, all beginning with the incorporation of EPA and DHA into cell membranes. From here, these omega-3 FA alter membrane physical characteristics and the activity of membrane-bound proteins, and once released by intracellular phospholipases, can interact with ion channels, be converted into a wide variety of bioactive eicosanoids, and serve as ligands for several nuclear transcription factors thereby altering gene expression. In as much as blood levels are a strong reflection of dietary intake, it is proposed that an omega-3 FA biomarker, the omega-3 index (erythrocyte EPA+DHA) be considered at least a marker, if not a risk factor, for coronary heart disease, especially sudden cardiac death. The omega-3 index fulfils many of the requirements for a risk factor including consistent epidemiological evidence, a plausible mechanism of action, a reproducible assay, independence from classical risk factors, modifiability, and most importantly, the demonstration that raising tissue levels will reduce risk for cardiac events. For these and a number of other reasons, the omega-3 index compares very favourably with other risk factors for sudden cardiac death.

show abstract

Fish Consumption and Risk of Sudden Cardiac Death

Cited by 842 publications

References 33 publications

Fish consumption in relation to other foods in the diet

Fish consumption in relation to other foods in the diet

The Role of the Autonomic Nervous System in Sudden Cardiac Death

Omega-3 fatty acids and cardiovascular disease: A case for omega-3 index as a new risk factor

Contact Info

Product

Resources

About