Category Archives: Fish

Diabetes Care Consensus Panel Recommends Fish

Cold-water fatty fish loaded with omega-3 fatty acids include salmon, trout, sardines, herring, and mackerel, but not goldfish

“The recommendation for the general public to eat a serving of fish (particularly fatty fish) at least two times per week is also appropriate for people with diabetes.”

Source: Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report | Diabetes Care

That’s been my recommendation to patients since 2007.

Steve Parker, M.D.

Conquer Diabetes and Prediabetes, Steve Parker MD

Salmon is a rich source of omega-3 fatty acids

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New Systematic Review Concludes Omega-3 Fatty Acids Have NO EFFECT On Cardiovascular Disease and Longevity

Conquer Diabetes and Prediabetes, Steve Parker MD

Salmon is a rich source of omega-3 fatty acids

That headline is the conclusion of a Cochrane systematic review of the evidence. As you read the summary below, be aware that the main omega-3 fatty acids are alpha-lenolenic acid (ALA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA).

From Cochrane Library:

Increasing EPA and DHA has little or no effect on all‐cause deaths and cardiovascular events (high‐quality evidence) and probably makes little or no difference to cardiovascular death, coronary deaths or events, stroke, or heart irregularities (moderate‐quality evidence, coronary events are illnesses of the arteries which supply the heart). EPA and DHA slightly reduce serum triglycerides and raise HDL (high‐quality evidence).

Eating more ALA (for example, by increasing walnuts or enriched margarine) probably makes little or no difference to all‐cause or cardiovascular deaths or coronary events but probably slightly reduce cardiovascular events, coronary mortality and heart irregularities (moderate/low‐quality evidence). Effects of ALA on stroke are unclear as the evidence was of very low quality.

There is evidence that taking omega‐3 capsules does not reduce heart disease, stroke or death. There is little evidence of effects of eating fish. Although EPA and DHA reduce triglycerides, supplementary omega‐3 fats are probably not useful for preventing or treating heart and circulatory diseases. However, increasing plant‐based ALA may be slightly protective for some heart and circulatory diseases.

Source: Omega‐3 fatty acids for the primary and secondary prevention of cardiovascular disease – Abdelhamid, AS – 2018 | Cochrane Library

These findings are contrary to my views. I’m not sure who’s right. I still aim for cold-water fatty fish consumption twice a week.

Steve Parker M.D.

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With All the Pollutants In Fish, Is it Still a Good Idea to Eat Them?

Dead whole fish aren't very appealing to many folks

Dead whole fish aren’t very appealing to many folks

Probably so. Mercury is the key pollutant people think about when considering polluted fish. Mercury toxicity isn’t on the list of top 10 killers in the U.S., but heart disease is.

Heart disease is #1 on the list of top causes of death, followed by cancer and chronic lower respiratory tract disease. “Heart disease” is a broad category; the primary killer is heart attacks. (Following heart disease as leading killer is cancer. Sadly, suicide is tenth leading cause of death. If you’re considering it, call the National Suicide Prevention Lifeline now.)

Eating fish regularly seems to reduce your risk of heart attack. I favor the cold-water fatty fish like salmon, trout, herring, and sardines.

I quote the New York Times:

“Numerous studies have found that people who eat fish on a regular basis are less likely to die of a heart attack than those who don’t eat it or eat it less than once a month, and a 2006 Harvard review concluded that eating one to two servings of fish rich in omega-3s every week cut the risk of dying of a heart attack by one-third.”

Source: Why Is Fish Good for You? Because It Replaces Meat? – The New York Times

Steve Parker, M.D.

PS: Click for ideas on reducing your risk of cancer.

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Seafood Linked to Lower Alzheimer Dementia Risk in Those Genetically Predisposed

…according to an article at the Journal of the American Medical Association. The study involved Chicago-area residents who had provided information about their eating habits. After death, their brains were biopsied, looking for typical pathological findings of Alzheimers Disease.

fresh salmon and lobsters

Rich sources of omega-3 fatty acids include salmon, sardines, herring, trout, and mackerel

Participants who ate seafood at least once a week had fewer Alzheimers lesions in their brains, but only if they were carriers of a particular gene the predisposes to Alzheimers. The gene is called apolipoprotein E or APOE ε4.

You’ve heard that seafood may be contaminated with mercury, right? The seafood eaters in this study indeed had higher brain levels of mercury, but it didn’t cause any visible brain damage.

The Mediterranean diet, relatively rich in seafood, has long been linked to a lower risk of dementia.

A weakness of the study is that the researchers didn’t report results of clinical testing for dementia in these participants before they died. You can have microscopic evidence of Alzheimers disease on a biopsy, yet no clinically diagnosis of dementia.

Steve Parker, M.D.

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1 in 5 Seafood Samples Is Incorrectly Labeled

Wish I were here

Wish I were here

Fraudulent labeling of fish and other seafood is a problem. It matters to me because I advocate frequent consumption of cold-water fatty fish as healthful. It’s the omega-3 fatty acids in those fish that are good for you.

If what you believe to be trout is actually catfish, you’re not getting the omega-3s you paid for.

Click over to the New York Times for details:

“One in five seafood samples tested worldwide turns out to be completely different from what the menu or packaging says, according to a report on seafood fraud released Wednesday by the ocean conservation group Oceana. Of the more than 25,000 seafood samples the group analyzed, 20 percent were incorrectly labeled.“It is likely that the average consumer has eaten mislabeled fish for sure,” said Beth Lowell, the senior campaign director for Oceana and an author of the paper. “You’re getting ripped off, while you enjoyed your meal you’re paying a high price for a low fish.”

Source: Catfished by a Catfish: 1 in 5 Seafood Samples Is Fake, Report Finds – The New York Times

On a related note…I’ve been eating a lot of canned smoked oysters lately. Nearly all on the supermarket shelves in Arizona USA come from China. Why is that? I worry about pollutants in those oysters, regardless of provenance. If you have any info on this issue, please share.

Steve Parker, M.D.

PS: Search my blog for the list of high omega-3 cold-water fatty fish, or read my books.

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Have You Tried a Sardicado Sandwich?

California or Hass avocado

California or Hass avocado

Several years ago, Alton Brown lost a significant amount of weight, and one of the items on his diet was sardine-avocado sandwiches. I like sardines. I like avocados. But I never ever would have considered eating them mixed together.

A while back, I read Franziska Spritzler’s The Low Carb Dietitian’s Guide to Health and Beauty (great book; my review). One of her recipes involves the sardine-avocado combo, so I’m resolved to give it a try. Her recipe was simply 4 oz (120 g) canned sardines mixed with 1/2 medium avocado and sea salt, stuffed in a large red bell pepper. I bet the sardine-avocado mix would be good on a bed of lettuce if I don’t have a bell pepper. A little black pepper and a squeeze of lemon, too?

If memory serves, I paid $1.29 for this tin of sardines. "Best used by" date is five years from now.

If memory serves, I paid $1.29 (USD) for this tin of sardines. “Best used by” date is five years from now.

I may even try Franziska’s Chocolate Avocado Pudding, another combo I never would have imagined.

Click for Alton Brown’s sardicado sandwich.

Steve Parker, M.D.

PS: If you don’t like the smell of sardines, my books won’t offend your olfactory sense.

low-carb mediterranean diet

Front cover of book

 

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“Doc, Will I Get Mercury Poisoning From the Fish You Recommend?”

paleo diet, low-carb, Steve Parker MD

 A beautiful brown trout

The Environmental Working Group published an article reviewing the risk of mercury poisoning from seafood consumption. I’m not familiar with EWG. I’m trying not to hold it against them that Dr. Mark Hyman is on the board of directors.

Anyway, the EWG has some advice for you if you worry about mercury toxicity from fish. I try to stay up to date on the issue since I’m convinced that consumption of cold-water fatty fish twice a week is good for your health, in general. If the mercury doesn’t kill you. Seafood is key component of the Ketogenic Mediterranean Diet, the foundation of the Low-Carb Mediterranean Diet.

Here are some quotes from the EWG article:

…EWG has compiled a list of “moderate mercury” species that would pose a mercury risk for pregnant woman and children who eat fish regularly. This list is more comprehensive than the 2004 EPA/FDA advisory, which warned that women of childbearing age and young children, who are most susceptible to the damage done by mercury, should eat only six ounces a week of albacore tuna and should avoid four other high-mercury species – swordfish, tilefish, king mackerel and shark.

EWG rightly points out that much of the “seafood” consumed in the U.S. really doesn’t provide much of the healthful omega-3 fatty acids.

Among popular seafood species, salmon stands out as an excellent choice.  Four to eight ounces of salmon weekly, depending on the species, can provide 100 percent of the recommended amount of omega-3s. Some types of farmed salmon present significant environmental health concerns. EWG recommends that people choose wild salmon instead.

EWG’s analysis highlights several other affordable and sustainably produced species, including anchovies, sardines, farmed trout, and mussels.  Just four to eight ounces of these species weekly would meet recommended omega-3 requirements for pregnant women and people with heart disease.

***

Americans eat more than 400 million pounds of canned imported tuna because it is affordable and can be stored for a long time. Canned tuna is the second most popular seafood in the U.S., after shrimp.  An average American eats an average of 2.5 pounds of tuna every year (NOAA 2012).  Albacore tuna, also called “white” tuna, contains significant amounts of omega-3s, but tests indicate that it also contains significant amounts of mercury. “Light” tuna is usually skipjack tuna but can also contain yellowfin tuna. Skipjack and yellowfin have lower mercury levels than albacore, but fewer omega-3s.

As Jim Gaffigan asked, “Has anyone even bothered to ask why the tuna are eating mercury?”

In 30 years of practicing medicine, including 12 years right on the Gulf Coast, I’ve never seen a case of mercury toxicity. Maybe I’ve missed it. Maybe it’s quite rare.

Read the whole enchilada.

Steve Parker, M.D.

h/t Conner Middelmann-Whitney

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