Three different ways to lower your risk of heart failure

By John M. Yarlott                  6-Aug-08

The connection between foods and coronary heart disease (CHD)

Scientists have discovered that an unbalance omega 6 (n6) and omega 3 (n3) fatty acids may lead to heart failure and other dietary diseases. These acids are known as essential fatty acids (EFA) that are obtained from the foods we eat. They are metabolized and stored in tissue membranes as highly unsaturated fatty acids (HUFA).[1]  The energy levels of tissue omega 6 and omega 3 HUFA have been measured in diverse groups of people and compared to the Mortality rates associated with those groups. It was found that heart failure rates are proportional to the percentage of n-6 long chain acids in the tissues of the study groups. An empirical formula was developed to estimate percentages of omega-6 in HUFA. [1] There are four variables used to predict risk in the formula: Omega 3 (n-3) and Omega 6 (n-6) short (18 carbon), and n-3 and n-6 long (20 and 22 carbons). When the formula is applied to a daily food plan the CHD risk factor in the range from 20% to90% is obtained. Researchers have correlated these risk factors with CHD mortality rates for various diet types. Typical USA diets have CHD mortality rates of  162 per 100,000 and the HUFA risk factor of 78%. The Japanese CHD mortality rates were 71 per 100,000 and a Tissue HUFA risk factor of 48%. The Mediterranean diet has a CHD mortality rate of 101 per 100,000 and a risk factor of 58%.

The Kim-2 Diet Planning Program

A computer program named Keep it Managed (KIM-2) was written that uses data from the USDA Nutrition database and the above mentioned empirical formula was written The program allows the selection of foods from the USDA database to create daily food plans. It calculates the CHD risk factor for each plan and allows the plan to be adjusted by making changes in the food selections and serving sizes. The program is available for downloading here [3].

There are many ways to lower the Mortality Rate associated with our diets. On the one hand we could eat fewer high risk foods and on the other hand increase the intake of Omega three in foods such as found seafood or fish oil supplements. The Mediterranean diet is an example of making better food choices while the traditional Japanese diet is richer in EPA and DHA omega 3’s.  

High risk foods

The Kim2 program was used to compare the effect of adding foods to a given meal plan. The plan chosen was a 1500 KCAL plan with an initial percent of the long 6 of 80%. Over 5,000 foods were systematically added to the base plan and the change in percent long 6 was recorded. Each food was assigned a food group and the results were subtotaled by food group. It was found that the following food groups raised the percent long 6 (increased mortality): all meats, eggs, margarines, Infant formula, seeds, and seafood from farms (the worst). All other food groups had little effect except for fish oil and seafood which significantly lowered the percent long 6.

Supplementing with fish oil

An example of the second option: supplement with fish oil, was tested using the KIM-2 software. A sample meal plan for the USA type diet is given below. Note that the overall HUFA risk is 80%. The second version of the same plan is shown below. Here a tablespoon of cod liver oil was added to the breakfast menu. Notice, the oveall risk was reduced  form 80% to 50% when the cod liver oil was added.

Granted that 14g of Fish Oil has more Omega-3 than the recommend Upper limit of 2.8g (1.2%), however this illustrates the point. If a Fish Oil supplement has 300 mg of n-3 per 1,000 mg capsule. Then 6.7 capsules would contain 2 mg of n-3! Below is a chart, on this basis, of Mortality rates vs. number of these fish oil capsules per day.

  This chart shows that 6 (1 g) capsules of Fish Oil per day could lower the CHD Mortality rate to about 100 per 100,000 people from about 180 per 100,000. A reduction of 45%! Adding Seafood to the diet would have similar results. People could use supplements in lieu of seafood and vice verse. The data in this chart was obtained by using the KIM-2 program to obtain the % en n-6 long in total HUFA for various serving sizes of fish oil in a typical 80% 1500 KCAL diet plan. The results were correlated with the Mortality rates using the following formula: Mortality=3.029*(%en n-6 long in total HUFA)-74.675 [1].

The dietary reference intakes (DRI) for n-3 polyunsaturated fatty acids (PUFA) are 0.6%-1.2 % of the daily energy. For a 2,000 KCAL diet that translates to 1.33-2.66 grams. Likewise for a 1500 KCAL diet the DRI translates to 1-2 grams n-3 per day. Approximately 10% of the total can come from HUFA n-3 n-6.

The Food table below was obtained by the addition of 1 ounce servings of each food in turn. The resulting % long HUFA in total HUFA is listed along with the % energy for each of the four omegas: n-3 short, n-3 long, n-6 short, and n-6 long.

 References:

1.      William E Lands: “Functional Foods in Primary Prevention or Nutraceuticals in Secondary Prevention”, Current Topics in Nutraceutical Research Vol. 1, No.2, pp. X-X, 2003

2.      Bill Lands: “A critique of Paradoxes in current advice on dietary lipids” www.sciencedirect.com

3.      KIM-2 Free Software to Choose Foods, http://efaeducation.nih.gov/sig/kim.html

4.      Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (2002). Food and Nutritional Board, Institute of Medicine, National Academies.