Doctor's Heart Series Chapter 4 : Polyunsaturated fats(Omega-3) and its benefits on heart disease...
Including Mediterranean lemon garlic salmon recipe.
Anthony Bourdain…
After a long 30-hour shift(Post-call) during my medical residency training, I started to prepare the food for myself; as an avid traveler and a foodie myself, I began to watch as a ritual during the post-call days. Anthony Bourdain(Tony as he was called). Tony traveled worldwide looking for exotic foods and sharing a meal with the remotest people on the planet. He was different and created a brand for himself. As tony used to come on the Travel channel, either swallowing the beating heart of cobra or taking a bite at scorpions on the streets of southeast Asia. Tony had to try it, always trying to get out and immerse himself in the local culture. He was always taking the road less traveled.
He interviewed locals about the food and his impressive questions. I had never been more interested in cooking until I started watching Bourdain; his unique interviewing style and asking provocative questions about cooking intrigued me. His book Kitchen confidential opened my mind more to cooking and the different aspects. He delves into American kitchens and restaurants and takes over the owners and workers alike. Few takeaways from the book; one should avoid fish on Monday to restaurant bathrooms predicting the food quality. He is hilarious, thought-provoking, and no bullshit and bares it all. Either one likes or hates him; I really adored him the way he reported on TV. His passion for food speaks volumes. The one episode with Obama was the classic where they sit on the plastic chair somewhere in Vietnam with beer and noodle bowl. Cook's tour, his other book, and video series were another classic almost a decade ago(probably 2). As a mamma's boy, I hardly entered the kitchen to make anything(spoiled me) during my early years. As I had more time at home during the pandemic, I started revisiting Bourdain (sadly died of suicide 2018), interested in preparing healthy meals and fish.
Mediterranean Lemon Garlic SalmonRecipe…
We all know Salmon is well packed with healthy benefits. I would like to share a simple Mediterranean Lemon garlic Salmon fish recipe (which I have improvised lately)
Wild Caught Pacific Salmon Filet (Any Salmon)
Fresh Lime
Garlic (Freshly minced garlic)
Salt / Ground Pepper/Paprika / Oregano
Olive oil/butter
Take a Salmon filet on the aluminum foil; nicely rub olive oil and sprinkle some melted butter over the Salmon. Then gently use the minced garlic sprinkle over the Salmon, use the freshly squeezed lemon juice enough over the Fish, use salt and pepper to taste, and use paprika and oregano depending on the spice level. Keep the Fish in the refrigerator for 1 hr. Next, Preheat the oven to 375 C, wrap the Fish in the Aluminum foil and leave it in the oven for 25 min. Voila! Fish is baked and ready to eat, umm!
Why fish or seafood ?…
Over 3 billion consume fish every day; that's a lot of seafood. Fish/seafood consumption has many benefits, including good fats, protein, vitamins, and minerals. It is packed with Omega-3 PUFAs Polyunsaturated fatty acids(DHA and EHA). People who consume 1-2 servings a week have been noted to have less cardiovascular disease and death. The health benefits related to the reduction in risk of CVD(heart disease) have triggered the mass consumption of fish all around the globe. Salmon is absolutely packed with Polyunsaturated fats (PUFAs) and provides an excellent source of healthy fats. There are different kinds of Salmon in the market. Wild-caught Pacific salmon is the best out there(fewer contaminants than farm-raised). Black Cod, Atlantic Mackerel, etc., are other types of fish that can be a good option. Some of the best and worst ones are attached below*. Fish and chips are not the healthier options as they tend to have trans fats(harmful fats high affinity to form plaques in arteries). Fish can be a great option on the top of Salad or by itself.
What are Omega 3 and Omega 6 fatty acids (Polyunsaturated Fatty acids or PUFAs)…
Polyunsaturated fatty acids - omega-3 (ω-3) and omega-6 (ω-6) are essential cell membranes components. In addition, they are precursors to many other substances in the body, such as regulating inflammatory responses. There is increasing support for omega-3 fatty acids in protecting against heart disease. It is known that they have anti-inflammatory effects, which may be necessary for this and other conditions. In addition, there is growing interest in the role of omega-3 fatty acids in preventing diabetes and certain types of cancer.
The human body can produce all the fatty acids it needs, except for linoleic acid (LA) - an omega-6 fatty acid, and alpha-linolenic acid (ALA) - an omega-3 fatty acid. These have to be consumed from the diet and are termed “essential fatty acids.” These fatty acids are needed for growth and repair but can also make other fatty acids. For example, omega-3 fatty acids, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) can be synthesized from ALA. However, as the conversion is limited, it is recommended that these sources are also included in the diet. ALA and LA are found in plant and seed oils. Although the levels of LA are usually much higher than those of ALA, rapeseed oil and walnut oil are excellent sources of the latter. EPA and DHA are found in oily fish (e.g., salmon, mackerel, herring).
Contaminants and fish consumption…
Mercury, dioxins, and polychlorinated biphenyls are common contaminants present in seafood, of which mercury has been most studied. Mercury metabolizes into Methylmercury and is accumulated at the top of the fish food chain, hence avoiding a particular type of fish Eg Shark, Swordfish, King Mackerel, etc. Methylmercury at higher doses affects the Central nervous system. The developing fetal and infant nervous systems are also susceptible to Methylmercury. The pollutants of most fish are low, and potential carcinogenic and other effects are outweighed by the potential benefits of fish intake. Potential risks of fish intake must be considered in potential benefits.
Trials…
There have been significant trials since the 1970s, as the observation of the Inuit tribe in Greenland living on fish found to have less heart disease in Japan. Hence started widespread epidemiological studies looking into EPA / DHA and its role in heart disease. For example, Reduce-It Trial/ASCEND Trial/ VITAL Trial / Meta-Analysis in 2020 (significant trials on DHA/EPA). Some trials showed a positive response and were dose-dependent(They did better with higher doses), and some were most effective for persons who had previous heart attacks or events (like myself). On the other hand, few studies have shown no benefit in taking omega-3 and preventing heart disease. Overall, people who eat fish rich in Omega 3 fatty acids regularly tend to eat less unhealthy options, leading to better health (selection bias).
Conclusion…
Modest consumption of fish (e.g., 1-2 servings/wk), especially species higher in the Omega-3 Poly Unsaturated fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), reduces the risk of coronary death by 36% and total mortality by 17%. Intake of supplements 250 mg/d of EPA and DHA(supplements available for vegetarians unable to eat fish) appears sufficient for primary prevention (However, studies differ in dosage and benefits). Also, the use is higher for people who have already suffered a heart event. However, women of childbearing age and nursing mothers should consume 2 seafood servings/wk, limiting the intake of selected species(high in mercury). Eating 6 oz of salmon a week carries significant benefits of PUFAs per week; I have attached a list from JAMA (Journal of America Medical Association) here to compare different fish and levels of contaminants and PUFAs. Fish was never part of my diet growing up; it was more red meat and chicken. However, the pandemic has introduced making fish as the staple diet.
Bottom line…
Studies and recommendations of various medical societies point towards one serving of omega -3 rich fish per week will provide enough benefits for inflammation and repair and possible beneficial effects on heart disease prevention. Walnuts appear to have plenty of ALA Omega-3(go on get your bag of walnuts).
Suman Manchireddy MD FACP FHM, Internal Medicine, Leesburg, VA Reliant MD Group LLC Email : care@reliantmd.com
I have attached various lists for easier understanding of Omega -3 availability in various foods, lists of fish to avoid, lists of foods and the contaminants (Journal of American Medical Association).
Selected Foods with ALA, EPA, DHA (Omega -3 or PUFAs)…
Various foods and the levels of Omega-3 (PUFAs) and contaminants…
We Will try to consume more seafoods
The only fish I can get my spouse to eat is Tilapia. I personally love most fish. I will try your salmon recipe. Now that I have a Foodi oven I can make my spouse his Tilapia and make myself salmon. I loved watching Anthony Bourdain on his travels.