The New Low-Cholesterol Diet: Fatty Fish

The right fish can do wonders for your heart

By R. Morgan Griffin
WebMD Weight Loss Clinic - Feature

Reviewed By Cynthia Haines, MD

The term "fatty fish" may sound unappealing, but actually these are the tastiest and healthiest foods from the sea. Oily fish such as salmon, tuna, sardines, mackerel, and trout are full of omega-3 fatty acids - good fats unlike the bad saturated fat you find in most meats. These fish should be a staple of everyone's heart-healthy diet.

How Does Fish Help?

Omega-3 fatty acids have been shown to lower triglycerides, which are a type of fat in the bloodstream. Experts aren't sure of the exact mechanism. Omega-3 fatty acids may also slow down the growth of plaques in the arteries and reduce inflammation throughout the body.

What's the Evidence?

A number of studies going back years have shown the benefits of fatty fish. In an important review of studies, researchers found that getting daily omega-3 fatty acids from fish oil could lower triglyceride levels by 25%-30%. The results were published in The American Journal of Clinical Nutrition in 1997.

Based on the mounting evidence, the FDA approved a new "qualified health claim" for the effects of omega-3 fatty acids in 2004. This means that the evidence for the benefits of fatty fish is strong but not yet conclusive. It also allows the makers or distributors of foods that contain omega-3 fatty acids to advertise that the product may reduce the risk of heart disease.

Getting Fatty Fish Into Your Diet

Fatty fish typically are cold-water fish. You have many good choices when it comes to fatty fish. The American Dietetic Association recommends:

  • Salmon
  • Tuna
  • Trout
  • Herring
  • Sardines
  • Mackerel

Four ounces of salmon alone offers 83% of the omega-3s you need each day. If these fish aren't to your taste, you can also try white fish such as halibut and cod. A 4-ounce serving of halibut offers 25% of the omega-3s you need each day; cod offers about 15%.

One important point to keep in mind: How you prepare the fish is almost as important as which type of fish you eat.

"The way that you prepare any of these foods makes a big difference in your blood cholesterol level," says Keecha Harris, DrPH, RD, a spokeswoman for the American Dietetic Association (ADA.) "It's always best to broil, grill, or steam these foods."

Any health benefits from fish are cancelled out if you deep-fry them in a vat of vegetable oil.

The reliable tuna sandwich can be a healthy choice. ADA spokeswoman Ruth Frechman, RD, recommends tuna with low-fat mayo or pickle relish on whole grain bread.

You can also get a very quick and tasty meal by microwaving salmon and other fish. It only takes a few minutes. One big advantage is that you don't dry out the fish, which is easy to do using more conventional methods.

How Much Fish Do You Need?

Current recommendations are to eat two 4-ounce servings of fish a week, says ADA spokeswoman Suzanne Farrell, MS, RD. "The important thing is to find fish that you really like," she says. The American Heart Association recommends that people who have heart disease get at least one serving a day.

What if you just can't stand fish?

"If I meet people who don't like fish, I don't think it's a good idea to force them to eat it," Farrell tells WebMD. "Luckily, there are some other ways to get omega-3 fatty acids." She recommends walnuts, flaxseed, canola oil, and omega-3 enriched eggs.

Calories Count

Remember, fatty fish is still fatty. While the omega-3 fatty acids have lots of benefits, they're also high in calories. You'll gain weight if you overeat these fish. Most Americans, however, don't even eat the recommended 8 ounces a week.

Also, eating too much of some types of fish can carry other risks. You may have heard about mercury in some sea fish, like tuna. Other fish like salmon can contain toxins like PCBs. These risks may be especially worrisome to small children or women who are pregnant or plan to become pregnant.

The FDA says that up to 12 ounces -- about 2 meals -- of canned light tuna, salmon and certain other fish are safe even for children and pregnant women. However, you should pay attention to local advisories about the safety of local fish. If you're concerned, ask your health care provider for advice.

Low-Cholesterol Diet Includes:

SOURCES: Suzanne Farrell, MS, RD, spokeswoman, American Dietetic Association. Ruth Frechman, RD, Los Angeles; spokeswoman, American Dietetic Association. Keecha Harris, DrPH, RD, spokeswoman, American Dietetic Association. FDA web site. American Dietetic Association web site. National Heart, Lung, and Blood Institute web site. American Heart Association web site. Harris, W. American Journal of Clinical Nutrition, 1997; vol 65: pp 1645S-1654S. Kris-Etherton, P. Circulation, November 19, 2002; vol 106: pp 2747-2757. The World's Healthiest Foods web site.

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Last Editorial Review: 9/30/2005 2:47:14 PM