Dr. John Day, Cardiologist

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Should I Eat Fish?

Do you like fish?  Based on its profound health benefits, you may decide to become a fish lover, if not one already.

If you eat at least two servings per week, studies suggest that you can extend your life by 2.2 years!  Not only will you live longer but fish will also decrease your risk of heart disease by 36%, help to prevent dementia, lower your triglycerides, and lower your blood pressure.

In this article I will discuss the health effects of eating fish and answer the question, should I eat fish?

My Fish Story

I did not always like fish.  In fact, I hated fish until this past year.  I hated the smell, texture, and taste.  Now, at the age of 47, I can say for the first time publicly that I like fish.

I am not really sure how I finally came to like the taste of fish.  It was something that happened very gradually.  As I became increasingly convinced of the health benefits of fish, I forced myself to start eating it.  Slowly, over time, I began to enjoy the taste.  Now I love my wild Alaskan salmon!

Indeed, it has been scientifically proven that people can learn to like foods they previously hated.  This was certainly the case with me.

Live 2.2 Years Longer by Eating Fish Study

Can eating oily fish really allow you to live longer?  Yes, according to a recent study by my friend, Dr. Dariush Mozaffarian, at Harvard University.  I should mention that Dariush and I did our residency training together many years ago at Stanford University in the 1990s.

In Dariush’s study of 2,692 people followed for 16 years, he found that the highest oily fish eaters not only lived 2.2 years longer but also had 40% lower risk of dying from heart disease, 47% lower risk of dying from a stroke, and a 45% lower risk of dying from an arrhythmia.

Dariush concluded in an interview that the minimum amount of oily fish needed to get these benefits seen in this study works out to be about two servings per week.  If a life long fish hater, like me, can learn to like fish at the age of 47 then this is something that we can all learn to like.

American Heart Association’s Fish Recommendations

Based on the very strong scientific data supporting fish in our diets, the American Heart Association recommends that we eat at least two servings of fish each week, preferably an oily fish high in the omega 3 fatty acids.  Despite these recommendations, less than 1 in 5 Americans follow these guidelines.  Even scarier is that about half of us really don’t eat fish at all.

Can I get all of my omega 3s from nuts and seeds?

Not all omega 3 fatty acids are created equal.  The omega 3 fatty acids in walnuts, chia seeds, hemp seeds, or flax seeds are the short chain omega 3s (ALA).  The omega 3s in fish are the long chain omega 3 fatty acids or EPA and DHA.  EPA and DHA have the best track record for long-term health benefits.

While the body can convert some of the shorter chain omega 3s from walnuts, chia seeds, hemp seeds, and flax seeds to EPA and DHA, most of us will be lacking in these critical omega 3s unless we eat fish.  For vegetarians, you can get your DHA and EPA from where the fish do, namely marine algae.

Why do so many people avoid fish?

I suspect that the media’s hyped fear of mercury, dioxins, and PCBs in fish has frightened so many people from eating this incredibly heart healthy food.  Fish is healing food for the heart and brain.

Unfortunately, these industrial pollutants have made their way into our food supply, including fish.  However, as long as you are eating the right fish in the right amounts you don’t need to worry about mercury, PCBs, or dioxins.  Let me explain.

Mercury and Fish

Unfortunately, the fish available to us today is not the same fish that was available to our ancestors.  Today, we have to worry about mercury toxicity with fish.

While the media would have us to believe that any fish will poison us with mercury that it absolutely not the case.  Many of my patients are afraid to eat fish based on all of these media reports.

Yes, it is true that some fish are high in mercury.  However, many healthy oily fish, which are high in the protective omega 3s, are also very low in mercury.  In general, the smaller the fish the lower the mercury content.  Some of the fish which are very high in omega 3s and yet very low in mercury include the following:

   -Wild Alaskan salmon

   -Atlantic mackerel

   -Sardines

   -Anchovies

   -Trout

   -Oyster

   -Herring

Selenium Prevents Mercury Toxicity

While the media has done a good job of scaring us away from fish due to mercury risks, what they don’t tell us is that selenium binds mercury and gets it out of our body.  Fortunately, many fish are also very high in selenium so any potential mercury risks in these fish is extremely low.

Previous studies showing harm from mercury in fish were done with shark or pilot whale meat which are very low in selenium. For example, just one serving of salmon, sardines, tuna, or shrimp nearly give you all of the selenium you need for the day.

As the right amount of selenium in your diet has been shown to help protect against cancer and heart disease, to make sure you are getting enough just one Brazil nut will give you all the selenium you need for the day.  Work closely with your doctor if you are taking a selenium supplement as selenium supplements have been shown to cause harm.

PCBs and Dioxins in Fish

Once again, the media would scare us from eating fish due to the risks of PCBs and dioxins.  While we should be frightened of PCBs and dioxins from industrial pollution, fish is not where we get most of these carcinogens.

For example, according to a Harvard University report, more than 90% of the PCBs and dioxins we are exposed to come primarily from animal meat, dairy, eggs, and to a much lesser degree from vegetables.  Thus, if you are really frightened of PCBs and dioxins then you should also limit your intake of animal meat, dairy, and eggs.

This Harvard University report also states that if 100,000 people ate farmed salmon, which has 16 times the amount of PCBs and dioxins as wild salmon, for 70 years that it would cause 24 deaths from cancer.  However, eating farmed salmon over this same period of time would also prevent 7,000 people from dying of heart disease!

For me, I want the best of both worlds.  I want all of the protection salmon has to offer without the risk of cancer.  This is why I choose wild Alaskan salmon which is 16 times lower in these contaminants according the the Environmental Working Group and I eat one Brazil nut each day.

Can I just take fish oil instead of eating fish?

Perhaps it is because you don’t like the taste of fish or that it just is easier to take a pill.  Unfortunately, when it comes to health it doesn’t work that way.  Many vitamins and supplements, including vitamins C and E, beta-carotene, folic acid, estrogen, and testosterone, have all been linked to heart disease or cancer.

Fish oil is no exception.  Even fish oil, with its healthy halo effect, has been linked to prostate cancer.

It is a combination of everything in healthy fish that provides us with the health benefits not just a concentrated form of the omega 3s.  Nutrition is so much more than just isolated and concentrated compounds.  If you don’t like the taste of fish it has been scientifically shown that you can retrain your brain to like healthy foods.  I know this was definitely the case with me.

Nutritional Benefits of My Favorite Fish

It was probably knowing all of the good things I was feeding my body that allowed me to start liking wild Alaskan salmon.  Here are some of the amazing health benefits you get from just one four ounce serving of this salmon according to WHFoods website.  Even better, all of these nutrients come with only 158 calories!

   -Vitamin B12: 236%

   -Vitamin D: 128%

   -Selenium: 78%

   -Vitamin B3: 56%

   -Omega 3: 55%

   -Protein: 53%

Dr. Day’s Personal Fish Rules

While my diet is primarily plant based, I do eat healthy fish at least twice weekly because of the compelling health benefits and also now because I like the taste.  It did take two years of forcing myself to eat fish every week before I finally started liking the taste.  Here are my personal guidelines to eating fish:

1. Eat fish twice a week.

2. Focus on oily fish with the omega 3s.

3. Avoid the fish high in mercury, dioxins, and PCBs.

4. Get the right amount of dietary selenium to bind mercury.

5. I avoid fish oil supplements due to the link to prostate cancer.

To get back to our original question, should I eat fish?  My answer would be yes given the many health benefits of fish.

Have you always liked fish or did you learn to like it like me?  Do you have a favorite fish? Please leave me a comment and let me know!