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EDITORIALS: Eric Brunner and Hiroyasu Iso Fish oil and secondary prevention of cardiovascular disease BMJ 2008; 337: a2541 [Full text]

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Marine extinction is due to population pressure

Caroline Richmond   (16 January 2009)

Oily fish .. but nobody asked the fish--so what to do?

Eddie Vos   (19 January 2009)

Eicosapentanenoic?

Peter J Flegg   (19 January 2009)

Re: Oily fish .. but nobody asked the fish--so what to do?

Leslie O Simpson   (20 January 2009)

Adiponectin and Fish Oil

Michael D Beary   (5 February 2009)

Marine extinction is due to population pressure 16 January 2009
Caroline Richmond, Journalist SW3 5AQ Send response to journal: Re: Marine extinction is due to population pressure	You say that the world’s marine fauna is being pushed towards extinction largely for commercial gain, but partly in the name of public health. Underlying both is population pressure: world population has tripled from 2.3bn to nearly 7bn since 1940. This problem is rarely addressed, and it should be. We are an increasingly large proportion of the planet's biomass, and as our biomass gets larger, everything else has to shrink. If we have endless population growth, we will empty the seas without achieving this. Competing interests: None declared
Oily fish .. but nobody asked the fish--so what to do? 19 January 2009
Eddie Vos, maintains health-heart.org Sutton (Qc) Canada J0E 2K0 Send response to journal: Re: Oily fish .. but nobody asked the fish--so what to do?	Brunner and Iso's excellent editorial(1) highlights the importance of fish-based omega-3s, but the idea of two or more fatty fish meals a week, a suggestion made by ever more heart-disease organizations, is not sustainable with 76% of fish species at, over or past their limits of exploitation(2). World fish oil production(2) has dropped to about 1 billion kg/year and rather than making the oil available in cheap pills for humans (which is probably sustainable), in 2003, 87% of fish oil was used for aquaculture, 92% in the developing world. In addition, about 20-25 billion kg fish is used to produce about 30 billion kg farmed fish with most fish oil going for high-cost salmon species where, ironically, often the skin gets removed, discarding the tissue where salmonids store fats. Interestingly, plant based omega-3, alpha-linolenic acid (cheap sources: rapeseed/canola, flaxseed) is endogenously elongated to eicosapentaenoic (but not docosahexaeinoic) acid [one of the fatty acids found in any fish oil] and it has similar cardiac benefits, as convincingly shown by the results and blood fatty acid analysis of the LYON study [Tables 4 and 7 in (3)]. Non sustainable fish-flesh and expensive prescription (ethyl-ester) solutions are not acceptable and, here, plant based omega-3 and smart fish oil based food store supplement supplementation avenues must be urgently explored and adopted. vos@health-heart.org 1. Brunner E, Iso H. Fish oil and secondary prevention of cardiovascular disease. BMJ. 2008 Dec 23;337:a2541. Medline 19106136 2. FAO/WHO FIRIC/C1018 2006. Use of fishery resources as feed input to aquaculture development: trends and policy implications. ftp://ftp.fao.org/docrep/fao/009/a0604e/a0604e00.pdf 3. de Lorgeril M, Renaud S, Mamelle N, Salen P, Martin JL, et al. Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet. 1994 Jun 11;343(8911):1454-9. Medline 7911176 4. Vos E, Cunnane SC. {alpha}-Linolenic acid, linoleic acid, coronary artery disease, and overall mortality. Am J Clin Nutr. 2003 Feb;77(2):521- 2. http://www.ajcn.org/cgi/content/full/77/2/521 Medline 12540417 Competing interests: None declared
Eicosapentanenoic? 19 January 2009
Peter J Flegg, Consultant Physician Blackpool. UK, FY3 8NR Send response to journal: Re: Eicosapentanenoic?	I started to pick my way through this editorial with a sense of increasing alarm. Had I been wrong all these years, and worse still, been misleading my juniors and students? As I read the article through to the end, it seemed as though my fears were confirmed. I really didn't know how to spell eicosapentaenoic. A quick check from other handy sources told me I shouldn't have worried. They seemed to confirm I was right all along, and that there is no extra "n" that would produce an extra syllable. As a final arbiter, I decided to resort to Google fight (yes, I know, but sometimes one just can't help it). And now my doubts have resurfaced somewhat. Eicosapentaenoic has 3,460,000 hits, but the "incorrect spelling" eicosapentanenoic yields only a paltry 10,000 fewer. Too close to call, or just a sign of the vagaries of the internet? Competing interests: None declared
Re: Oily fish .. but nobody asked the fish--so what to do? 20 January 2009
Leslie O Simpson, retired experimental pathologist Dunedin, New Zealand, 9077 Send response to journal: Re: Re: Oily fish .. but nobody asked the fish--so what to do?	Eddie Vos correctly draws attention to the potential problems arising from the depletion of fish stocks, but he did not draw attention to the importance of oily fish. Food fish from NZ waters are poor sources of omega-3 fatty acids, so the recommended weekly intake of fish would not produce adequate amounts of omega-3 fatty acids. While plant-derived alphalinolenic acid will be effective in those people who have a functional delta-6-desaturase to elongate the alphalinolenic acid to eicosapentaenoic acid, in several chronic states, D-6-D is dysfunctional. On a visit to Comox in British Columbia, I was made aware of salmon oil being prepared from the waste from a salmon processing factory. This could be the way to the future, by ensuring that no omega-3 rich material is wasted. Competing interests: None declared
Adiponectin and Fish Oil 5 February 2009
Michael D Beary, Consultant Psychiatrist Priory Hospital North London. London. N14 6RA Send response to journal: Re: Adiponectin and Fish Oil	The authors have not mentioned fish oil increases adiponectin levels 2-3 fold. This hormone produced by subcutaneous fat is inversely related to visceral fat area and the signs of the metabolic syndrome. It constitutes about 1% of plasma protein and is a likely candidate for the transmitting the benefits of a diet rich in oily fish. Improvement in the population's cardio-vascular health depends on changing behaviour. We know about the need to stop smoking. Matsuzawa has shown that fit Sumo wrestlers have little visceral fat and are metabolically healthy. Clearly exercise can transform the well-being of even the most obese. Now we know that 3 or 4 meals of salmon, mackerel or herring will improve matters further. 1.Neschen S, Morino K, Rossbacher JC, Pongratz RL, Cline GW, Sono S, Gillum M, Shulman GI.Fish oil regulates adiponectin secretion by a peroxisome proliferator-activated receptor-gamma-dependent mechanism in mice.Diabetes Apr 55(4) 924-8 2.Matzuzawa Y. Pathophysiology and molecular mechanisms of visceral fat syndrome: the Japanese experience. Diabetes Metab Rev 1997,13:3-13 Competing interests: None declared