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Association between fish consumption, long chain omega 3 fatty acids, and risk of cerebrovascular disease: systematic review and meta-analysis

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e6698 (Published 30 October 2012) Cite this as: BMJ 2012;345:e6698

Re: Association between fish consumption, long chain omega 3 fatty acids, and risk of cerebrovascular disease: systematic review and meta-analysis

In their fascinating meta-analysis article Chowdhury, et al. (2012) found that fish consumption was “…moderately but significantly associated with a reduced risk of incident cerebrovascular disease…” but not so with omega 3 supplement use. (1) This brings to mind some questions. Could current fish consumption reflect early-life dietary patterns? Could current fish consumption reflect maternal and family food habits? Thus could fish consumption reflect lifetime omega 3 intake patterns whereas omega 3 supplements reflect short-time bents? If so how might this be significant?

Although there may be lifelong shaping of the epigenome, early life influences on the epigenome could be highly important because they can put the individual on a disease trajectory. (2,3) It has been asserted that epigenetics, such as hypomethylation of DNA, plays a role in vascular disease and stroke risk. (4,5) Using an animal model, Kulkarni, et al. (2011) found that the omega 3 fatty acid DHA promotes healthy global DNA methylation in the placenta. (6) Could DHA also have a role in shaping the epigenome in such a way as to influence cerebrovascular disease risk later in life? Could this be one of the mechanisms by which fish consumption promotes cerebrovascular health? Could omega 3 fatty acids promote health in part through an epigenetic mechanism? What impact might omega 3 fatty acids have on the epigenome at different points in the lifecycle?

References
1. Chowdhury R, Stevens S, Gorman D, Pan A, Warnakula S, Chowdhury S, Ward H, Johnson L, Crowe F, Hu FB, Franco OH Association between fish consumption, long chain omega 3 fatty acids, and risk of cerebrovascular disease: systematic review and meta-analysis. BMJ. 2012 Oct 30;345:e6698.
2. Szyf M The early-life social environment and DNA methylation. Clin Genet. 2012 Apr;81(4):341-9.
3. Attig L, Gabory A, Junien C. Nutritional developmental epigenomics: immediate and long-lasting effects. Proc Nutr Soc. 2010 May;69(2):221-31.
4. Turunen MP, Aavik E, Ylä-Herttuala S Epigenetics and atherosclerosis. Biochim Biophys Acta. 2009 Sep;1790(9):886-91.
5. Baccarelli A, Wright R, Bollati V, Litonjua A, Zanobetti A, Tarantini L, Sparrow D, Vokonas P, Schwartz J Ischemic heart disease and stroke in relation to blood DNA methylation. Epidemiology. 2010 Nov;21(6):819-28.
6. Kulkarni A, Dangat K, Kale A, Sable P, Chavan-Gautam P, Joshi S. Effects of altered maternal folic acid, vitamin B12 and docosahexaenoic acid on placental global DNA methylation patterns in Wistar rats. PLoS One. 2011 Mar 10;6(3):e17706.

Competing interests: No competing interests

04 December 2012
Celia M Ross
Activities Assistant
Franciscan Care Center
Hockessin, Delaware, USA
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