Red Fish, White Fish; Dark Fish, Atrial Fibrillation

Red Fish, White Fish; Dark Fish, Atrial Fibrillation
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The consumption of dark fish (such as salmon, swordfish, bluefish, mackerel, and sardines) may increase our risk of atrial fibrillation—an irregular heartbeat rhythm associated with stroke, dementia, heart failure, and a shortened lifespan.

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Another surprising fish story out of Massachusetts recently. Atrial fibrillation is the most common clinical cardiac arrhythmia—an irregularity of our heartbeat rhythm—which can set us up for a stroke, increase our risk of dementia and heart failure, and significantly shorten our lifespan.

Previous findings on the effect of diet have been conflicting. Some studies have found alcohol, caffeine, and fish consumption to be good, in terms of preventing or resolving atrial fibrillation, and other studies have shown them all to be bad.

It’s when this kind of situation arises in nutritional science, you pull out the big guns, and put it to the test in one of the bigger, better studies, like the famous Framingham Heart Study population, like they did here.

They found no effect either way, in general, from the consumption of alcohol, caffeine, or fish. But when they looked closer, they observed an association between the consumption of dark fish and atrial fibrillation. A six-fold higher hazard ratio. What they’re talking about is basically salmon, swordfish, bluefish, mackerel, sardines; that kind of thing.

They conclude that their findings may suggest a “true adverse effect of dark fish and fish oil on certain subtypes of [atrial fibrillation],” proposing that “potential toxins such as dioxins and methyl mercury accumulated in certain fish may have a negative effect on cardiac arrhythmia.”

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Serena.

Please consider volunteering to help out on the site.

Images thanks to Popfossa and marc kjerland / flickr

Another surprising fish story out of Massachusetts recently. Atrial fibrillation is the most common clinical cardiac arrhythmia—an irregularity of our heartbeat rhythm—which can set us up for a stroke, increase our risk of dementia and heart failure, and significantly shorten our lifespan.

Previous findings on the effect of diet have been conflicting. Some studies have found alcohol, caffeine, and fish consumption to be good, in terms of preventing or resolving atrial fibrillation, and other studies have shown them all to be bad.

It’s when this kind of situation arises in nutritional science, you pull out the big guns, and put it to the test in one of the bigger, better studies, like the famous Framingham Heart Study population, like they did here.

They found no effect either way, in general, from the consumption of alcohol, caffeine, or fish. But when they looked closer, they observed an association between the consumption of dark fish and atrial fibrillation. A six-fold higher hazard ratio. What they’re talking about is basically salmon, swordfish, bluefish, mackerel, sardines; that kind of thing.

They conclude that their findings may suggest a “true adverse effect of dark fish and fish oil on certain subtypes of [atrial fibrillation],” proposing that “potential toxins such as dioxins and methyl mercury accumulated in certain fish may have a negative effect on cardiac arrhythmia.”

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Serena.

Please consider volunteering to help out on the site.

Images thanks to Popfossa and marc kjerland / flickr

Doctor's Note

Check out Boosting Heart Nerve Control for how we can improve heart rhythm function through diet, and check out my other videos on alcoholcaffeine; and the persistent organic pollutants that build up in the aquatic food chain. The mercury that accumulates in fish (see Cannibalistic Feed Biomagnification) can also affect brain function in children (see Maternal Mercury Levels), as well as in adults (see Fish Fog).

Also, be sure to check out my associated blog posts: Mercury Testing Recommended Before Pregnancy, and Eating To Extend Our Lifespan.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

24 responses to “Red Fish, White Fish; Dark Fish, Atrial Fibrillation

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    1. Great Vid!! Let me tell you why!
      For some reason everytime I tell a patient about a plant based diet (which is probably between 5-10 times per day) why is it that nearly everyone, after I get done telling them about not eating animals/meat, they ask, “Can I still eat fish?”  Then by the sheer inquisitively, perplexed look on my face they respond with, “No?  But it has lots of Omega-3’s”
       I respond, “Sure it does, but if you also like dioxin, DDT and Mercury in your diet and want to act like the Mad Hatter on Alice in Wonderland, then by all means find the fillets and grill the gills.”  This is when they always start to look despondent. (I’m not ‘Fibbin’ either ;-} )
      Why is it people think fish are not animals?  Any insight?

      This video, again, is just one more reason to help keep our patients informed and safe.  If we are going by studies back in the Framingham days as increasing risk of disease what do you think we would find on a study done on todays fish?  Yikes!




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    2. The title could have been, “Red Fish, White Fish; Dark Fish, Afibish.”

      Of course, my humor side got the best of me again. 




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  1. It’s just incredible how toxic everything around has become, and the future is looking even more so, doesn’t it?  Is wild fish from Northern waters (Alaska) any better?  Or is it filled with mercury and Prozac there too?  Are you saying in this video that f.e. halibut is relatively safer to eat than salmon?

    Damage to environment is irreversible as I see it.  And I can’t say I see a lot of healthy looking people around, especially teens and small children, so can’t truly be hopeful.  How do you feel about this, Dr Greger?




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    1.  All fish will contain certain levels of contaminants, even the “cleanest” fish, like Alaskan salmon still contain modest levels of pcb’s and it is recommended children should not consume this fish no more than 3 times a month. Fish are probably the most polluted of the animal products and since we are striving to achieve an optimally healthy diet, fish should be excluded from the diet.




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      1. Thanks very much.  If you were to eat any animal protein twice a week, what would you go for?  Cleanliness is the key of course.




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        1.  I am personally vegan simply because I cannot view any animal product as healthy to eat. They all have their issues and one can achieve excellent health on a whole foods plant based diet without meat. If one is trying to cure themselves of type 2 diabetes for example, the inclusion of meat, even once a week, regresses the healing of this disease.
          http://nutritionfacts.org/videos/how-to-treat-diabetes/

          if you must have that meaty taste I would say go for mock meats, although even these foods are highly processed, but they are better than the actual meat itself.




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  2. Studies are still conflicting: Wu JH, Lemaitre RN, King IB, Song X, Sacks FM, Rimm EB, Heckbert SR, Siscovick DS, Mozaffarian D. Association of plasma phospholipid long-chain ω-3 fatty acids with incident atrial fibrillation in older adults: the cardiovascular health study. Circulation 2012 Mar 6; 125(9):1084-93. 
    http://circ.ahajournals.org/content/125/9/1084.abstract
    Source Circulation. 2012 Mar 6;125(9):1084-93. http://www.ncbi.nlm.nih.gov/pubmed/22282329




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  3. What about fish oil? I use Norwegian Gold CO2 extracted pills which are IFOS certified. Other than these, I am vegan. …Concerned that the pills might not be the best way to obtain EPA and DHA though, even though it appears they are the cleanest and least oxidized on the market.




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  4. This is the truth! I weighed 297lbs at the age of 38 was on BP and cholesterol meds. So I decided to lose weight by eating healthier and jogging 3 years ago. I stopped eating red meat and salmon became my meat of choice. I had my first afib event after jogging 4 miles on a hot June 2010 day. It was very scary, I drove myself to the hospital, I converted spontaneously before reaching the hospital. I had a second event in the following October which did send me to the hospital. A battery of tests revealed no clear reason for my Afib. On top of eating salmon 2 – 3 times daily generally in the form of sushi I was taking fish oil as well. They put me on meds to control the afib, despite that, I had my worse event that Nov. I sought to educate myself as the doctors were just treating me. I had lost 50 pounds I was eating what I thought was very healthy and exercising daily. It really stressed me that I was eating better that I had in 15 years So, I scoured the internet. I found one report by an electrophysiologist in New York that showed a relationship between fish consumption and afib development. When I printed the report and brought it to my personal electrophysiologist he had never heard of it and said “Go eat some salmon and see if you go in to afib.” I’m not joking. My Nov event I had consumed a lot of salmon the day before, too much for it to be a coincidence in my mind. I have since completely stopped eating any animal products.
    I am down to a much healthier 186lbs and I have not had an afib event since and I am off all medications.




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    1. Gary B: That’s an awesome story. I’m sorry you had to go through all that, but I love happy endings. Thanks for sharing your story. I expect it will help other people too. Good luck!




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    2. you were very extreme. anything taken to that level causes harm. i eat salmon 2 xs a week, & other fish. the oil pills are too much.




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    3. Gary how are you doing, anymore AFib? I have had several incidents and they all seem unrelated to anything except first one due to too much thyroid meds. Just had AFib today after 2 years :( Trying to find natural ways to avoid it. brit




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    4. I agree 100% with you on Salmon. I believe if eaten in moderation no problem, but I too, was over eating it. I stopped eating it and so did my Afib stop. We all have to learn and find our triggers. My doctor didn’t agree either. LOL Good luck.




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  5. are there any studies that differentiate between herbivore and
    omnivore/carnivore fish? of all the fish mentioned above only
    sardines eat plankton. lower on the food chain so the level of
    contaminants should be much less.




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    1. This great vid caused me to reflect on my own condition. In 2000, prior to my reading anything by Ornish, McDougall, Greger or Esselstyn, I had a LAD to LIMA bypass. I became a veggie the next day. After a few years, my wife said that I should eat fish because it was healthy (had “good” fat) and I read that it also had lots of Omega 3s. She also said, “what are our friends going to feed you when we go to their place for dinner? I agreed to start eating fish (it wasn’t a tough sell for her because I am an avid fisherman. Still am but give the fish away to my friends whom I’ve been unable to convince to become vegans) and I love eating fish! Overe the next five or more years I had AF about six or so times. I read the China Study in about 2010 and McDougall and the others and became a vegan. I didn’t keep records about the incidence of my AF but I’m sure I haven’t had it in at least four years. This isn’t a study of any kind but what an interesting coincidence!!

      Granville Airton




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  6. A recent study showed a positive association between fish eating and reduced risk of dementia. It’s possible fish eating is associated with a generally healthy lifestyle, which could explain the result. Or perhaps eating fish reduced eating even less healthy meat. I am wondering what is known about veganism and dementia risk. The study did not, it seems. address this.




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    1. David: I don’t know about the study you are referring to. However, I do know about Dr. Barnard’s book, “Power Foods For the Brain – an effective 3-step plan to protect your mind and strenthen your memory”. The book is the result of Dr. Barnard’s research into what we know about Alzheimers and other forms of dementia. When all was said and done, Dr. Barnard believes that the best science suggests that we eat no meat, dairy or eggs for optimum brain health. I don’t think any one study would trump that work. That’s just my opinion. But I thought I would point you to the book in case you weren’t aware of it:
      http://www.amazon.com/Power-Foods-Brain-Effective-Strengthen/dp/1455512206/ref=sr_1_1_twi_1?ie=UTF8&qid=1414102360&sr=8-1&keywords=power+foods+for+the+brain




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      1. Thanks. Actually I just realized I mistated what I read – the study showed somewhat larger brain volume in certain areas including the hippocampus. I forget the details e.g. significance of the difference, and only read a popular summary in an AARP newsletter. Needless to say, I am quite skeptical of the claims.




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  7. This is more a test than a comment in order to find out how to receive feedback from fellow plant-based companions.
    I am 72 (Jan. 2017) and was started feeling dizzy with heart palpitation during the summer of 2012. Soon I felt my heart and at two aortic places where there was a distinct discomfort, together with greater weakness, anxiety, and shortness of breath.
    During a regular checkup, Summer 2013, the EKG was so worrisome to the GP that I was shipped off to the remote hospital some 90 miles away in an ambulance. EKGs every eight hours. ‘Tell us when you do not feel well.’ Blood test to determine if I had a heart attack (negative). After 48 hours of observation in a recliner due to no beds being available, I was releases by the emergency doctor with the remark that he did not worry about my heart, but more about my state of mind. He spoke about anxiety and stress symptoms. I was advised to take my BP medicines (Amlodepine) more regularly. Needless to say, I had HBP for some 20 years.
    Yet sweating after little exertion, some wheezing, fluttering heartbeat, heavy feeling in the chest, easily fatigued, sudden redness of the face, were symptoms that worried me.
    I started reading, came across our favorite Drs., such as Dr. Geger, Dr Fuhrman, Dr Esselstyn, you know of them. It was clear that I had to change my ways, deal with my addictions: milk products, especially cheeses and bread with a slice of tomatoes ;-) and Pepsy Cola. I was feeling my heart too much for comfort. The addictions were severe and I struggled. Admittedly, it was ultimately the fear about my failing health that prompted me to eat more health-promoting.
    The last day of 2014 I had a brief fainting spell during a gathering and woke up with some heads over me asking if I was okay. I answered just let me lie here. They moved me to a couch and the party was over for me. I remember sitting in my car for a long time, making sure that I was okay to drive. (I was.)
    By the time Summer of 2015 came around and there was only little improvements of symptoms, I wanted a diagnosis, which I received from a cardiologist. The echocardiogram showed normal strong heart valve function, but enlarged left upper heart chamber and left bundle branch block that causes arrhythmia. I have cardiac arrhythmia atrial fibrillation, and LBBB – Complete left bundle branch block
    Prescription: More BP meds Irbesartan and Tenormin which is supposed to avoid insufficient blood flow to my heart, Xarelto blood thinner.
    By that time I had studied enough and it was clear that a complete commitment to a lifestyle change was the only way to stay alive longer. Since than I am eating the most nutritionally-dense food, and are guided by Dr. Greger’s Daily Dozen.
    Half a year later, the EKG showed that the bundle block was now on the right side.
    I do not understand why my BP has not gone down without medication. I must still take Amlodepine 5mg and Irbesartan 150mg. to keep under 120/80. My pulse pressure is between 40 and 50, and my pulse is always under 60, and as low as 40. I have refused all other meds, because my intake of cruciferous veggies every day should keep my blood thin enough. While my LDL was around 190 five years ago, I can not get it lower than 130, while I would want to be way under 100. On the HDL I am stuck around 45, and want to be over 60.
    My supplements to strengthen the heart are: an increased consumption of garlic, onions and celery (potassium); legumes, seeds, nuts, whole grains and leafy veggies for magnesium, CoQ10 in pill form; can’t get hawthorn extract here in Central America; Vit D3 2,000+ IU/day; EPA+DHA 3,000 mg/day from lab-grown microalgae.
    Basically I am 1 1/2 years without any processed food. How long did it take you to become free of meds? These symptoms have gone better or gone away: sweating after little exertion, no more wheezing, some fluttering heartbeat upon waking up (sometimes high BP 150/100), no more heavy feeling in the chest, better stamina also due to daily exercising, no more sudden redness of the face.
    I thank you for reading this far. If you have any suggestions or observations, please be so kind and share them. I live in an environment where I am basically the only one who attempts to get better with nutrition. Thank you kindly.




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  8. Which type of fish has the least mercury or least health risks? Also, although I don’t personally condone either, I have been asked if it is healthier to eat fish or chicken, since they are both lean meats compared to beef.

    Hoping to get answers to provide them to my omnivore friends and family when they ask.
    Thanks!




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    1. hayenh: Due to good marketing, lots of people in our society have a perception that fish and chicken are “lean” meats. However, that idea is more myth than reality. The NutritionData.Self website uses the USDA database to report nutrition of various foods. I just did some research for you and came up with the following information for 1 ounce of steak, chicken and fish:

      > Steak: 78 calories, 60% fat. 5 grams fat, 2 of which is saturated fat
      > Chicken: 82 calories, 55% fat. 5 grams fat, 1 of which is saturated fat
      > Salmon: 65 calories, 52% fat. 4 grams fat, 1 of which is saturated fat
      These numbers are from the following pages respectively: http://nutritiondata.self.com/facts/beef-products/3775/2, http://nutritiondata.self.com/facts/poultry-products/10046/2, http://nutritiondata.self.com/facts/finfish-and-shellfish-products/4232/2

      The numbers above depend a lot on cut and cooking method. So, someone’s actual consumption may be higher or lower than these numbers. The point is, I think the differences are pretty trivial. And that is only looking at the fat content. When you consider all the other health problems with animal products, including the animal protein (increasing cancer risk) and lack of fiber and significant micronutrients, contaminants, etc, there’s nothing good about any of those products. I think that telling people that one is better than the other gives people a false sense of safety.

      The same argument holds for fish and mercury levels. Even if you could find a fish with low mercury levels, there are still other contaminants plus a whole host of other health risks associated with consuming fish. In good conscience, I personally could not tell someone to eat say chicken as an alternative to a hamburger, suggesting that it is significantly healthier.

      Following are overviews of just some of the risks associated with consuming fish and chicken: http://nutritionfacts.org/topics/Fish and http://nutritionfacts.org/topics/Chicken




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