Fish consumption and omega-3 fatty acid status and determinants in long-term hemodialysis.
BACKGROUND
Blood levels of the anti-inflammatory and cardioprotective omega-3 eicosapentaenoic (EPA) and docosahexaenoic (DHA) fatty acids are determined primarily by dietary consumption. There is reason to believe that hemodialysis patients are at risk for inadequate omega-3 intake and, consequently, low blood levels.


METHODS
This question was tested in 75 long-term hemodialysis patients and 25 matched controls by measuring fasting, predialysis plasma and red blood cell (RBC) fatty acid levels using gas chromatography and performing a fish-consumption survey.


RESULTS
Sixty-seven percent of patients did not meet American Heart Association fish-consumption guidelines for healthy persons. Compared with controls, patients had lower plasma omega-3 levels (mean % wt: DHA, 1.33 +/- 0.38 [SD] versus 1.51 +/- 0.36; P = 0.0370; omega-3 index [ie, EPA plus DHA], 1.67 +/- 0.49 versus 1.92 +/- 0.40; P = 0.0249). RBC levels, which estimate more long-term consumption, showed mixed results (EPA, 0.29 +/- 0.08 versus 0.33 +/- 0.11; P = 0.0816; DHA, 4.65 +/- 0.92 versus 3.16 +/- 1.15; P < 0.0001; omega-3 index, 4.95 +/- 0.95 versus 3.49 +/- 1.22; P < 0.0001). RBC omega-3 levels in patients roughly reflected fish consumption. Independent predictors of plasma and RBC omega-3 levels at the 0.05 level of significance included age, race, sex, alcohol use, and fish servings.


CONCLUSIONS
Hemodialysis patients consumed fish in quantities far below current American Heart Association recommendations and manifested suboptimal omega-3 levels given their high heart disease risk. These results identify a potentially modifiable cardiovascular risk factor.
Friedman
Allon N
AN
Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA. allfried@ipui.edu
Moe
Sharon M
SM
Perkins
Susan M
SM
Li
Yong
Y
Watkins
Bruce A
BA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000572:American Heart Association; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D016022:Case-Control Studies; D002849:Chromatography, Gas; D015331:Cohort Studies; D004032:Diet; D004281:Docosahexaenoic Acids / Q000032:analysis / Q000097:blood; D015118:Eicosapentaenoic Acid / Q000032:analysis / Q000097:blood; D004912:Erythrocytes / Q000737:chemistry; D015525:Fatty Acids, Omega-3 / Q000032:analysis / Q000097:blood* / Q000737:chemistry; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000097:blood* / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009751:Nutritional Requirements; D006435:Renal Dialysis; D012307:Risk Factors; D017747:Seafood; D013997:Time Factors
D015525:Fatty Acids, Omega-3; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid