Japan's Heart-Healthy Diet: Fish Is Key

July 28, 2008 -- It might be called the Japanese paradox.

Men in Japan have similar lifetime cholesterol, blood pressure, and type 2 diabetes rates as men in the U.S., and they are far more likely to smoke.

Heart Health Videos

Video: Cholesterol Guidelines

Video: Young People and Heart Disease

Video: Predicting Heart Disease

All Heart-Related Videos

Related Slideshows

• Best and Worst Fast-Food Breakfasts
• 7 Most Effective Exercises

Related to heart health

coronary artery disease, angina, atherosclerosis, clogged arteries, cardiovascular disease, chest pain, heart attack, heart disease, myocardial infarction, bypass surgery, angiogram, angioplasty, anger and heart disease , aspirin therapy, stents, EKG

© 2008 WebMD, LLC. All rights reserved.

So why is it that the rate of heart disease among men living in Japan is less than half that of men living in the U.S. and that Japanese men tend to have less artherosclerosis -- the artery-clogging plaque that leads to heart attacks and strokes?

A new study suggests that the answer may be found in the sea.

(Trying to get more omega-3sin your diet? Tell us what is working for you on WebMD's Men’s Health: Man-to-Man board.)

High Omega-3 Levels

Because they ate more fish, men living in Japan who participated in the study had twice the levels of omega-3 fatty acids in their blood as white men and Japanese men living in the U.S. They also had less severe degrees of atherosclerosis.

The finding lends support to the hypothesis that omega-3, which is found primarily in fatty fish like tuna, mackerel, and salmon, protects against plaque buildup in the arteries.

Sources of omega-3 fatty acids are fish oils, which contain docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), and plant sources. Alpha-linolenic acid (ALA), which is converted into omega-3 fatty acids in the body, is a plant-source omega-3 fatty acid.

Studies have generally used fish oils. While plant sources with ALA may have the same benefits, less is known about them.

"The extremely high intake of fish in Japan may explain the much lower rate of atherosclerosis and subsequent coronary heart disease," researcher Akira Sekikawa, MD, PhD, tells WebMD. "This study does not prove that omega-3 is protecting these men, but we showed that artery thickness decreased as omega-3 levels went up."

The Japanese diet has become increasingly westernized since the end of World War II, but fish consumption in Japan is still among the highest in the world.

People in Japan eat an average of 3 ounces of fish every day, while the average American finds it difficult to manage the two servings of fish a week recommended for heart health by the American Heart Association, omega-3 researcher William Harris, PhD, tells WebMD.

He adds that the average omega-3 intake in Japan of 1 gram a day is about eight times higher than the amount the typical American gets.

"We are not a nation that loves fish, and that isn't likely to change," he says. "But it is increasingly clear that we need to get more omega-3 into our diets."

Fish oil supplements are one way of doing this. Studies in individuals with heart disease have shown a benefit of supplemental omega-3 fatty acids. Based on these studies, the American Heart Association recommends that people with heart disease take 1 gram of EPA plus DHA daily.