Fish


I never cared much for fish growing up. At home, fish came in brown squares out of the freezer. On family camping trips, we’d have salmon patties made with canned salmon. Once, on a family vacation down east, I raked for clams in the Chesapeake Bay, and my mom steamed them. They were OK, but not special.
My mind began to change when I became a faculty and would be invited to dinner with out-of-town seminar speakers. Restaurants get the best cuts of meat and fish, and for many types of fish, the preparation makes a lot of difference.
Now, I love sushi and sashimi and regularly grill salmon, trout and tuna. Since we’re ensconced in the Ocean State, I’m looking forward to a greater variety.
I’m not a believer in food as medicine. Yes, moderating intake of fats and oils and of sugar is a good idea, but the lettuce in your salad isn’t an antidote for the fats in your salad dressing.
For years, we’ve been told that the omega-3 fatty acids in fatty fish like salmon is protective against heart disease. Now, it looks like there may be less to that than meets the eye. Add to that the mercury in seafood, and the advice is to limit yourself to a single serving per week.
But don’t take my word for it: this guy is a real doctor:
“Much of my faith in fish and fish oil, however, was based on observational data and one randomized trial from the mid-90s in patients following heart attacks (the GISSI trial). The strongest evidence for the benefit of eating fatty fish has always come from observational studies that show individuals with a higher intake of omega-3 fatty acids (e.g., EPA and DHA) and with a higher red blood cell level of EPA and DHA have lower cardiovascular risk.
“By early 2021, based on several new trials of fish oil supplements, I concluded that "there is no compelling evidence for you to take over-the-counter fish oil supplements for primary or secondary prevention of cardiovascular disease." This is the same advice I have been giving since 2013.
“The STRENGTH study, which showed absolutely no benefit of supplementing with EPA/DHA on reducing a composite cardiovascular endpoint, has triggered me to start looking more closely at the quality and strength of the evidence for the fish recommendations in general.
“The PURE study found no significant association between fish intake and any health outcome after adjustment for known confounders.These findings and an old Welsh randomized trial have caused me to question whether eating fish does, indeed, protect us against atherosclerotic complications like stroke and heart attack.”

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