BALTIMORE, MARYLAND. Several studies have shown that regular fish consumption protects against cardiovascular disease. Other studies have shown that consuming mercury-contaminated fish increases the risk of coronary heart disease. The beneficial effect of fish consumption is believed to be due to the presence of the omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in the tissue of fish and shellfish. Two recent studies have attempted to answer the question “Are the beneficial effects of fish oils (EPA and DHA) outweighed by the negative effects of mercury”?
Study 1 Found Higher Mercury Levels Led to Higher Risk of First Heart Attack
The first study, carried out by a team of researchers from eight European countries, Israel and the United States, involved 684 men who had suffered a first non-fatal heart attack and 724 matched controls. All participants had their mercury level measured in toenail clippings and their level of DHA measured in a fat tissue sample taken from the buttock. Participants with a mercury level of 0.66 mcg/gram were found to have twice (odds ratio of 2.16) the risk of having a first heart attack when compared with participants having a mercury level of 0.11 mcg/gram. This risk assessment was arrived at after adjusting for age, DHA level in adipose tissue, body-mass index, waist:hip ratio, smoking status, alcohol intake, HDL cholesterol level, diabetes, history of hypertension, family history of heart attack, blood levels of vitamin E and beta-carotene, and toenail level of selenium.
The research team also found that participants with a high (0.44% of total fatty acids) fat tissue content of DHA had a 41% lower risk of having a first heart attack than did those with a low (0.10% of total fatty acids) fat tissue level of DHA. This risk assessment was arrived after adjusting for all other known risk factors including toenail mercury level.
The researchers point out that the main sources of mercury are occupational exposure (dentists), exposure to silver-mercury amalgam in dental fillings, and fish consumption. They conclude that the health benefit of fish consumption is significantly diminished if the fish is high in mercury. They also confirm the cardioprotective effect of fish oils (DHA).
Study 2 Found No Clear Association Between High Mercury Levels and Heart Disease Risk
The second study was part of the Health Professionals Follow-Up Study begun in 1986 as a cooperative venture between the Harvard School of Public Health, the Brigham and Women’s Hospital, and Harvard Medical School. The study involved 33,737 male health professionals who had toenail clippings analyzed for mercury in 1987. After 5 years of follow-up 470 participants had been diagnosed with coronary heart disease. The researchers observed that dentists, who are habitually exposed to mercury, had toenail mercury levels (0.91 mcg/gram) that were twice as high as the levels found in non-dentists (0.45 mcg/gram). They also found a direct relationship between fish consumption and mercury level with participants consuming an average of 357 grams (3/4 lb) of fish per week having a level of 0.75 mcg/gram while those who consuming 145 grams (1/3 lb) per week had a level of 0.29 mcg/gram. After adjusting for age, smoking and other risk factors for heart disease the researchers conclude that there is no clear association between total mercury exposure and the risk of coronary heart disease, but that a weak relation cannot be ruled out.
Guallar, E, et al. Mercury, fish oils, and the risk of myocardial infarction. New England Journal of Medicine, Vol. 347, November 28, 2002, pp. 1747-54
Yoshizawa, K, et al. Mercury and the risk of coronary heart disease in men. New England Journal of Medicine, Vol. 347, November 28, 2002, pp. 1755-60
Bolger, PM and Schwetz, BA. Mercury and health. New England Journal of Medicine, Vol. 347, November 28, 2002, pp. 1735-36