Fish, Chips and Chanukah 2010
Jacob Schor, ND, FABNO
November 1, 2010
We will celebrate Chanukah early this year; the first candle is to be lit on Wednesday night, December 1. No doubt some of my readers will point out that this is not early as Chanukah always falls on the 24th day of Kislev.
This holiday is something of a celebration of oil and by tradition we favor fried foods for our meals. We have in recent years tried serving our guests alternatives to the classic meal of fried potato pancakes. Some of our guests last year found the chili rellenos on our menu somewhat different. http://denvernaturopathic.com/chanukah2009chilirellenos.htm
I haven’t given up with looking for alternatives and this year will promote fish and chips as Chanukah food. Not only will this meal amply meet the oil consumption requirement but, fish and chips, though many people don’t know it is absolutely traditional Jewish food.
We often mistakenly think of fish and chips as British food. After all, over 10,500 fish and chip shops operate in England, though this is a significant drop from the record high of 35,000 fish and chip shops open there during the 1920s.
Where did the British learn to fry fish? They learned from Jewish immigrants of course.
Fried fish in batter originated with the Portuguese Marranos. These Sephardic Jews fled the Spanish Inquisition, first to Holland and later to London. They brought their talent for deep frying fish with them to London in the early 1500s. Manuel Brudo, writing in 1544, described how the Marrano refugees fried fish, first sprinkling it with flour and then dipping it in eggs and bread crumbs. Lady Judith Montefiore, the anonymous editor of the first Jewish cook book in English (The Jewish Manual: or Practical Information in Jewish & Modern Cookery; with a Collection of Valuable Recipes and Hints Relating to the Toilette, edited by a Lady, which was published in1846) called for “Florence oil” in her recipe for fried fish, obviously referring to olive oil.
Thomas Jefferson, before he became President, wrote home from London in the early 1800s of eating a meal of 'fried fish in the Jewish fashion' and brought the recipe home to Monticello. This Jewish fish recipe appears in a collection of Jefferson’s favorite recipes put together by his daughter Virginia.
Potatoes, being a New World food were a late addition to the menu. Credit for inventing deep fried potatoes, what we Americans call French fries and the British chips, usually goes to a Belgian housewife from the Meuse Valley (that’s Belgium not France.)
Jews were the first to serve both fish and chips together. A 13-year-old Jewish boy named Joseph Malin began selling fish with chips together in 1860 in the East End of London. He fried the potatoes in his family’s basement, bought the fried fish from a shop and sold the combo from a tray he carried on the streets.
A rival claim gives credit to John Lees of Lancaster who started selling fish and chips from a hut in the Mossley market in 1863.
As no one disputes the basic contention that fried fish was first sold in London as Jewish food, there should be no argument that it is a suitable choice for a Chanukah meal.
All of this discussion of course is but a prelude or an excuse for me to review some recent research about the health benefits of fish, olive oil and turmeric.
What’s turmeric have to do with either fish and chips or Chanukah? Well the famed Sarah Russell, prior to reinventing herself as Madame Rachel and opening a beauty salon for the well to do, sold fried fish and boiled potatoes. In this earlier ‘career’ she set herself apart from competing vendors by heavily flavoring her batter with turmeric. http://www.thejc.com/arts/arts-features/30174/a-tale-money-vanity-and-a-ruthless-con-artist
Some, though not all studies, show a correlation with increasing fish oil consumption and lowered risk for atrial fibrillation. Vitanen et al in a 2009 article in Circulation found that upper quartile of men measuring blood DHA levels compared to the lowest quartile had a 38% lower risk of atrial fibrillation.
A September 2010 paper reported on the effect of fish oil on a relatively new chemical marker of congestive heart failure, B-type natriuretic peptide (BNP) levels, in patients with coronary heart disease. Adding a gram of fish oil a day along with routine drug treatments improved the BNP levels. Over a 9 month trial, average BNP dropped from (745.5 to 235.8 pg/dL (p=0,008).
Another September 2010 paper, one that seems to be geared toward boosting our holiday spirits, suggests that fish and wine, two essentials to the modern Mediterranean diet, are more effective when both consumed.
It is not all good news. A March paper analyzing data from the Women’s Health Initiative found no apparent protection against atrial fibrillation afforded to women by high fish consumption. The Rotterdam study found a similar lack of benefit against atrial fibrillation four years ago in 2006. So don’t expect a cure for A-Fib. But do expect some protection against heart attacks.
The European Journal of Heart Failure published a large trial in October 2009, also using Rotterdam data. High fish intake lowered risk of heart failure by about 25% in women but had no significant effect in men. This is all rather confusing and suggests, at least to this humble reader, that the real explanation is a bit more complicated than simply eating more fish. That’s why we have words like ‘multi-factorial’ available to use in these sorts of discussions.
An interesting rat study coming out of Hershey Medical School in March 2010, suggests fish oil in combination with tamoxifen significantly increased tamoxifen’s protection against breast cancer induction; adding fish oil to tamoxifen “potentiated the tumor-suppressive effect of tamoxifen.”
It’s not just the fish data that seems to have taken a turn toward confusion. A November 2010 paper suggests that although mono-unsaturated fats like olive oil lower cholesterol in contrast to saturated fats like lard, they do not change risk of atherosclerosis or cardiac mortality as previously assumed. One must suspect that the answer is not in the form of fat, saturated versus mono-unsaturated but it is the abundant and protective polyphenols present in olive oil that provide the benefit.
A May 2010 rat study from Australia admirably demonstrates the value of olive polyphenols. Researchers fed rats a high carbohydrate high, fat diet that consisted of 52% carbohydrate; 24% fat, and 25% fructose, (kind of a burger, fries and soda diet) and watched them develop metabolic syndrome. Those rats that were also given small amounts of an olive leaf polyphenol extract remained healthy without developing signs of the syndrome.
And a turmeric paper of interest is the October 2010 paper by Goel and Aggarwal reviewing curcumin beneficial action during cancer chemotherapy or radiation therapy. Curcumin sensitizes cancer cells so treatments are more effective.
All this being said, please don’t get me wrong, fried fish and potatoes are not that good for you. Each year when I send out holiday recipes I receive return emails from people that are outraged that I’ve suggested such horrible ingredients. The cream of mushroom soup recipe found in a 2007 article on mushrooms and breast cancer wins the prize to date for provoking outrage. [http://denvernaturopathic.com/mushroomsandbreastcancer.html]
In fact, thinking about this, I won’t include a recipe this year.
Nevertheless, let me wish you all a happy holiday season.
Past Chanukah Newsletters:
Chanukah Guacamole and Chili Rellenos
December 1, 2009
Chanukah Latkes Dec 2006
Circulation. 2009 Dec 8;120(23):2315-21. Epub 2009 Nov 23.
Serum long-chain n-3 polyunsaturated fatty acids and risk of hospital diagnosis of atrial fibrillation in men.
Virtanen JK, Mursu J, Voutilainen S, Tuomainen TP.
Research Institute of Public Health, School of Public Health and Clinical Nutrition, University of Kuopio, Kuopio, Finland. email@example.com
BACKGROUND: Atrial fibrillation (AF) is a common cardiac arrhythmia. Regular fish consumption has been shown to reduce the risk of AF in some but not all studies. Long-chain n-3 polyunsaturated fatty acids (PUFAs) from fish have been suggested to account for these beneficial effects. We tested this hypothesis by studying the association between the serum long-chain n-3 PUFAs eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid and risk of AF in men.
METHODS AND RESULTS: A total of 2174 men from the prospective population-based Kuopio Ischemic Heart Disease Risk Factor Study, 42 to 60 years old and free of AF at baseline in 1984 to 1989, were studied. During the average follow-up time of 17.7 years, 240 AF events occurred. In the Cox proportional hazards model, the multivariable-adjusted hazard ratio in the highest (>5.33%) versus the lowest (<3.61%) quartile of eicosapentaenoic acid plus docosapentaenoic acid plus docosahexaenoic acid was 0.65 (95% confidence interval 0.44 to 0.96, P for trend=0.07). Evaluated individually, only serum docosahexaenoic acid was associated with the risk of AF (hazard ratio in the highest versus the lowest quartile 0.62, 95% confidence interval 0.42 to 0.92, P for trend=0.02). Exclusion of subjects (n=233) with myocardial infarction or congestive heart failure either at baseline or that preceded the AF event during follow-up slightly strengthened the associations. Serum intermediate chain-length n-3 PUFA, alpha-linolenic acid, or hair methylmercury concentration were not associated with the risk.
CONCLUSIONS: An increased concentration of long-chain n-3 PUFAs in serum, a marker of fish or fish oil consumption, may protect against AF. Serum docosahexaenoic acid concentration had the greatest impact.
Med Clin (Barc). 2010 Sep 27. [Epub ahead of print]
[Effect of omega-3 acids on clinical evolution, plasma inflammatory biomarkers and B-type natriuretic peptide levels in patients with coronary heart disease.]
[Article in Spanish]
Martínez-Quintana E, Rodríguez-González F, Torres-Fuentes E, López-Ríos L, Nieto-Lago V.
Servicio de Cardiología, Complejo Hospitalario Universitario Insular-Materno infantil, Las Palmas de Gran Canaria, Gran Canaria, España.
BACKGROUND AND OBJECTIVE: The consumption of fish has been associated with a minor risk of cardiovascular mortality.
PATIENTS AND METHODS: Thirty-one patients with clinical and angiographic evidence of coronary illness and no data of heart failure were followed up. One gram per day of omega-3-acid ethyl esters was added to their usual cardiologic treatment. Demographic, clinical and analytical data (lipid, ESR, CRP, lipoprotein[a], fibrinogen, and BNP levels) were evaluated at the beginning and at 9 months.
RESULTS: Six patients had cardiologic events in the follow up although none presented acute coronary syndrome. Significant differences were seen in HDL cholesterol (mg/dL) (38,5[9,6] vs. 42,1 (11,0), p=0,000), hemoglobin (g/dL) (13,2 [1,7] vs. 13,9 (1,7), p=0,009) and pro-BNP (pg/dL) (745,5 [1,035,7] vs. 235,8 [194,0], p=0,008) levels. No significant differences existed either in the inflammatory parameters or in total cholesterol, LDL cholesterol and triglycerides.
CONCLUSION: One gram day of omega-3-acid ethyl esters added to the usual cardiologic treatment in patients with coronary heart disease improves pro BNP levels of patients with preserved left ventricular function without modifying serum inflammatory parameters.
Copyright © 2010 Elsevier España, S.L. All rights reserved.
PMID: 20880559 [PubMed
Curr Pharm Biotechnol. 2010 Sep 28. [Epub ahead of print]
Diet and Heart Health: Moderate wine Drinking Strengthens the Cardioprotective Effects of Fish Consumption.
de Leiris J, Besse S, Boucher F.
Laboratoire TIMC - PRETA, UMR5525 CNRS, Groupe Coeur et Nutrition, Université Joseph Fourier, Grenoble 1 - Bât Jean Roget, 38 706 la Tronche cedex, France. firstname.lastname@example.org.
Growing evidence indicates that the Mediterranean diet is beneficial to human health. Many epidemiological and research studies have reported that this diet pattern is able to limit the development and progression of coronary heart disease, one of the leading cause of morbidity and mortality in both developed and developing countries worldwide. There is now a large consensus about recommending Mediterranean diet to reduce atherosclerosis and coronary artery disease and to limit the risk of fatal complications such as sudden cardiac death and heart failure. This review underlines the role of two of the specific components of the Mediterranean diet, namely marine omega-3 fatty acids and wine, and the link between moderate wine consumption and fatty acid profiles.
PMID: 20874685 [PubMed - as supplied by publisher]
Am J Cardiol. 2010 Mar 15;105(6):844-8.
Dietary fish intake and incident atrial fibrillation (from the Women's Health Initiative).
Berry JD, Prineas RJ, van Horn L, Passman R, Larson J, Goldberger J, Snetselaar L, Tinker L, Liu K, Lloyd-Jones DM.
Department of Medicine, Division of Cardiology, University of Texas Southwestern Medical School, Dallas, Texas, USA. email@example.com
Experimental and clinical trial data have suggested an association between fish oil intake and atrial fibrillation (AF). However, previous observational studies have reported conflicting results regarding this association. Thus, we sought to compare the association between dietary fish intake and incident AF in a large sample of older, postmenopausal women. We included 44,720 participants from the Women's Health Initiative clinical trials who were not enrolled in the dietary modification intervention arm and without AF at baseline. The dietary intake of nonfried fish and omega-3 fatty acid intake was estimated from a Food Frequency Questionnaire at study entry. Incident AF was determined by follow-up electrocardiography at years 3 and 6. The baseline characteristics and rates of incident AF were compared across the quartiles of fish intake. Adjusted logistic regression models were used to evaluate the association between dietary nonfried fish intake and incident AF. A total of 378 incident cases of AF occurred during the follow-up period. In the age-adjusted models, no association was found between dietary nonfried fish intake and incident AF (odds ratio 1.17, 95% confidence interval 0.88 to 1.57 for quartile 4 vs quartile 1 of dietary fish intake). Similar findings were observed in the multivariate models and in the subgroup analyses. In conclusion, in a large cohort of healthy women, we found no evidence of an association between fish or omega-3 fatty acid intake and incident AF.
Am Heart J. 2006 Apr;151(4):857-62.
Intake of very long-chain n-3 fatty acids from fish and incidence of atrial fibrillation. The Rotterdam Study.
Brouwer IA, Heeringa J, Geleijnse JM, Zock PL, Witteman JC.
Wageningen Centre for Food Sciences, Wageningen, The Netherlands. firstname.lastname@example.org
BACKGROUND: Atrial fibrillation is the most common sustained cardiac arrhythmia. It is a major cause of morbidity and mortality through an increased risk of thromboembolic stroke. Experimental as well as observational evidence suggests that n-3 polyunsaturated fatty acids may have antiarrhythmic effects. The objective of this study was to examine whether high intakes of fish and its very long-chain n-3 fatty acids eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) are associated with risk of incident atrial fibrillation.
METHODS: We used data from the Rotterdam Study, a prospective cohort study. At baseline, dietary intake data were available for 5184 subjects free from atrial fibrillation. Dietary intake was assessed using a semiquantitative food-frequency questionnaire, and incidence of atrial fibrillation was continuously monitored during follow-up. Cox proportional hazards model (adjusted for lifestyle and disease factors) was used to examine the associations between intakes of EPA plus DHA and of fish with atrial fibrillation.
RESULTS: After a mean follow-up of 6.4 (+/-1.6) years, 312 subjects developed atrial fibrillation. Intake of EPA and DHA in the third textile compared with first was not associated with risk of atrial fibrillation (relative risk 1.18, 95% CI 0.88-1.57). Furthermore, no association was observed with intake of >20 g/d fish compared with no fish intake (relative risk 1.17, 95% CI 0.87-1.57).
CONCLUSIONS: In this study, intakes of EPA and DHA and the consumption of fish were not associated with the onset of atrial fibrillation. This finding does not support that n-3 fatty acids have a general antiarrhythmic effect.
Eur J Heart Fail. 2009 Oct;11(10):922-8.
Intake of very long chain n-3 fatty acids from fish and the incidence of heart failure: the Rotterdam Study.
Dijkstra SC, Brouwer IA, van Rooij FJ, Hofman A, Witteman JC, Geleijnse JM.
Division of Human Nutrition, Wageningen University, PO Box 8129, 6700 EV Wageningen, The Netherlands.
AIMS: Evidence is accumulating for a cardioprotective effect of fish or its n-3 fatty acids, eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA). We examined EPA plus DHA and fish intake in relation to incident heart failure in the population-based Rotterdam Study.
METHODS AND RESULTS: The analysis comprised 5299 subjects (41% men, age approximately 68 years) free from heart failure for whom dietary data were available. During 11.4 years of follow-up, 669 subjects developed heart failure. The relative risk (RR) of heart failure in the top vs. bottom quintile of EPA plus DHA intake was 0.89 (95% CI 0.69-1.14), after adjustment for lifestyle and dietary factors. For fish intakes > or = 20 g/day, the RR was 0.96 (0.78-1.18) compared with no fish intake. In sex-specific analysis, a high EPA plus DHA intake tended to be protective in women (RR = 0.75, 0.54-1.04) but not in men (RR = 1.00, 0.73-1.36). An inverse association for EPA plus DHA was also observed in diabetics (RR = 0.58, 0.32-1.06), which was borderline statistically significant.
CONCLUSION: Our findings do not support a major role for fish intake in the prevention of heart failure. The potentially protective effect of EPA plus DHA in diabetic patients, however, warrants further investigation.
Cancer Prev Res (Phila). 2010 Mar;3(3):322-30. Epub 2010 Feb 23.
The impact of fish oil on the chemopreventive efficacy of tamoxifen against development of N-methyl-N-nitrosourea-induced rat mammary carcinogenesis.
Manni A, Xu H, Washington S, Aliaga C, Cooper T, Richie JP Jr, Bruggeman R, Prokopczyk B, Calcagnotto A, Trushin N, Mauger D, Verderame MF, El-Bayoumy K.
Division of Endocrinology, Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA. email@example.com
The antiestrogen tamoxifen reduces breast cancer incidence in high-risk women but is unable to inhibit the development of hormone-independent tumors. Omega-3 polyunsaturated fatty acids (n-3 PUFA), known ligands of the peroxisome proliferator activated receptor-gamma (PPARgamma), generally exert tumor-suppressive effects. Based on the known crosstalk between the estrogen and the PPARgamma receptors, we tested the hypothesis that the combination of tamoxifen with n-3 PUFA results in a superior antitumor action over the individual interventions. In this study, we report for the first time that the combination of a fish oil diet rich in n-3 PUFA and tamoxifen seemed to inhibit N-methyl-N-nitrosourea-induced mammary carcinogenesis, tumor multiplicity, and volume to a greater extent than the individual interventions. The potential superiority of the combination was particularly evident at a suboptimal dose of tamoxifen, which, by itself, was unable to significantly decrease tumor development. Because activation of PPARgamma is known to inhibit oxidative stress, we examined the effects of our interventions on circulating and tumor levels of glutathione, a major intracellular antioxidant. Our results indicate that reduction in the level of oxidative stress may be a potential mechanism by which the n-3 PUFA-rich diet potentiated the tumor-suppressive effect of tamoxifen. Our interventions were well tolerated without evidence of toxicity. Combined administration of tamoxifen and n-3 PUFA is a promising new approach to breast cancer prevention. Because of its safety, this combination can quickly be translated to the clinic if its superiority can be supported by future studies.
Curr Atheroscler Rep. 2010 Nov;12(6):391-6.
Dietary monounsaturated fatty acids appear not to provide cardioprotection.
Degirolamo C, Rudel LL.
Department of Translational Pharmacology, Consorzio Mario Negri Sud, via Nazionale 8/A, 66030, S. Maria Imbaro, CH, Italy. firstname.lastname@example.org
Dietary interventions have been consistently proposed as a part of a comprehensive strategy to lower the incidence and severity of coronary heart disease (CHD), in the process providing long-term cardioprotection. Replacement of dietary saturated fatty acids (SFA) with higher intakes of monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA) has been reported to be inversely associated with risk of CHD. The observed lower incidence of CHD among populations consuming a Mediterranean-type diet, mainly enriched in MUFA from olive oil, has long supported the belief that MUFA are an optimal substitution for SFA. However, both epidemiologic and interventional studies suggest that although substituting MUFA-rich foods for SFA-rich foods in the diet can potentially lower total plasma cholesterol concentrations, this substitution does not lower the extent of coronary artery atherosclerosis. In addition, although recent evidence suggests that the source of MUFA (animal fat vs vegetable oils) may differentially influence the correlation between MUFA intake and CHD mortality, animal studies suggest that neither source is cardioprotective.
J Nutr. 2010 May;140(5):946-53. Epub 2010 Mar 24.
Olive leaf extract attenuates cardiac, hepatic, and metabolic changes in high carbohydrate-, high fat-fed rats.
Poudyal H, Campbell F, Brown L.
School of Biomedical Sciences; 5School of Veterinary Sciences, The University of Queensland, Brisbane, 4072, Australia.
Olive oil, an important component of the Mediterranean diet, produces cardioprotective effects, probably due to both oleic acid and the polyphenols such as oleuropein and hydroxytyrosol. Our aim in this study was to assess whether a polyphenol-enriched extract from the leaves of Olea europaea L. with oleuropein as the major component attenuated the cardiovascular, hepatic, and metabolic signs of a high-carbohydrate, high-fat (HCHF) diet (carbohydrate, 52%; fat, 24%, 25% fructose in drinking water) in rats. Male Wistar rats were fed either a cornstarch diet (CS) or a HCHF diet for a total of 16 wk. Diets of the treatment groups [CS+olive leaf extract (OLE) and HCHF+OLE] were supplemented with 3% OLE after 8 wk of being fed their respective CS or HCHF diets for a further 8 wk. After 16 wk, HCHF rats developed signs of metabolic syndrome, including elevated abdominal and hepatic fat deposition, collagen deposition in heart and liver, cardiac stiffness, and oxidative stress markers (plasma malondialdehyde and uric acid concentrations), with diminished aortic ring reactivity, abnormal plasma lipid profile, impaired glucose tolerance, and hypertension. Compared with HCHF rats, those in the HCHF+OLE group had improved or normalized cardiovascular, hepatic, and metabolic signs with the exception of elevated blood pressure. These results strongly suggest that an OLE containing polyphenols such as oleuropein and hydroxytyrosol reverses the chronic inflammation and oxidative stress that induces the cardiovascular, hepatic, and metabolic symptoms in this rat model of diet-induced obesity and diabetes without changing blood pressure.
Nutr Cancer. 2010 Oct;62(7):919-30.
Curcumin, the golden spice from Indian saffron, is a chemosensitizer and radiosensitizer for tumors and chemoprotector and radioprotector for normal organs.
Goel A, Aggarwal BB.
Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas, USA.
Curcumin (diferuloylmethane), the yellow pigment in Indian saffron (Curcuma longa; also called turmeric, haldi, or haridara in the East and curry powder in the West), has been consumed by people for centuries as a dietary component and for a variety of proinflammatory ailments. Extensive research within the last decade in cell culture and in rodents has revealed that curcumin can sensitize tumors to different chemotherapeutic agents including doxorubicin, 5-FU, paclitaxel, vincristine, melphalan, butyrate, cisplatin, celecoxib, vinorelbine, gemcitabine, oxaliplatin, etoposide, sulfinosine, thalidomide, and bortezomib. Chemosensitization has been observed in cancers of the breast, colon, pancreas, gastric, liver, blood, lung, prostate, bladder, cervix, ovary, head and neck, and brain and in multiple myeloma, leukemia, and lymphoma. Similar studies have also revealed that this agent can sensitize a variety of tumors to gamma radiation including glioma, neuroblastoma, cervical carcinoma, epidermal carcinoma, prostate cancer, and colon cancer. How curcumin acts as a chemosensitizer and radiosensitizer has also been studied extensively. For example, it downregulates various growth regulatory pathways and specific genetic targets including genes for NF-κB, STAT3, COX2, Akt, antiapoptotic proteins, growth factor receptors, and multidrug-resistance proteins. Although it acts as a chemosensitizer and radiosensitizer for tumors in some cases, curcumin has also been shown to protect normal organs such as liver, kidney, oral mucosa, and heart from chemotherapy and radiotherapy-induced toxicity. The protective effects of curcumin appear to be mediated through its ability to induce the activation of NRF2 and induce the expression of antioxidant enzymes (e.g., hemeoxygenase-1, glutathione peroxidase, modulatory subunit of gamma-glutamyl-cysteine ligase, and NAD(P)H:quinone oxidoreductase 1, increase glutathione (a product of the modulatory subunit of gamma-glutamyl-cysteine ligase), directly quench free radicals, and inhibit p300 HAT activity. These preclinical studies are expected to lead to clinical trials to prove the potential of this age-old golden spice for treating cancer patients.
PMID: 20924967 [PubMed - in process]