Evidence supporting the use of: Fish (including shell)
For the health condition: Congestive Heart Failure

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Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Fish, particularly oily fish, are a well-established dietary source of omega-3 polyunsaturated fatty acids (PUFAs), such as EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). Numerous scientific studies and clinical trials have investigated the role of omega-3 fatty acids in cardiovascular health, including their potential benefits in patients with congestive heart failure (CHF). Meta-analyses and large randomized controlled trials, such as the GISSI-HF trial, have demonstrated that supplementation with omega-3 PUFAs can lead to modest reductions in mortality and cardiovascular hospitalizations among patients with CHF. The mechanism is thought to involve anti-inflammatory effects, improvement in endothelial function, anti-arrhythmic properties, and favorable modulation of cardiac remodeling and neurohormonal activation. Shellfish, while less studied than finfish, also contain beneficial omega-3s, though often at lower concentrations. Major clinical guidelines, including those from the American Heart Association, recommend consumption of fish as part of a heart-healthy diet for patients with heart failure or at risk of cardiovascular disease. However, while the evidence is robust for cardiovascular prevention and some improvement in outcomes for heart failure, the absolute effect size is modest, and fish/omega-3 intake should be considered an adjunct to standard medical therapy, not a replacement. Thus, the use of fish to support CHF is scientifically validated, with good but not overwhelming evidence for benefit.

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