Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease.

BACKGROUND: Cardiovascular diseases (CVDs) are defined as conditions involving decreased blood flow to the heart that can lead to heart attacks, stroke or other disorders. CVDs are a common cause of death in low- and middle-income countries. In South Africa (SA) in particular, CVD is the leading cause of death after HIV/AIDS, responsible for 1 in 6 deaths. CVD risk factors include unhealthy diets, hypertension, obesity, high cholesterol levels and diabetes. Omega-3 fatty acids may have a protective role in the risk of developing heart disease. OBJECTIVES: To evaluate the consequences of an increased intake of fish and plant-based omega-3 fatty acids on the risk of CVD mortality and events. METHODS: The inclusion criteria for this review were randomised controlled trials (RCTs) lasting at least 12 months, which investigated men and women aged ≥18 years. These participants had to be at any risk of CVD while receiving dietary supplements and an advised diet to promote the intake of omega-3. This diet included oily fish, fish oils and seeds rich in omega-3. Comparisons with the interventions included the participants' usual diet, no advice, no supplements, placebo or lower-dose omega-3. The review evaluated the effectiveness of these interventions on primary (e.g. CVD deaths and events), secondary (e.g. major adverse cerebrovascular or CVD events, body weight and other adiposity measures, and lipids) and tertiary (e.g. blood pressure and side-effects) outcomes. RESULTS: Evidence from this review indicates that increasing the intake of long-chain omega-3 fatty acids (LCn3) or alpha-linolenic acid (ALA) probably has little or no effect on all-cause CVD or coronary heart disease mortality. Evidence was of moderate certainty, except for all-cause mortality, where there was a high certainty. CONCLUSIONS: According to moderate- to high-certainty evidence, short-chain fatty acids and LCn3 have little or no effect on mortality or cardiovascular health. However, omega-3 ALA slightly reduces the risk of CVD events and arrhythmias.

Results from the healthy active kids South Africa 2018 report card

Background. Healthy Active Kids South Africa (HAKSA) Report Cards were produced in 2007, 2010, 2014 and 2016. Objective. The 2018 Report Card aims to report on the latest available evidence relating to the physical activity (PA), nutrition and body composition of South African (SA) children and adolescents. Methods. A review was conducted using the following databases: PubMed; Africa Journals Online; and Africa-Wide (EBSCOhost). Articles published from January 2016 to September 2018 were included for review by the HAKSA scientific advisory group. Data were extracted, and a grade for each indicator was assigned based on the available evidence and the consensus of the scientific advisory group. This included 12 PA indicators, 6 nutrition indicators and 3 body composition indicators. Results. There was no evidence of a significant change in any of the indicators since the 2016 Report Card. Grades for certain indicators have been downgraded (from 2016) to bring these to the attention of relevant stakeholders and industry. These include food insecurity and grades that relate to the implementation of policy on PA and nutrition in the school environment, and on advertising and media relating to nutrition. Conclusion. Key priorities for action include: safe opportunities for physical activity; minimising the gap between policy and implementation (school culture and environment, and government strategies); and the double burden of over- and undernutrition, which relates to the continuing concern about food insecurity in SA. There is a need for further research, including surveillance, on all indicators, for future Report Cards