[Prevention of coronary disease and sudden death by nutrition]

Nutrition influences sudden cardiac death (SCD) not only by determining the development of atherosclerotic coronary disease but possibly also by more specific rhythm stabilizing abilities of some nutrients. QUANTITATIVE ASPECTS: A body mass index >30 is associated with a 2.6-fold risk of SCD, probably via the risk factors diabetes and hypertension. QUALITATIVE ASPECTS: alpha-linolenic acid (ALA) is a substrate for the production of the N-3-fatty acids eicosapentaenoic acid (EPA) und docosahexaenoic acid (DHA). The consumption of ALA correlates with decreased MI risk. Fish consumption is (in case control studies) associated with reduced MI-risk and (in prospective controlled studies) with decreased risk of SCD. Two or more fish meals/week and the estimated N-3-fatty acids (n-3-FA) ingestion of > 1.2 g/week correlate with a reduced SCD-risk. The blood level of the N-3-FA EPA and DHA correlate highly with a reduced risk for SCD. It is likely that the marine production of N-3-FA will not suffice to supply the amount needed for large scale prevention. Industrial farming of algae and genetic modification of mammal muscle cells resulting in improved ability to transform N-6-FA to corresponding N-3-FA could contribute to better availability of N-3-FA for prevention. Nutrition influences sudden cardiac death (SCD) not only by determining the development of atherosclerotic coronary disease but possibly also by more specific rhythm stabilizing abilities of some nutrients.