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Atherosclerosis in 16th-Century Greenlandic Inuit Mummies

Authors:
Samuel Wann at University of Wisconsin - Milwaukee
Samuel Wann
Jagat Narula at Icahn School of Medicine at Mount Sinai
Jagat Narula
Ron Blankstein
Ron Blankstein
Ron Blankstein
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Randall C. Thompson
Randall C. Thompson
Randall C. Thompson
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Abstract

This case series examines 4 Greenlandic Inuit mummies from approximately the 16th century for evidence of atherosclerosis.
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Research Letter | Cardiology
Atherosclerosis in 16th-Century Greenlandic Inuit Mummies
L. Samuel Wann, MD; Jagat Narula, MD, PhD; Ron Blankstein, MD; Randall C. Thompson,MD; Bruno Frohlich, PhD; Caleb E. Finch, PhD; Gregory S. Thomas, MD, MPH
Introduction
Atherosclerosis is often thought of as unique to modern Homo sapiens, the product of our
contemporary diet, lifestyle, and environment superimposed on primordial susceptibility. However,
the HORUS Study Group has found that atherosclerosis existed at least as far back as 4000 BCE.
1
Arterial calcification has been found in 34 of 137 mummified remains from 3 continents across wide
variations in lifestyle and heritage, including in hunter-gatherer populations.
1,2
None of these
individuals consumed a primarily marine-based diet rich in ω-3 fatty acids. Fifty years ago, Danish
researchers
3
hypothesized that high intake of marine animals rich in fish oil containing ω-3 fatty acids
protected native Greenlandic Inuit peoples from atherosclerosis. Davis and colleagues
4
found fish
oil reduced the atherosclerosis induced in rhesus monkeys exposed to a high-cholesterol atherogenic
diet. In 2019,
5
interest persists in the actions of ω-3 fatty acids in their natural and highly purified
forms. To better understand the early history of human atherosclerosis, we performed a case series
study of Inuit hunter-gatherer people living 500 years ago who consumed a marine-based diet.
Methods
Five Inuit mummies curated at the Peabody Museum of Archaeology and Ethnology, Cambridge,
Massachusetts, were studied at the Heart and Vascular Center of the Brigham and Women’s Hospital,
Boston, Massachusetts. Permission to perform imaging was granted by the Peabody Museum of
Archaeology and Ethnology. These natural mummies, preserved primarily by the cold environment,
were discovered by Martin Luther on the Greenlandic island of Uunartaq, Greenland, in 1929.
6
Grave
goods and typical clothing indicated burial in the 1500s, when these individuals would have lived in
stone, whale bone, and seal skin huts and hunted from kayaks with spears, bows, and arrows for their
diet of fish, birds, marine mammals, and caribou.
Multidetector whole-body computed tomography (CT) images were obtained at 80 and 120 kV
with 6-mm slice thickness with 50% overlap and reconstructed using multiple kernels with a third-
generation dual-source CT scanner (Siemens). Images were reviewed and interpreted by consensus
of 5 cardiologists (L.S.W., J.N., R.B., R.C.T., and G.S.T.) and 2 radiologists with extensive experience
interpreting mummy CT images. Age and sex were estimated from bone and dental development by
a physical anthropologist (B.F.).
Results
An infant mummy was excluded from further analysis owing to paucity of non–bony tissue.Based on
skeletal and dental features, the remaining mummies were adolescents or young adults, including 2 men
who died at ages 18 to 22 years and 25 to 30 years and 2 women who died at ages 16 to 18 years and 25 to
30 years (Figure 1). The causes of death could not be determined. Remnants of the carotid arteries, the
thoracic and retroperitoneal aorta, and iliac arteries were preserved in all 4 individuals, but reliable ana-
tomic landmarks within the heart could not be identified. Three mummies had evidence of calcified ath-
eroma, identified as discrete high-density regions in an arterial distribution (Figure 2). Incomplete visual-
ization of the arterial vascular tree precluded accurate grading of the magnitude or severity of vascular
calculation and evaluation of clinical disease. Nevertheless, the appearance of vascular calcification in
these 3 mummies resembled previous observations of atherosclerosis in mummies and living humans.
Author affiliations and article information are
listed at the end of this article.
Open Access. This is an open access article distributed under the terms of the CC-BY License.
JAMA Network Open. 2019;2(12):e1918270. doi:10.1001/jamanetworkopen.2019.18270 (Reprinted) December 27, 2019 1/4
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Discussion
This cases series presents evidence for the presence of calcified plaques in the mummified remains
of 3 young Inuit individuals living 500 years ago, suggesting the presence of atherosclerosis despite
their vigorous lifestyle and marine-based diet. While we cannot know the incidence of ancient
ischemic events, cardiovascular deaths were rare among mid-20th century Inuit people, similar to
contemporary Amazonian Tsimane people, who have low-grade atherosclerosis and low incidence of
Figure 1. Adult Inuit Mummified Individual Who Was Scanned With Computed Tomography
Courtesy of the Peabody Museum of Archeology and
Ethnology,Harvard University, PM 29-10-10/61570.0.
Figure 2. Computed Tomography Images Showing Calcified Atherosclerotic Plaques
2-Dimensional reconstruction of abdomen
A
3-Dimensional reconstruction of abdomen
B
2-Dimensional reconstruction of chest
C
3-Dimensional reconstruction of chest
D
2-Dimensional reconstruction of neck
E
3-Dimensional reconstruction of neck
F
Arrows indicate calcified atherosclerotic plaques.
JAMA Network Open | Cardiology Atherosclerosis in 16th-Century Greenlandic Inuit Mummies
JAMA Network Open. 2019;2(12):e1918270. doi:10.1001/jamanetworkopen.2019.18270 (Reprinted) December 27, 2019 2/4
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cardiovascular death.
7-9
The etiologic complexity of atherosclerosis confounds identification of single
factors, such as ω-3 fatty acids, as causal or protective. Other factors may include environmental
smoke,
10
which is produced by indoor fires used by Inuit and many other ancient peoples who also
incurred atherosclerosis.
ARTICLE INFORMATION
Accepted for Publication: October 2, 2019.
Published: December 27, 2019. doi:10.1001/jamanetworkopen.2019.18270
Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2019 Wann LS et al.
JAMA Network Open.
Corresponding Author: L. Samuel Wann, MD, Ascension Healthcare, 4175 N Oakland Ave, Milwaukee, WI 53211
(samuelwann@gmail.com).
Author Affiliations: Ascension Healthcare, Milwaukee, Wisconsin (Wann); Icahn School of Medicine at Mount
Sinai, New York, New York (Narula); Brigham and Women’s Hospital, Boston, Massachusetts (Blankstein); St Luke’s
Mid-America Heart Institute, Kansas City, Missouri (Thompson); Smithsonian Institution, Washington, DC
(Frohlich); University of Southern California, Los Angeles (Finch); Memorial Care Heart & Vascular Institute,
Fountain Valley, California (Thomas).
Author Contributions: Dr Wann had full access to all of the data in the study and takes responsibility for the
integrity of the data and the accuracy of the data analysis.
Concept and design: Wann, Thompson, Finch, Thomas.
Acquisition, analysis, or interpretation of data: Wann, Narula, Blankstein, Thompson, Frohlich, Thomas.
Drafting of the manuscript: Wann, Thompson, Frohlich, Thomas.
Critical revision of the manuscript for important intellectual content: Wann, Narula, Blankstein, Thompson,
Finch, Thomas.
Statistical analysis: Wann, Frohlich.
Obtained funding: Frohlich.
Administrative, technical, or material support: Wann, Blankstein, Thompson,Frohlich, Thomas.
Supervision: Wann.
Conflict of Interest Disclosures: None reported.
Funding/Support: The Paleocardiology Foundation, a nonprofit charity unrelated to industry, provided funds to
transport the mummies from the Peabody Museum to Brigham and Women’s Hospital, where computed
tomography scanning was performed without charge.
Role of the Funder/Sponsor:The funder had no role in the design and conduc t of the study; collec tion,
management, analysis, and interpretation of the data; preparation, review, or approvalof the manuscript; and
decision to submit the manuscript for publication.
Additional Contributions: All authors are members of the Horus Study Group. Other Horus Study Group members
who participated in the study design and data analysis included Adel H. Allam, MD (Al-Azar University); Guido P.
Lombardi, MD, MS (Universidad Peruana Cayetano Heredia); Crystal Medina, MD, MPH, and David E. Michalik, DO
(University of California, Irvine); Michael I. Miyamoto, MD (Providence St. Joseph Health); Christopher J. Rowan,
MD (Renown Hospital Nevada); M. Linda Sutherland, MD, and James D. Sutherland, MD, MS (Memorial Care Heart
& Vascular Institute); Michael L. Steigner MD (Brigham and Women’sHospital); Emily M. Venable, AB (Harvard
University); and Albert R. Zink, PhD (Eurac Research). They were not compensated for their contributions.
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JAMA Network Open | Cardiology Atherosclerosis in 16th-Century Greenlandic Inuit Mummies
JAMA Network Open. 2019;2(12):e1918270. doi:10.1001/jamanetworkopen.2019.18270 (Reprinted) December 27, 2019 3/4
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JAMA Network Open | Cardiology Atherosclerosis in 16th-Century Greenlandic Inuit Mummies
JAMA Network Open. 2019;2(12):e1918270. doi:10.1001/jamanetworkopen.2019.18270 (Reprinted) December 27, 2019 4/4
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... 2.0. Механизмы кардиопротекции при применении ω-3 ПНЖК В научной литературе описаны разноплановые механизмы кардиопротекции ω-3 ПНЖК по влиянию на сердечно-сосудистую систему [13][14][15][16][17][18][19][20][21][22]. По составу все длинноцепочечные ЖК (С>17 атомов) -важные составляющие биологических мембран (сетчатки, центральной нервной системы, мускулатуры), ω-3 и ω-6 ПНЖКпредшественники простагландинов, тромбоксанов, лейкотриенов, активные модуляторы тромбогенеза, артериального давления, воспаления и иммунных процессов. ...
... Оказалось, что аборигены, которые родились и жили на Аляске, имели более низкие показатели смертности от ССЗ, отношение риска (ОР) составило 0,67 (95 % доверительный интервал -ДИ 0,55-0,81), но у аборигенов была несколько выше частота развития геморрагического инсульта (ОР 1,36) [16]. Вместе с тем этой элегантной научной гипотезе несколько противоречат данные современных исследований мумий гренландских инуитов [18]. Установлено, что у мумий молодых мужчин были проявления коронарного и каротидного атеросклероза, найденные с помощью метода компьютерной томографии. ...
... Установлено, что у мумий молодых мужчин были проявления коронарного и каротидного атеросклероза, найденные с помощью метода компьютерной томографии. Существует точка зрения, что это могло быть из-за длительной экспозиции дыма костров в пещерах («indoor fire»), по аналогии с курением табака [18]. С середины 80-х годов прошлого века было опубликовано много проспективных исследований и мета-анализов, в которых изучался вопрос о связи количества потребляемой рыбы и частоты развития ССЗ [19][20][21][22][24][25][26][27]. ...
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Along with increased levels of low-density cholesterol, lipid factors of the risk of cardiovascular complications (CVC) include hypertriglyceridemia, particularly increased plasma levels of remnant particles. Omega-3 polyunsaturated fatty acids (ω-3 PUFA) are essential for normal functioning of cell membranes, retina, nerve tissue, skeletal muscles, etc. Among the large family of fatty acids (FA), eicosapentaenoic (EPC) and docosahexaenoic (DHX) FA are most studied. The beneficial effect of ω-3 PUFA consumption on the cardiovascular system is related with improvement of blood rheology, antiarrhythmic and anti-inflammatory effects, and a decrease in triglycerides. Large randomized studies of ω-3 PUFA (mixed EPC and DHX or only EPC) have demonstrated their efficiency and safety and a capability for reducing the incidence of CVC and sudden death as well as improvement of the prognosis in various patient populations. In the STRENGTH study (combination of omega-3 and statins), no significant decrease in the risk of CVC was achieved in patients with high triglycerides and low high-density lipoproteins. The ω-3 PUFA treatment is regulated by current international Guidelines and Consensuses as a part of combination therapy with statins for reduction of the risk of CVC and correction of pronounced hypertriglyceridemia.
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... Dr. Leroy has recounted several common myths that merit correction. The romantic notion that hunter-gatherers have been free of "diseases of modernity" was contradicted by the extensive atherosclerosis found in autopsies of Masai individuals (31) and in ancient Inuit remains (32). Meat ingestion clearly contributes to atherosclerosis. ...
... Being a critic of the diet-heart hypothesis, Mann precisely described the Masai as almost free of cardiovascular disease, despite intimal thickening and high intakes of animal fat. Likewise, the authors reporting on Inuit mummies not only mentioned that atherosclerosis could as well have been due to indoor fires, but also that they remained agnostic about clinical outcomes, especially as cardiovascular deaths were rare among mid-20th century Inuit (32). ...
Children and adults should avoid consuming animal products to reduce risk for chronic disease: NO
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Excessive attention to the animal versus plant binary food choice reflects society's moral views on eating right. To claim that avoidance of animal products is required to prevent chronic disease is not supported by evidence, makes little sense from an evolutionary perspective, and distracts policy makers from common-sense approaches to achieve adequate nutrition. Animal products provide highly bioavailable nutrients, some of which are not easily obtained from plants, and can play a key role in meeting the nutritional challenges of populations in both high- and low-income countries. This role goes beyond the need for protein and relates to vitamins, minerals, and numerous often-overlooked nutrients, such as long-chain fatty acids, taurine, and choline. Restrictive dietary prescriptions that exclude animal products complicate the quest for optimal nutrition by undermining dietary diversity and flexibility, and by introducing a dependency on fortification and supplementation. Thus, a vegan diet may put the general population at increased risk of poor nutrition, a problem of particular concern for those with special nutritional requirements.
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... During the past 15 years, there have been an increasing number of studies finding evidence for ASCVD in ancient human remains using non-invasive methods such as computed tomography (CT). Mummies from North and South America, Greenland, Europe, North Africa, and East Asia show that the disease affected individuals with different lifestyles and environmental conditions, and that it has been with us for over 5,000 years-much longer than previously widely believed [11][12][13][14][15][16][17]. ...
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Background Several computed tomographic studies have shown the presence of atherosclerosis in ancient human remains. However, while it is important to understand the development of atherosclerotic cardiovascular disease (ASCVD), genetic data concerning the prevalence of the disease-associated single nucleotide polymorphisms (SNPs) in our ancestors are scarce. Objective For a better understanding of the role of genetics in the evolution of ASCVD, we applied an enrichment capture sequencing approach to mummified human remains from different geographic regions and time periods. Methods Twenty-two mummified individuals were analyzed for their genetic predisposition of ASCVD. Next-generation sequencing methods were applied to ancient DNA (aDNA) samples, including a novel enrichment approach specifically designed to capture SNPs associated with ASCVD in genome-wide association studies of modern humans. Findings Five out of 22 ancient individuals passed all filter steps for calculating a weighted polygenic risk score (PRS) based on 87 SNPs in 56 genes. PRSs were correlated to scores obtained from contemporary people from around the world and cover their complete range. The genetic results of the ancient individuals reflect their phenotypic results, given that the only two mummies showing calcified atherosclerotic arterial plaques on computed tomography scans are the ones exhibiting the highest calculated PRSs. Conclusions These data show that alleles associated with ASCVD have been widespread for at least 5,000 years. Despite some limitations due to the nature of aDNA, our approach has the potential to lead to a better understanding of the interaction between environmental and genetic influences on the development of ASCVD.
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Background Although atherosclerosis is usually thought of as a disease of modernity, the Horus Team has previously reported atherosclerotic vascular calcifications on computed tomographic (CT) scans in ancient Egyptians. Objectives The purpose of this study was to compare patterns and demographic characteristics of this disease among Egyptians from ancient and modern eras. Methods We compared the presence and extent of vascular calcifications from whole-body CT scans performed on 178 modern Egyptians from Cairo undergoing positron emission tomography (PET)/CT for cancer staging to CT scans of 76 Egyptian mummies (3100 bce to 364 ce). Results The mean age of the modern Egyptian group was 52.3 ± 15 years (range 14 to 84) versus estimated age at death of ancient Egyptian mummies 36.5 ± 13 years (range 4 to 60); p < 0.0001. Vascular calcification was detected in 108 of 178 (60.7%) of modern patients versus 26 of 76 (38.2%) of mummies, p < 0.001. Vascular calcifications on CT strongly correlated to age in both groups. In addition, the severity of disease by number of involved arterial beds also correlated to age, and there was a very similar pattern between the 2 groups. Calcifications in both modern and ancient Egyptians were seen peripherally in aortoiliac beds almost a decade earlier than in event-related beds (coronary and carotid). Conclusions The presence and severity of atherosclerotic vascular disease correlates strongly to age in both ancient and modern Egyptians. There is a striking correlation in the distribution of the number of vascular beds involved. Atherosclerotic calcifications are seen in the aortoiliac beds almost a decade earlier than in the coronary and carotid beds.
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Atherosclerosis across 4000 years of human history: The Horus study of four ancient populations
Article
Full-text available
  • Mar 2013
  • LANCET
Background: Atherosclerosis is thought to be a disease of modern human beings and related to contemporary lifestyles. However, its prevalence before the modern era is unknown. We aimed to evaluate preindustrial populations for atherosclerosis. Methods: We obtained whole body CT scans of 137 mummies from four different geographical regions or populations spanning more than 4000 years. Individuals from ancient Egypt, ancient Peru, the Ancestral Puebloans of southwest America, and the Unangan of the Aleutian Islands were imaged. Atherosclerosis was regarded as definite if a calcified plaque was seen in the wall of an artery and probable if calcifications were seen along the expected course of an artery. Findings: Probable or definite atherosclerosis was noted in 47 (34%) of 137 mummies and in all four geographical populations: 29 (38%) of 76 ancient Egyptians, 13 (25%) of 51 ancient Peruvians, two (40%) of five Ancestral Puebloans, and three (60%) of five Unangan hunter gatherers (p=NS). Atherosclerosis was present in the aorta in 28 (20%) mummies, iliac or femoral arteries in 25 (18%), popliteal or tibial arteries in 25 (18%), carotid arteries in 17 (12%), and coronary arteries in six (4%). Of the five vascular beds examined, atherosclerosis was present in one to two beds in 34 (25%) mummies, in three to four beds in 11 (8%), and in all five vascular beds in two (1%). Age at time of death was positively correlated with atherosclerosis (mean age at death was 43 [SD 10] years for mummies with atherosclerosis vs 32 [15] years for those without; p<0·0001) and with the number of arterial beds involved (mean age was 32 [SD 15] years for mummies with no atherosclerosis, 42 [10] years for those with atherosclerosis in one or two beds, and 44 [8] years for those with atherosclerosis in three to five beds; p<0·0001). Interpretation: Atherosclerosis was common in four preindustrial populations including preagricultural hunter-gatherers. Although commonly assumed to be a modern disease, the presence of atherosclerosis in premodern human beings raises the possibility of a more basic predisposition to the disease. Funding: National Endowment for the Humanities, Paleocardiology Foundation, The National Bank of Egypt, Siemens, and St Luke's Hospital Foundation of Kansas City.
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Bang HO, Dyerberg J, Nielsen AB. Plasma lipid and lipoprotein pattern in Greenlandic West-coast Eskimos. Lancet 1, 1143-1145
Article
Full-text available
  • Jul 1971
: The plasma-lipid pattern, including quantitative lipoprotein electrophoresis, was examined in 130 Eskimos (69 females, 61 males)—hunters and/or fishermen, and their wives—in the northern part of the west coast of Greenland, and consuming a predominantly meat diet rich in polyunsaturated fatty acids. Most types of lipid were decreased, compared with Danish controls and Eskimos living in Denmark. The most remarkable finding was much lower levels of pre-β-lipoprotein and consequently of plasma-triglycerides in Greenlandic Eskimos than in Danish controls. These findings may explain the very low incidence of ischæmic heart-disease and the complete absence of diabetes mellitus in Greenlandic Eskimos.
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Air Pollution and Cardiovascular Disease: JACC State-of-the-Art Review
Article
  • Oct 2018
  • J AM COLL CARDIOL
Fine particulate matter <2.5 μm (PM2.5) air pollution is the most important environmental risk factor contributing to global cardiovascular (CV) mortality and disability. Short-term elevations in PM2.5 increase the relative risk of acute CV events by 1% to 3% within a few days. Longer-term exposures over several years increase this risk by a larger magnitude (∼10%), which is partially attributable to the development of cardiometabolic conditions (e.g., hypertension and diabetes mellitus). As such, ambient PM2.5 poses a major threat to global public health. In this review, the authors provide an overview of air pollution and health, including assessment of exposure, impact on CV outcomes, mechanistic underpinnings, and impact of air pollution reduction strategies to mitigate CV risk. The review concludes with future challenges, including the inextricable link between air pollution and climate change, and calls for large-scale trials to allow the promulgation of formal evidence-based recommendations to lower air pollution–induced health risks.
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Coronary Atherosclerosis in Indigenous South American Tsimane: A Cross-Sectional Cohort Study
Article
  • Apr 2017
Background: Conventional coronary artery disease risk factors might potentially explain at least 90% of the attributable risk of coronary artery disease. To better understand the association between the pre-industrial lifestyle and low prevalence of coronary artery disease risk factors, we examined the Tsimane, a Bolivian population living a subsistence lifestyle of hunting, gathering, fishing, and farming with few cardiovascular risk factors, but high infectious inflammatory burden. Methods: We did a cross-sectional cohort study including all individuals who self-identified as Tsimane and who were aged 40 years or older. Coronary atherosclerosis was assessed by coronary artery calcium (CAC) scoring done with non-contrast CT in Tsimane adults. We assessed the difference between the Tsimane and 6814 participants from the Multi-Ethnic Study of Atherosclerosis (MESA). CAC scores higher than 100 were considered representative of significant atherosclerotic disease. Tsimane blood lipid and inflammatory biomarkers were obtained at the time of scanning, and in some patients, longitudinally. Findings: Between July 2, 2014, and Sept 10, 2015, 705 individuals, who had data available for analysis, were included in this study. 596 (85%) of 705 Tsimane had no CAC, 89 (13%) had CAC scores of 1-100, and 20 (3%) had CAC scores higher than 100. For individuals older than age 75 years, 31 (65%) Tsimane presented with a CAC score of 0, and only four (8%) had CAC scores of 100 or more, a five-fold lower prevalence than industrialised populations (p≤0·0001 for all age categories of MESA). Mean LDL and HDL cholesterol concentrations were 2·35 mmol/L (91 mg/dL) and 1·0 mmol/L (39·5 mg/dL), respectively; obesity, hypertension, high blood sugar, and regular cigarette smoking were rare. High-sensitivity C-reactive protein was elevated beyond the clinical cutoff of 3·0 mg/dL in 360 (51%) Tsimane participants. Interpretation: Despite a high infectious inflammatory burden, the Tsimane, a forager-horticulturalist population of the Bolivian Amazon with few coronary artery disease risk factors, have the lowest reported levels of coronary artery disease of any population recorded to date. These findings suggest that coronary atherosclerosis can be avoided in most people by achieving a lifetime with very low LDL, low blood pressure, low glucose, normal body-mass index, no smoking, and plenty of physical activity. The relative contributions of each are still to be determined. Funding: National Institute on Aging, National Institutes of Health; St Luke's Hospital of Kansas City; and Paleocardiology Foundation.
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The Tres Ventanas Mummies of Peru
Article
The Tres Ventanas mummies of Peru are thought to be among the oldest mummies in existence, dating to between 8,000 and 10,000 years ago. A preliminary assessment is made of the potential of these mummies for use in future research on mummified remains. Although the Tres Ventanas cave and the four mummies were explored and then excavated by Frederic Engel in 1966-67, and the project is named in his honor as the "Engel Study Group", the importance of both the physical remains and the context in which they were found has only come to light in the last few years. Most important is the paleopathological examination of these remains, since these mummies are found in a high altitude area of Peru where adaptation to the limited partial pressure of oxygen is perhaps a key component in broadening our understanding of human diversity in past populations. Anat Rec, 298:1026-1035, 2015. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.
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Fish Oil Inhibits Development of Atherosclerosis in Rhesus Monkeys
Article
  • Sep 1987
  • Arteriosclerosis
The effect of feeding fish oil (Menhaden) on the progression of rhesus monkey atherosclerosis was determined by feeding diets containing 2% cholesterol and either 25% coconut oil (Group I), 25% fish oil/coconut oil (1:1) (Group II), or 25% fish oil/coconut oil (3:1) (Group III) for 12 months (n = 8/group). The average serum cholesterol levels were 875 mg/dl for Group I, 463 mg/dl for Group II, and 405 mg/dl for Group III. HDL cholesterol levels were 49 mg/dl for Group I, 29 mg/dl for Group II, and 20 mg/dl for Group III. An average of 79% of the aortic intima was involved with atherosclerosis in Group I, 48% in Group II, and 36% in Group III. The aortas of both fish-oil groups (II or III) contained significantly less cholesterol (total, free, and esterified), as well as less acid lipase, cholesteryl esterase, and ACAT activities when compared to the coconut-oil group (I) (p less than 0.05). Microscopically, the aortic and carotid artery lesions were smaller in cross-sectional area and in thickness, and contained less macrophages in the fish-oil groups (II and III) when compared to the coconut-oil group (I) (p less than 0.05). This protective effect was not consistently enhanced by increasing the proportion of fish oil to 3:1 (Group III) over 1:1 (Group II). The results indicate that fish oil-containing diets reduce serum cholesterol levels and inhibit atherosclerosis even in the face of lowered HDL cholesterol levels when compared to a pure coconut oil/cholesterol diet in rhesus monkeys. Therefore, fish-oil diets exert effective protective control of progression of atherosclerosis during severe atherogenic stimuli.
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Plasma lipid and lipoprotein pattern in Greenlandic West-coast Eskimos
  • Jan 1971
  • 1143-1145
  • HO Bang
  • J Dyerberg
  • AB Nielsen