L. Samuel Wann, MD1; Jagat Narula, MD, PhD2; Ron Blankstein, MD3; et alRandall C. Thompson, MD4; Bruno Frohlich, PhD5; Caleb E. Finch, PhD6; Gregory S. Thomas, MD, MPH7
JAMA Netw Open. 2019;2(12):e1918270. doi:10.1001/jamanetworkopen.2019.18270
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 researchers3 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 colleagues4 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.
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