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Fish - Yes; Fried Fish - No

Eating oily fish, like salmon, herring or mackerel, twice a week helps to prevent heart attacks and strokes. Eating oily fish more often than twice a week has not been shown to be any more protective. On the other hand, eating fried fish may increase risk of stroke (Neurology, published online December 22, 2010).

The most popular fried fish are frozen fish sticks, fast-food fish sandwiches and other inexpensive fish products. Most of these are made with farmed tilapia or catfish that are not good sources of omega-3 fatty acids. We don't know whether this is the reason that fried fish are linked with increased risk of strokes, or whether the unhealthful cooking method cancels out the benefits of any fish.

Polyunsaturated fats in fish are classified by their structure into omega-3s and omega-6s. Omega-3s form prostaglandins that help prevent inflammation that causes heart attacks and strokes. Omega-6s have not been shown to prevent heart attacks and strokes. The fish that are rich sources of omega-3s are those that eat plankton or other fish that have eaten plankton. Almost all deep water fish are rich in the healthful omega-3s.

Of the four most commonly farmed fish (Atlantic salmon, trout, tilapia, and catfish) only trout and Atlantic salmon contain relatively high amounts of omega-3s. In contrast, tilapia (the fastest-growing and most widely-farmed fish) and catfish have much lower concentrations of omega-3s, and their fatty acids are the same as chicken (Journal of the American Dietetic Association, July 2008 and December 2008).

Whether or not a farmed fish contains omega-3s depends on what the fish are fed. Catfish and tilapia can thrive on corn. Since corn is cheaper than fish meal, they are usually fed omega-6 -rich corn, instead of omega-3 -rich fish meal, and thus they have insignificant amounts of omega-3 fats in their bodies. However, salmon and most other farmed fish cannot live on just corn, so they must be fed fish meal that is loaded with omega-3s. All salmon (farmed and wild-caught) are high in omega-3s.

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Dear Dr. Mirkin: What would cause osteoporosis in a middle-aged man?

All men and many women with osteoporosis need to be evaluated to find the cause. More than 75 percent of men with osteoporosis have a serious cause (Osteoporosis International, published online October 9, 2010). Common causes include *low levels of the male hormone, testosterone, *vitamin D deficiency, *excessive loss of calcium through the urine, *an overactive thyroid, *being given too much thyroid hormone, *an overactive parathyroid gland, *smoking, *drinking too much alcohol, *not getting enough exercise, or *taking certain drugs, such as cortisones, that weaken bones.

All people with weak bones should get the following tests: 25-hydroxyvitamin D, testosterone, luteinizing hormone, follicle-stimulating hormone, thyroid-stimulating hormone, parathyroid hormone, and spot urinary calcium-to-creatinine ratio, calcium, phosphorus, and creatinine. If that doesn't tell you why your bones are weakened, you may need to be checked for inability to absorb calcium from your intestines (celiac panel), bone disease (such as multiple myeloma), or taking glucocorticoids, which are often prescribed to transplant patients and those with autoimmune diseases.

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Dear Dr. Mirkin: What harm comes from taking several sugared drinks a day?

Ingesting just one sugar-sweetened drink per day increases your risk for diabetes (Diabetes Care, October 27, 2010). All sugared drinks can enter the intestines immediately to cause a rapid rise in blood sugar that *causes high blood insulin levels that *turns sugar into fats called triglycerides that *fill up your muscles and fat cells with fats that *prevent your insulin receptors from responding to insulin that *causes your pancreas to release even higher levels of insulin that *causes diabetes. Eventually you can exhaust your pancreas and have no insulin, and have to take insulin injections for the rest of your life. This applies to fruit juices as well as sugared soft drinks.

Artificial sweetened drinks do not raise blood sugar very much, but they can stimulate appetite centers in your brain to make you eat more and gain weight.
More on artificial sweeteners

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Recipe of the Week:

Baked Salmon with Portobello Mushrooms

You'll find lots of recipes and helpful tips in The Good Food Book - it's FREE

January 2nd, 2011
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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