Please remember that all benefits are subject to the definitions, limitations and exclusions in this brochure and are payable only when we determine they are medically necessary. Plan physicians must provide or arrange your care. We have no calendar year deductible. Be sure to read Section 4, Your costs for covered services, for valuable information about how cost sharing works. Also read Section 9 about coordinating benefits with other coverage, including with Medicare. YOUR PHYSICIAN MUST GET PRECERTIFICATION FOR SOME SERVICES AND OR PROCEDURES. Please refer to the precertification information shown in Section 3 to be sure which services require precertification.
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Figure. Stages of arterial plaque formation. Image reproduced from the Diabetes Roundtable. Because the type of fats we eat affects the behavior of cells and tissues, some studies have explored whether omega-3 fatty acids found in fish affect arterial plaques. In one report, consumption of marine omega-3s was linked to increased plaque stability. Others have reported that higher fish consumption was associated with less narrowing of the arteries. Dr. Arja Erkkila and colleagues in Finland have been studying this phenomenon in patients with coronary artery disease for several years. Now, they report that postmenopausal women with higher levels of the omega-3 fatty acid DHA in their blood plasma had a significantly slower rate of artery narrowing compared with women whose DHA levels were lower. DHA docosahexaenoic acid ; is one of the two main omega-3s found in fish.
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Dariush Mozaffarian, Channing Laboratory, Dept of Medicine, Brigham and Women's Hosp and Harvard Med Sch; Depts of Epidemiology and Nutrition, Harvard Sch of Public Health, Boston, MA; Arja T Erkkila, Alice H Lichtenstein, Cardiovascular Nutrition Laboratory, JM USDA Human Nutrition Rsch Cntr on Aging at Tufts Univ, Boston, MA; Eric B Rimm, Depts of Epidemiology and Nutrition, Harvard Sch of Public Health; Channing Laboratory, Brigham and Women's Hosp and Harvard Med Sch, Boston, MA; David M Herrington; Section on Cardiology, Dept of Internal Medicine, and the Dept of Public Health Sciences, Wake Forest Univ, Winston-Salem, NC Background. Relationships between diet and progression of established coronary atherosclerosis are not well-identified, particularly among postmenopausal women, in whom risk factors for progression may differ from men. Objectives. To investigate the association between saturated fat intake and progression of coronary atherosclerosis among postmenopausal women and evaluate how other nutrients influence this relationship. Methods. Among 235 postmenopausal women with established CHD enrolled in a trial of hormone replacement in 199596, usual dietary intake was assessed at baseline using a Willett FFQ. Quantitative coronary angiography was performed at baseline and after 3.1 years mean follow-up in 2, 243 coronary segments. The primary outcome was change in mean minimal coronary artery diameter . Results. Greater saturated fat intake was associated with higher HDL and HDL2 cholesterol, higher apoprotein A-1, lower triglycerides, and lower total cholesterol: HDL ratio all p 0.05 ; . After adjustment for age, education, diabetes, smoking, lipid-lowering medication use, angiographic characteristics, carbohydrate intake, and total caloric intake, women with higher saturated fat intake had less decline in mean minimal coronary artery diameter p 0.002 ; and less progression of coronary stenosis as percent of reference diameter p 0.003 ; . There was 0.21 mm decline in mean minimal coronary artery diameter in the lowest quartile of intake, versus 0.09 mm, 0.07 mm, and no decline in the second, third, and highest quartiles of intake, respectively p 0.003, p 0.002, and p 0.001 for comparison with first quartile, respectively ; . This inverse association was more pronounced among women with lower monounsaturated fat intake p 0.04 for interaction ; , and also possibly lower total fat p 0.08 for interaction ; and higher carbohydrate p 0.11 for interaction ; intake. Conclusions. Among postmenopausal women, greater saturated fat intake is associated with a more favorable lipoprotein profile and less progression of coronary atherosclerosis. While results may be due to residual confounding, these relationships, as well as potential interactions with monounsaturated fat, total fat, and carbohydrate intake, warrant further investigation.
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