Fish intake benefits patients with prior CVD, not general population
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Minimal fish intake was associated with lower risk for major CVD and mortality among patients with prior CVD, but not those without CVD, according to a study published in JAMA Internal Medicine.
According to the researchers, fish intake of 175 g (approximately two servings) weekly was associated with lower risk for major CVD and mortality among patients with prior CVD, but not in general populations.
Effect on triglyceride levels
“There is considerable evidence from short-term randomized trials that fish has beneficial effects on blood lipids such as lowering of triglyceride levels, which we also found. Such beneficial effects on triglyceride levels are more pronounced in people with elevated triglyceride levels, a common characteristic of people at high risk for vascular disease,” Andrew Mente, PhD, associate professor in the Population Health Research Institute, Hamilton Health Sciences and McMaster University in Ontario, Canada, told Healio.
The researchers analyzed 191,558 participants from four cohort studies (mean age, 54 years; 48% men) for whom fish consumption had been included on food frequency questionnaire. The cohort included participants from the PURE study without vascular disease and patients with vascular disease from three other studies. The outcomes of interest were mortality and major CVD events, defined as MI, stroke, congestive HF or sudden death. Median follow-up was 7.5 years.
After adjustment for known confounders, in the PURE population, there was no association between fish intake and any outcome. Compared with little or no fish intake ( 50 g per month), an intake of 350 g per week or more (approximately four servings) was not significantly associated with risk for major CVD (HR = 0.95; 95% CI, 0.86-1.04), CVD mortality (HR = 0.94; 95% CI, 0.8-1.1), non-CVD mortality (HR = 1; 95% CI, 0.9-1.12) or total mortality (HR = 0.96; 95% CI, 0.88-1.05), the researchers wrote.
However, among patients with prior CVD, consumption of at least 175 g per week of fish was associated with reduced risk for major CVD (HR = 0.84; 95% CI, 0.73-0.96) and mortality (HR = 0.82; 95% CI, 0.74-0.91) compared with those who consumed 50 g per month of fish or less, Mente and colleagues found.
Consumption of oily fish
“If you are generally healthy, there’s no clear protection, although fish is probably a safe choice as well. In addition, the protection of fish is seen mainly for fish that contain high amounts of omega-3 fats, or so-called oily fish, such as herring, mackerel, sable, salmon, tuna (steak or can) and sardine. Other types of fish that contain low amounts of omega-3 fats are generally neutral. So, the implications for dietary patterns are to try to incorporate two servings of oily fish into your weekly routine, especially if you have existing cardiovascular disease or are at high risk,” Mente told Healio.
According to Mente, because the findings are from observational studies and cannot directly prove a causal relationship, randomized trials of oily fish consumption with long-term clinical outcomes are needed.
“This is by far the most diverse study of fish intake and health outcomes in the world and the only one with sufficient numbers with representation from high-, middle- and low-income countries from all inhabited continents of the world,” Mente told Healio.
For more information:
Andrew Mente, PhD, can be reached at Population Health Research Institute, Hamilton Health Sciences and McMaster University, Second Floor, Room C2-105, 237 Barton St. East, Hamilton, ONL8L 2X2, Canada.
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