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Fish consumption associated with lower MI incidence in type 2 diabetes
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In middle-aged and older adults with type 2 diabetes, fish consumption was associated with a lower risk for myocardial infarction and may be associated with coronary heart disease-related death, but not with stroke incidence, according to findings from a population-based study.
“Dietary counseling is a key component in diabetes management, largely aimed toward prevention of [cardiovascular disease],” Alice Wallin, PhD, of the Institute of Environmental Medicine at the Karolinska Institutet in Stockholm, and colleagues wrote. “However, there are gaps in the scientific evidence for dietary recommendations in this group of patients, including sparse data on the association between fish consumption and CVD risk and mortality. Specific recommendations for people with type 2 diabetes follows the recommendations on fish consumption for the general public and are largely based on the same evidence.”
Wallin and colleagues analyzed data from 2,225 adults aged at least 45 years with type 2 diabetes at baseline from two population-based cohorts: the Swedish Mammography Cohort and the Cohort of Swedish Men, followed between 1998 and 2012 (912 women). Participants completed food frequency questionnaires, including items assessing specific finfish consumption (herring/mackerel, salmon/whitefish and cod/saithe) and shellfish. Monthly consumption of fried fish was queried in a separate questionnaire section. Researchers calculated Dietary Approaches to Stop Hypertension (DASH) diet score to estimate overall diet quality. Participants were followed for first hospitalization or death from MI or stroke, as well as death from any cause during follow-up. Researchers used Cox proportional hazard models to estimate HRs for MI, stroke, total mortality and CHD-related mortality by categories of total fish ( 3 servings per month; 1 to < 2 servings per week; 2-3 servings per week and 3 servings per week), as well as individual fish and shellfish (< 1 serving per month; 1-3 servings per month or 1 serving per week) and monthly fried fish consumption (tertiles).
During a mean follow-up of 11.8 years, there were 333 incident MI events and 321 incident stroke events (284 ischemic; 13 hemorrhagic and 24 undefined). During a mean of 13.2 years, there were 771 deaths, with CHD as the underlying cause for 154.
In adjusted models, fish consumption was inversely associated with MI incidence, but not with stroke. Compared with adults who consumed three or fewer servings of fish per month, the HR for those who consumed at least three servings of fish per week was 0.6 for MI (95% CI, 0.39-0.92) and 1.04 for stroke (95% CI, 0.66-1.64).
For total mortality, the HRs were lowest for moderate fish consumption of one to fewer than two servings per week (HR = 0.82; 95% CI, 0.64-1.04) and two to three servings per week (HR = 0.79; 95% CI, 0.61-1.01) vs. those who consumed three or fewer monthly servings.
For CHD-related mortality, researchers found that one to fewer than two servings per week of total fish consumption was associated with lower risk (HR = 0.53; 95% CI, 0.32-0.9). Among individual fish, moderate consumption of cod/saithe was associated with total and CHD-related mortality.
Researchers observed an interaction between total fish consumption and age (P = .04), and in further analysis, found that the strong, inverse association was restricted to those aged at least 65 years. – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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