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Fish consumption and cardiovascular diseases

A. Nordøy*

Department of Medicine, University Hospital, University of Tromso, Tromso, Norway

* Correspondence: Professor Arne Nordoy, Department of Medicine, University Hospital, 9038 Tromso, Norway.

Abstract

Population studies indicate that a high intake of fish, such as reported in the early Eskimo and Japanese studies, is associated with a low mortality of coronary heart disease (CHD). This has been associated with measurable effects on a series of established and possible risk factors. A much lower daily intake of fish was recorded in most of the later population studies and had only small or unmeasurable effects on established risk factors. However, the association of fish intake with reduced CHD mortality, particularly sudden cardiac death, seems to be reasonably well established. Beneficial effects are found at a level of consumption of about 30 g per day, or one fish meal per week compared with populations rarely or never consuming fish. Such findings are also reflected in studies that include analysis of fatty acid composition in adipose tissue and cell membranes. Furthermore, there seem to be indications that fish consumption has a significant association with a low mortality in population groups with a high risk for CHD, whereas in low-risk populations this association is less impressive. Not all observational studies, however, observed a significant association between fish intake and CHD mortality. Population studies on fish consumption and consumption of omega-3 fatty acids have several limitations which may explain these discrepant results. Not all observational studies have included confounding factors in their statistical analysis and residual confounding is likely in nearly all studies. Fish consumption may be a marker for a healthier lifestyle or, alternatively, fish consumers may be at higher self-perceived risk for CHD and are therefore eating fish to reduce their high baseline risk. Other dietary factors may be associated with fish consumption and many studies include only a single measure of fish consumption and, thus, have no ability to account for changes in intake over time.

Key Words: Dietary fish • cardiovascular-disease

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