Abstract
PurposeEpidemiological evidence on the association between fish consumption and risk of type 2 diabetes is heterogeneous across geographical regions. Differences related to fish consumption pattern could possibly help explain the discrepancy between the findings. We therefore aimed to investigate the association between fish consumption (total, fried, specific fish items) and type 2 diabetes incidence, taking exposure to contaminants present in fish (polychlorinated biphenyls and methyl mercury) into consideration.MethodsThe population-based Cohort of Swedish Men, including 35,583 men aged 45–79 years, was followed from 1998 to 2012. We estimated hazard ratios (HRs) with 95 % confidence intervals (CIs) using Cox proportional hazards models.ResultsDuring 15 years of follow-up, 3624 incident cases were identified. Total fish consumption (≥4 servings/week vs. <1 serving/week) was not associated with type 2 diabetes in multivariable-adjusted analysis (HR 1.00; 95 % CI 0.85–1.18); however, a statistically non-significant inverse association was observed after adjustment for dietary contaminant exposures (HR 0.79; 95 % CI 0.60–1.04). Fried fish (≥6 servings/month vs. ≤1 servings/month) and shellfish consumption (≥1 serving/week vs. never/seldom) were associated with HRs of 1.14 (95 % CI 1.03–1.31) and 1.21 (95 % CI 1.07–1.36), respectively.ConclusionsWe observed no overall association between total fish consumption and type 2 diabetes. The results indicated that dietary contaminants in fish may influence the relationship. Fried fish and shellfish consumption were associated with higher type 2 diabetes incidence. These findings suggest that more specific advice on fish species sub-types (varying in contamination) and preparation methods may be warranted.
Highlights
Type 2 diabetes is a growing public health burden, and the prevalence has reached epidemic proportions globally [1]
Fish is the main source of dietary exposure to both persistent organic pollutants such as polychlorinated biphenyls (PCBs) [27] and methyl mercury (MeHg) [28], which have been associated with type 2 diabetes [29, 30]
To explore potential impact of the statistical adjustment of collinear variables, we examined the association between total fish consumption and incidence of type 2 diabetes across strata of dietary PCB and MeHg exposures
Summary
Type 2 diabetes is a growing public health burden, and the prevalence has reached epidemic proportions globally [1]. Results from epidemiological studies on fish consumption in relation to risk of developing diabetes have, been largely inconsistent and inconclusive [3,4,5,6,7,8,9,10,11,12,13,14,15,16]. Eur J Nutr (2017) 56:843–852 determined by geographical location (e.g. types of fish consumed, preparation methods and degree of contamination) could possibly help explain the discrepancy between the findings, but previous studies on fish consumption in relation to type 2 diabetes risk have not fully accounted for such factors. We aimed to investigate the association of total fish consumption, fried fish and specific fish items with incidence of type 2 diabetes in a large population-based prospective study, taking exposure to contaminants present in fish into consideration
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