Abstract
Fish is a source of important nutrients and may play a role in preventing heart diseases and other health outcomes. However, studies of overall mortality and cause-specific mortality related to fish consumption are inconclusive. We examined the rate of overall mortality, as well as mortality from ischaemic heart disease and cancer in relation to the intake of total fish, lean fish, and fatty fish in a large prospective cohort including ten European countries. More than 500,000 men and women completed a dietary questionnaire in 1992–1999 and were followed up for mortality until the end of 2010. 32,587 persons were reported dead since enrolment. Hazard ratios and their 99 % confidence interval were estimated using Cox proportional hazard regression models. Fish consumption was examined using quintiles based on reported consumption, using moderate fish consumption (third quintile) as reference, and as continuous variables, using increments of 10 g/day. All analyses were adjusted for possible confounders. No association was seen for fish consumption and overall or cause-specific mortality for both the categorical and the continuous analyses, but there seemed to be a U-shaped trend (p < 0.000) with fatty fish consumption and total mortality and with total fish consumption and cancer mortality (p = 0.046).
Highlights
We examined the rate of overall mortality, as well as mortality from ischaemic heart disease and cancer in relation to the intake of total fish, lean fish, and fatty fish in a large prospective cohort including ten European countries
Fish is a source of many important nutrients, such as high quality proteins, vitamins A, B, D and E, minerals like iron, zinc, selenium and iodine, and the marine omega-3 fatty acids [3], and according to a report from the joint Food and Agriculture Organization/World Health Organization (FAO/WHO) expert consultation [49], there is convincing evidence that fish consumption lowers the risk of death from coronary heart disease
In a Danish cohort study on both men and women they found that men who were eating fish once a month or less had lower all-cause mortality compared with those eating fish once a week, and that all-cause mortality seemed to increase with increasing frequency of fish intake [28]
Summary
Fish is a source of many important nutrients, such as high quality proteins, vitamins A, B, D and E, minerals like iron, zinc, selenium and iodine, and the marine omega-3 fatty acids (eicosapentaenoic, EPA, and docosahexaenoic, DHA, acids) [3], and according to a report from the joint Food and Agriculture Organization/World Health Organization (FAO/WHO) expert consultation [49], there is convincing evidence that fish consumption lowers the risk of death from coronary heart disease. Research on fish consumption and cancer risk is not as encouraging; a report from the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) only found limitedsuggestive evidence for decreased risk of colorectal cancer with fish consumption [48]. In a Danish cohort study on both men and women they found that men who were eating fish once a month or less had lower all-cause mortality compared with those eating fish once a week, and that all-cause mortality seemed to increase with increasing frequency of fish intake [28]. A similar study from the USA found a reduced risk of all-cause mortality in white men consuming fish once a week compared to never consumption, but not in black men and women [16]. In a case–control study in Hong Kong Chinese, higher consumption of one to three times a week was associated with lower mortality compared with the lowest fish consumption of less than or equal to three times a month [44]
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