Abstract
High fish consumption and omega-3 polyunsaturated fatty acid (PUFA) intake are suggested to benefit mental well-being but the current evidence is conflicting. Our aim was to evaluate whether a higher level of fish consumption, a higher intake of omega-3 PUFAs, and a higher serum concentration of omega-3 PUFAs link to a lower 12-month prevalence of depressive episodes.We used data from the nationwide Health 2000 Survey (n = 5492) and the Fishermen Study on Finnish professional fishermen and their family members (n = 1265). Data were based on questionnaires, interviews, health examinations, and blood samples. Depressive episodes were assessed with the M-CIDI (the Munich version of the Composite International Diagnostic Interview) and a self-report of two CIDI probe questions, respectively. Fish consumption was measured by a food frequency questionnaire (g/day) and independent frequency questions (times/month). Dietary intake (g/day) and serum concentrations (% from fatty acids) of PUFAs were determined. Fish consumption was associated with prevalence of depressive episodes in men but not in women. The prevalence of depressive episodes decreased from 9% to 5% across the quartiles of fish consumption (g/day) in men of the Health 2000 Survey (p for linear trend = 0.01), and from17% to 3% across the quartiles of fish consumption (times/month) in men of the Fishermen Study (p for linear trend = 0.05). This association was modified by lifestyle; in the Health 2000 Survey a higher level of fish consumption was related to a lower prevalence of depressive episodes in men who consumed the most alcohol, were occasional or former smokers, or had intermediate physical activity. The associations between depressive episodes and the intake or serum concentrations of omega-3 PUFAs were not consistent.In men, fish consumption appears as a surrogate for underlying but unidentified lifestyle factors that protect against depression.
Highlights
Depression is currently considered as a complex multifactorial disorder, where the risk factors from multiple domains are related and interacting with each other
In the Health 2000 Survey, there were no differences in fish consumption (g/day) or dietary fatty acid intake (g/day) between those having or those not having major depressive episodes (MDE) either in the men or the women (Table 2)
Our results give some support to the hypothesis that high fish consumption protects against depression
Summary
Depression is currently considered as a complex multifactorial disorder, where the risk factors from multiple domains are related and interacting with each other. Low fish consumption and low omega-3 polyunsaturated fatty acid (PUFA) intake are suggested to detrimentally affect various aspects of mental well-being [1,2]. Epidemiological studies based on non-clinical populations slightly support the inverse relationship between depressive symptoms and fish consumption or omega-3 PUFA intake [2]. A recent comprehensive review concluded that for all aspects of mood and behaviour, the current evidence regarding the benefits of high fish consumption or high omega-3 PUFA intake to mental well-being is limited and highly inconsistent according to epidemiological studies [8]. Inconsistent findings may be due to differences in study designs and methodology, target groups, measures of fish consumption or omega-3 PUFA intake, as well as the selection of confounding factors. There are no previous observational, population-based studies that have utilised M-CIDI interview to study the effects of fish consumption on mental wellbeing
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