High Fish Intake Research Articles

A Mediterranean-style diet, its components and the risk of heart failure: a prospective population-based study in a non-Mediterranean country.

Growing evidence emerged about the role of diet in heart failure (HF) development, but data are sparse and inconclusive. We examined the association between a Mediterranean-style diet, its components and HF risk. Analyses were carried out in 24 008 middle-aged participants of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam (Germany), including 209 incident HF cases within 8.2 years. The traditional Greek Mediterranean diet score (tMED) was used to assess dietary adherence. Cox's proportional hazards regression was applied to estimate the relationship between the adherence to the Mediterranean-style diet, its components and HF risk. After adjustment for age, sex and energy intake, a 2-unit increment in the tMED was associated with 26% lower risk of HF (HR (95% confidence interval (CI)): 0.76 (0.60-0.97)). After multivariable adjustment, this association was slightly attenuated and lost significance [HR (95%CI): 0.82 (0.64-1.05)]. Interestingly, we observed a significant association in multivariable adjusted models when milk products were excluded from the score (HR (95% CI): 0.75 (0.59-0.96)). Three score components were significantly associated with HF risk: alcohol (HR (95%CI): 0.73 (0.55-0.97) for moderate versus low/high intakes), meat: 2.04 (1.17-3.55) and fish: 0.59 (0.36-0.95), both for the highest versus the lowest quintile. The tMED was not significantly associated with HF risk, but low meat, high fish and moderate alcohol intake were inversely associated with HF risk in our non-Mediterranean population. Minor dietary changes could be valuable primary prevention measures, particularly the increase of fish consumption while reducing the intake of meat.

A posteriori data-derived dietary patterns and incident coronary heart disease: Making sense of inconsistent findings.

Inconsistent findings have been reported from numerous prospective studies for the relations of the 'Western' (unhealthy) and 'Prudent' (healthy) diet patterns, derived using factor, principle components, or cluster analysis methods, with incident coronary heart disease (CHD). Among contemporary prospective studies, the 'Prudent' diet pattern was inversely related to CHD risk in 7 of 12 studies, while the 'Western' diet pattern positively related to risk in only 3 of 11 studies. To explain these inconsistent findings, we compared the methods and results from these prospective studies conducted in the U.S., Europe, and Asia. A 'Prudent' diet pattern was consistently related to 18-65% lower risk of incident CHD in 7 studies conducted in the U.S., Europe and Asia. In 3 of 4 U.S. studies, but not cohorts in Europe or Asia, the 'Western' diet pattern was related to 37-64% greater CHD risk. In Asian cohorts, the 'Western' diet pattern was not related to increased CHD risk, which may be partially explained by the overall higher fish intake among Asians. The 'a posteriori', or data driven, approach to diet patterns is based on reported dietary intake and we found the components of each dietary pattern differed by geographic location and diet assessment instrument. We discuss how the non-standardized methods used to discern diet patterns from the dietary data may contribute to discrepant results. Further, the disparate findings may also be explained by differing sample characteristics, follow-up period, and CHD ascertainment. In summary, 'a posteriori' derived 'Prudent' diet pattern was related to cardiovascular health.

High intake of fatty fish, but not of lean fish, affects serum concentrations of TAG and HDL-cholesterol in healthy, normal-weight adults: a randomised trial

The aim of the present study was to examine whether high intake of lean or fatty fish (cod and farmed salmon, respectively) by healthy, normal-weight adults would affect risk factors of type 2 diabetes and CVD when compared with lean meat (chicken). More knowledge is needed concerning the potential health effects of high fish intake (>300 g/week) in normal-weight adults. In this randomised clinical trial, thirty-eight young, healthy, normal-weight participants consumed 750 g/week of lean or fatty fish or lean meat (as control) for 4 weeks at dinner according to provided recipes to ensure similar ways of preparations and choices of side dishes between the groups. Energy and macronutrient intakes at baseline and end point were similar in all groups, and there were no changes in energy and macronutrient intakes within any of the groups during the course of the study. High intake of fatty fish, but not lean fish, significantly reduced TAG and increased HDL-cholesterol concentrations in fasting serum when compared with lean meat intake. When compared with lean fish intake, fatty fish intake increased serum HDL-cholesterol. No differences were observed between lean fish, fatty fish and lean meat groups regarding fasting and postprandial glucose regulation. These findings suggest that high intake of fatty fish, but not of lean fish, could beneficially affect serum concentrations of TAG and HDL-cholesterol, which are CVD risk factors, in healthy, normal-weight adults, when compared with high intake of lean meat.

Fish-Derived Omega-3 Fatty Acids and Prostate Cancer: A Systematic Review.

Background. The use of natural health products in prostate cancer (PrCa) is high despite a lack of evidence with respect to safety and efficacy. Fish-derived omega-3 fatty acids possess anti-inflammatory effects and preclinical data suggest a protective effect on PrCa incidence and progression; however, human studies have yielded conflicting results. Methods. A search of OVID MEDLINE, Pre-MEDLINE, Embase, and the Allied and Complementary Medicine Database (AMED) was completed for human interventional or observational data assessing the safety and efficacy of fish-derived omega-3 fatty acids in the incidence and progression of PrCa. Results. Of 1776 citations screened, 54 publications reporting on 44 studies were included for review and analysis: 4 reports of 3 randomized controlled trials, 1 nonrandomized clinical trial, 20 reports of 14 cohort studies, 26 reports of 23 case-control studies, and 3 case-cohort studies. The interventional studies using fish oil supplements in patients with PrCa showed no impact on prostate-specific antigen levels; however, 2 studies showed a decrease in inflammatory or other cancer markers. A small number of mild adverse events were reported and interactions with other interventions were not assessed. Cohort and case-control studies assessing the relationship between dietary fish intake and the risk of PrCa were equivocal. Cohort studies assessing the risk of PrCa mortality suggested an association between higher intake of fish and decreased risk of prostate cancer–related death. Conclusions. Current evidence is insufficient to suggest a relationship between fish-derived omega-3 fatty acid and risk of PrCa. An association between higher omega-3 intake and decreased PrCa mortality may be present but more research is needed. More intervention trials or observational studies with precisely measured exposure are needed to assess the impact of fish oil supplements and dietary fish-derived omega-3 fatty acid intake on safety, PrCa incidence, treatment, and progression.

Dietary Approaches to Prevent Age Related Macular Degeneration:A Review

Age Related Macular Degeneration (ARMD) is the leading cause of irreversible blindness in older adults which has no cure and limited therapeutic options. ARMD may become an increasing concern in the developing countries like India as a result of socio-economic and dietary changes that accompany the economic development1. Diet is potentially one of the most cost effective strategies to prevent the development of end stage condition of ARMD. This review describes the current literature on the role of quality of diet and nutritional supplementation in prevention of advanced ARMD. Various researchers have explored the association between diet, nutrient intake and advanced ARMD. In the Age Related Eye Disease Study (AREDS), use of a daily antioxidant supplementation reduced the rate of progression from intermediate to advanced ARMD by 25% over a period of 5 years and resulted in a 19% reduction in the risk of moderate visual loss<sup>2</sup>. A high dietary fat intake was reported to be associated with a higher incidence of late ARMD whereas higher intakes of fish or n-3 fatty acids were associated with lower incidence of ARMD<sup>3</sup>. Chiu et al. reported that quality of dietary carbohydrates influences the risk of ARMD<sup>4</sup>. But at present, research shows insufficient evidence to recommend dietary modifications and nutritional supplementation in ARMD. Therefore to summarize, the temporal relationship of the diet to advanced ARMD, is a function of the quality of diet. Observational studies suggest that increased dietary intake of omega-3 fatty acids, macular carotenoids, antioxidants and oriental dietary pattern reduces the risk of ARMD whereas, poor dietary carbohydrates quality (as defined by dietary glycemic index) and western dietary pattern may increase the risk of ARMD.

Partial Least Square Discriminant Analysis Discovered a Dietary Pattern Inversely Associated with Nasopharyngeal Carcinoma Risk.

Evidence on the association between dietary component, dietary pattern and nasopharyngeal carcinoma (NPC) is scarce. A major challenge is the high degree of correlation among dietary constituents. We aimed to identify dietary pattern associated with NPC and to illustrate the dose-response relationship between the identified dietary pattern scores and the risk of NPC. Taking advantage of a matched NPC case–control study, data from a total of 319 incident cases and 319 matched controls were analyzed. Dietary pattern was derived employing partial least square discriminant analysis (PLS-DA) performed on energy-adjusted food frequencies derived from a 66-item food-frequency questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated with multiple conditional logistic regression models, linking pattern scores and NPC risk. A high score of the PLS-DA derived pattern was characterized by high intakes of fruits, milk, fresh fish, vegetables, tea, and eggs ordered by loading values. We observed that one unit increase in the scores was associated with a significantly lower risk of NPC (ORadj = 0.73, 95% CI = 0.60–0.88) after controlling for potential confounders. Similar results were observed among Epstein-Barr virus seropositive subjects. An NPC protective diet is indicated with more phytonutrient-rich plant foods (fruits, vegetables), milk, other protein-rich foods (in particular fresh fish and eggs), and tea. This information may be used to design potential dietary regimen for NPC prevention.

Association of fish consumption and dietary intake of marine n-3 PUFA with myocardial infarction in a prospective Danish cohort study.

Several studies have investigated the potential benefits of marine n-3 PUFA in CVD, generally suggesting a lower risk of CHD. However, recent trials have questioned these results. This study investigated the association of fish consumption with dietary intake of marine n-3 PUFA with incident myocardial infarction (MI). In a Danish cohort study, 57 053 subjects between 50 and 64 years of age were enrolled from 1993 to 1997. From national registries, we identified all cases of incident MI. Dietary fish consumption was assessed using a semi-quantitative food questionnaire, including twenty-six questions regarding fish intake. In addition, we calculated the intake of total and individual marine n-3 PUFA. During a median follow-up of 17·0 years, we identified 3089 cases of incident MI. For both men and women, a high intake of fatty fish was inversely related to incident MI. Thus, when comparing the highest and the lowest quintile of fatty fish intake, we found a 12 % lower relative risk of MI in men (hazard ratio (HR) 0·88; 95 % CI 0·77, 1·00) and a 22 % lower relative risk in women (HR 0·78; 95 % CI 0·63, 0·96) after adjustments. For women, similar associations were observed for individual and total marine n-3 PUFA. In contrast, intake of lean fish was not associated with MI. In conclusion, incident MI was inversely related to a high intake of fatty fish, but not lean fish. However, test for trends across quintiles was not statistically significant. In general, this study supports the view that consumption of fatty fish may protect against MI.

Variability of perfluoroalkyl substance concentrations in pregnant women by socio-demographic and dietary factors in a Spanish birth cohort

BackgroundPrenatal exposure to perfluoroalkyl substances (PFAS) might affect child health; but maternal determinants of PFAS exposure are unclear. We evaluated the socio-demographic and dietary factors of prenatal PFAS concentrations in a Spanish birth cohort. MethodsWe analyzed perfluorohexanesulfonic acid (PFHxS), perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and perfluorononanoic acid (PFNA) in 1216 plasma samples collected during the 1ST trimester of pregnancy (2003–2008). We used multivariable linear regressions to assess the geometric mean (GM) ratios of PFAS concentrations by socio-demographic and dietary factors. We used analysis of variance (ANOVA) to assess the variability of PFAS concentrations by maternal factors. ResultsGM PFAS concentrations ranged from 0.55ng/mL for PFHxS to 5.77ng/mL for PFOS. Women born outside of Spain had lower PFAS concentrations (e.g. GM ratio for PFHxS 0.53[95%CI: 0.46, 0.60] than Spanish women. PFHxS and PFOA concentrations were higher in mothers from the regions of Sabadell (2.13[1.93, 2.35] and 1.73[1.60, 1.88], respectively) and Valencia (1.40[1.28, 1.54] and 1.42[1.31, 1.53], respectively) than Gipuzkoa. PFOA and PFNA concentrations decreased with parity (≥2 children: 0.79[0.67, 0.94] and 0.82[0.68, 0.99], respectively). Younger women (i.e. <25years) had lower PFHxS (0.73[0.62, 0.86]) and PFOS (0.85[0.75, 0.96]) concentrations than older women. PFHxS and PFOA concentrations were lower in women who previously breastfed for >6months compared to those who never breastfed (0.79[0.67, 0.94] and 0.82[0.71, 0.95], respectively). High intake of fish and shellfish during pregnancy (i.e. ≥5.6 servings/week) was associated with 11% (1.11[1.04, 1.18]) higher PFOS concentrations than the lowest intake group. Our ANOVA models explained 26% to 40% of PFAS concentrations variability. ConclusionsPrenatal PFAS concentrations were mainly determined by maternal country of birth, region of residence, previous breastfeeding and age. Fish and shellfish intake also contributed to PFOS and PFOA concentrations.

Fish Intake in Pregnancy and Child Growth: A Pooled Analysis of 15 European and US Birth Cohorts.

Maternal fish intake in pregnancy has been shown to influence fetal growth. The extent to which fish intake affects childhood growth and obesity remains unclear. To examine whether fish intake in pregnancy is associated with offspring growth and the risk of childhood overweight and obesity. Multicenter, population-based birth cohort study of singleton deliveries from 1996 to 2011 in Belgium, France, Greece, Ireland, Italy, the Netherlands, Norway, Poland, Portugal, Spain, and Massachusetts. A total of 26,184 pregnant women and their children were followed up at 2-year intervals until the age of 6 years. Consumption of fish during pregnancy. We estimated offspring body mass index percentile trajectories from 3 months after birth to 6 years of age. We defined rapid infant growth as a weight gain z score greater than 0.67 from birth to 2 years and childhood overweight/obesity at 4 and 6 years as body mass index in the 85th percentile or higher for age and sex. We calculated cohort-specific effect estimates and combined them by random-effects meta-analysis. This multicenter, population-based birth cohort study included the 26,184 pregnant women and their children. The median fish intake during pregnancy ranged from 0.5 times/week in Belgium to 4.45 times/week in Spain. Women who ate fish more than 3 times/week during pregnancy gave birth to offspring with higher body mass index values from infancy through middle childhood compared with women with lower fish intake (3 times/week or less). High fish intake during pregnancy (>3 times/week) was associated with increased risk of rapid infant growth, with an adjusted odds ratio (aOR) of 1.22 (95% CI, 1.05-1.42) and increased risk of offspring overweight/obesity at 4 years (aOR, 1.14 [95% CI, 0.99-1.32]) and 6 years (aOR, 1.22 [95% CI, 1.01-1.47]) compared with an intake of once per week or less. Interaction analysis showed that the effect of high fish intake during pregnancy on rapid infant growth was greater among girls (aOR, 1.31 [95% CI, 1.08-1.59]) than among boys (aOR, 1.11 [95% CI, 0.92-1.34]; P = .02 for interaction). High maternal fish intake during pregnancy was associated with increased risk of rapid growth in infancy and childhood obesity. Our findings are in line with the fish intake limit proposed by the US Food and Drug Administration and Environmental Protection Agency.

Replacing pork and chicken with herring (Clupea harengus) increases plasma glucosamine and decreases carbon flux through the citric acid cycle in overweight men and women

Many national nutrition recommendations recommend reducing meat intake and increasing fish intake, due to the association between higher fish intake and reduced risk of cardiovascular disease. Although many studies have looked at the health benefits of the n‐3 fatty acids abundant in fatty fish, few intervention studies have investigated the short‐term effects of replacing meat with fish. As part of a wider series of studies revisiting the comparative effects of meat and herring on human metabolism, we used GC‐MS/MS metabolomics to investigate the effects of replacing lean chicken and pork with herring in overweight and obese adults. In a researcher blinded randomised crossover study, eleven subjects ate five frozen meals/wk over 4 wk, with the frozen meals containing 150 g each of either pork or chicken fillets, or herring fillets. The diets were similar in macronutrient content except for a higher amount of fat in the herring meals. Major metabolic changes observed in plasma were that glucosamine, glutamine and ornithine concentrations increased after the herring diet (all p&lt;0.05 after four wk), while chicken and pork led to increases of agmatine, citric acid, isocitric acid and oxalic acid (all p&lt;0.05 after four wk). Glucosamine is commonly associated with better joint health, though we are unaware of any association between increasing plasma concentrations of glucosamine and lower incidence of joint‐related diseases or complaints. Chicken and pork increased concentrations of citric and isocitric acid, while herring increased glutamine, suggesting that these two different diets had an effect on central carbon metabolism, with a differential regulatory effect at α‐ketoglutaric acid. A further effect was evident on arginine metabolism, possibly related to flux through the urea cycle, based on higher concentrations of arginine/ornithine after the herring diet, while chicken and pork increased agmatine, an arginine metabolite via arginine decarboxylase. An additional finding was that methyl histidine, previously suggested to be biomarker of meat intake in urine, was found to be higher after two weeks of the chicken and pork diet (p=0.003), though this was no longer significant after four wk (p=0.05). These findings add to our understanding of the wider effects of both fish and meat on human metabolism beyond effects on lipids and underline the importance of protein choice on health.Support or Funding InformationThis work was supported by a Chalmers Life Sciences Area of Advance Grant to A Ross and by grants from Region Västra Götaland, the Swedish National Board of Fisheries (Dr 223‐2451‐01), The Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning (FORMAS) (Grant No 2001‐1246).

Does providing lactating women with their individual breast milk DHA level promote an increase in DHA intake?

BACKGROUNDEssential long‐chain polyunsaturated fatty acids including docosahexaenoic acid (DHA) and arachidonic acid (AA) are especially important for normal infant growth and neurodevelopment. Breast milk DHA levels are highly variable and are dramatically affected by maternal intake, whereas AA levels are more stable. Recent recommendations for fish and DHA intake during pregnancy and lactation may be confusing for lactating women and their healthcare providers limiting anticipated improvements in milk DHA levels and provision for breastfeeding infants.OBJECTIVEThe purpose of this study was to determine 1) current milk DHA content in Midwestern US women, 2) factors that influence milk DHA levels, and 3) the effect of feedback regarding milk DHA levels on dietary intake of DHA as it relates to milk DHA content.METHODSLactating women were invited to participate by answering a survey about DHA intake and providing a milk sample (1 drop on an antioxidant‐treated card) for analysis by gas chromatography at baseline and again in 4 weeks. Individual levels were reported to participants. Women with baseline milk DHA higher than the worldwide average (WWA, 0.32%) were advised to make no changes, whereas women with lower levels were advised to increase DHA intake.RESULTSMilk from 81 women was available at baseline. DHA content was highly variable (0.05–0.73%) with a median 0.18%. Baseline milk DHA levels were inversely associated with weeks of lactation (R= −0.23, P=0.04) and parity (R= −0.25, P=0.03), but not with pre‐pregnancy BMI, age, or length of gestation. Women who reported taking DHA supplements at baseline (n=41) had higher levels than those who did not (n=40; 0.23% vs. 0.15%, P&lt;0.0001), but fish intake was unrelated to milk DHA levels. Median milk DHA content increased significantly from baseline to 4 week follow‐up. (n=64; 0.18% to 0.23%, P&lt;0.01). Those who reported changing their diet (n=43) had significantly greater change in their milk DHA compared to those who did not (40% vs. −9%, P&lt;0.01). There was no interaction between group (above‐ or below‐WWA milk DHA level) and their reported change in DHA intake.CONCLUSIONSMedian milk DHA levels in Midwestern US women were lower than previously reported levels for non‐supplementing US women from 10 years ago (~0.20%), hence dietary guidelines to avoid fish during pregnancy/lactation may be reducing DHA intakes as reflected by milk DHA levels. DHA supplementation (but not higher fish intake) was associated with higher milk DHA levels. Offering women information on their own milk's DHA level and providing them with international recommendations for DHA intake motivated dietary changes as quickly reflected in their milk DHA content.Support or Funding InformationThis study was internally funded by OmegaQuant Analytics, LLC. Dr. Baack receives funding support from the Eunice Kennedy Shriver National Institute of Child Health &amp; Human Development of the National Institutes of Health (K08HD078504) and an NIH Center of Biomedical Research Excellence (COBRE) grant (P20 GM103620‐01A1).

Dietary Patterns and the Frequency of Disomy in Human Sperm

To determine whether dietary patterns are associated with the frequency of sperm aneuploidy in a human sperm. It was shown that the role of nutrition, especially dietary pattern, remains unexamined as a risk factor in sperm aneuploidy. In contrast to the traditional analytical approach used in nutritional epidemiology, dietary pattern analysis considers overall diet rather than individual nutrients or foods. The study population consisted of 212 men who were attending an infertility clinic for diagnostic purposes and who had semen concentration of ≥15 (10(6)/ml) (World Health Organization, 2010). Sperm aneuploidy was assessed using multicolor fluorescent in situ hybridization (DNA probes specific for chromosomes 13, 18, 21, X, Y). Diet was assessed via food frequency questionnaire and dietary patterns were identified by factor analysis. Men were classified into 3 groups according to scores of each dietary pattern: Western, Mixed, Prudent. In multivariate analysis, Prudent dietary pattern characterized by high intakes of fish, chicken, fruit, cruciferous vegetables, tomatoes, leafy green vegetables, legumes, and whole grains decreases disomy of chromosomes XX and 21 (P = .01 and P = .005) compared with Western dietary pattern characterized by high intakes of red and processed meat, butter, high fat dairy, refined grains, pizza, snacks, high-energy drinks, and sweets. Higher consumption of Prudent dietary pattern was associated with decreased frequencies of sperm disomy. As this is the first study to analyze the relation of diet and the frequency of sperm aneuploidy, our findings merit further studies, in other populations.

Abstract P271: Diet in Association with Weight Change and the Development of Overweight and Obesity - A Prospective Study of Men

Background: Obesity has become an epidemic affecting all age and socioeconomic groups worldwide with tremendous health consequences. Research is needed to determine modifiable lifestyle factors, including dietary factors, to prevent adults from becoming overweight or obese. Hypothesis: Diet is associated with weight change and overweight and obesity development. Methods: The Harvard Alumni Health Study is a prospective cohort study of men who matriculated at Harvard University from 1916-1950, and who have been followed by periodic questionnaires since 1962. We studied 6614 men free of cancer, cardiovascular disease, and diabetes (mean age, 65.5 years) who were nonobese (body mass index (BMI) &lt;30 kg/m 2 ) based on a 1988 questionnaire that also inquired about lifestyle, clinical, and dietary factors (23-item food frequency questionnaire). We considered individual dietary factors and a derived Dietary Approaches to Stop Hypertension (DASH) score of 6 dietary components: high intake of fruits, vegetables, fish, and low-fat dairy products, and low intake of sweets and red/processed meats). Men reported body weight on follow-up questionnaires in 1993 and 1998; 5- and 10-year body weight changes were computed along with the odds ratios (ORs) (95% confidence intervals (CIs)) of becoming overweight or obese, adjusting for various lifestyle and clinical factors as well as baseline BMI. Results: Over a 10-year period, 631 of 3906 initially normal weight (BMI≤25 kg/m 2 ) men became overweight or obese, and 230 of 6614 men initially nonobese (BMI≤30 kg/m 2 ) became obese. The multivariable-adjusted 5-year mean changes in body weight (standard deviation) were 0.03 (0.12), -0.12 (0.07), and -0.36 (0.09) kg, among men consuming total dairy products ≤6 times/week, 1-2 times/day, and ≥3 times/day (P-trend: 0.009), respectively, primarily driven by high-fat dairy intake (P, trend = 0.02). These associations weakened for 10-year weight changes. Higher tea consumption was inversely associated with greater 10-year (P-trend = 0.04), but not 5-year, weight loss. Among initially normal weight men, alcohol intake was inversely associated with a lower odds of becoming overweight or obese (OR (95% CI) for ≥168 versus 0 grams/week, 0.69 (0.49, 0.98); P, trend = 0.08). Other individual dietary factors were not associated with the odds of becoming overweight or obese. When investigating a combination of 6 beneficial dietary factors derived from the DASH score, an inverse linear association was observed with a lower OR of becoming obese (P-trend = 0.048), but not for becoming overweight or obese. Conclusion: In this prospective study of older men, selected individual dietary factors as well as a broader score reflecting a beneficial diet was related to less weight gain and lower odds of becoming overweight or obese.

Nutrition, sleep, physical exercise: Impact on mental health

Until recently nutrition and various other lifestyle factors were predominantly in the focus of medical disciplines like cardiology, endocrinology or gastroenterology. As mental disorders are multifactorial diseases and as such are complex, emerging evidence suggests that nutrition, exercise and sleep also play an important role in the aetiology, progression and treatment of mental disorders. In this regard research has mostly focused on depression and anxiety, but there is also evidence for other mental disorders like schizophrenia or autism. Some details concerning the relationship between diet and sleep on neuro-transmitter processes, immune-inflammatory pathways or oxidative stress will be demonstrated.Modifications of life style factors and diet are increasingly recognized as potential therapeutic options. Mostly used are nutrient-based supplements and essential elements in combination. But also healthy diet patterns with a high intake of vegetable, fruits and fish have proven beneficial in the treatment. If we better understand the microbiota-gut-brain axis and its impact on behavior, mood and cognitive processes, diet and lifestyle factors can not only contribute to the treatment but also to the prevention of mental disorders.Disclosure of interestThe author has not supplied his declaration of competing interest.

Adolescent dietary patterns and premenopausal breast cancer incidence.

Mammary tissue experiences the highest rate of proliferation during adolescence representing a period of heightened susceptibility. Few prospective studies have examined adolescent diet and breast cancer, and none have examined dietary patterns. Thus, we examined the association between adolescent dietary patterns and a diet quality index, the Alternative Healthy Eating Index (AHEI), and breast cancer in the Nurses' Health Study II among those who completed a 124-item food frequency questionnaire about their high-school diet (HS-FFQ). Cox proportional hazards regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (95% CI). Among 45204 women who completed the HS-FFQ, 863 cases of premenopausal breast cancer and 614 cases of postmenopausal cancer were diagnosed. A marginal inverse association was observed between the 'prudent' dietary pattern, characterized by high intake of vegetables, fruits, legumes, fish and poultry, and premenopausal breast cancer. Women in fifth quintile had a multivariable adjusted HR (95% CI) of 0.84 (0.67-1.04) for premenopausal breast cancer (Ptrend= 0.07) compared with the first quintile. Scoring higher on the AHEI was borderline significantly associated with premenopausal breast cancer with a HR of 0.81 (0.64-1.01) for the fifth quintile (Ptrend= 0.08), and this association appeared to be stronger for estrogen receptor-negative/progesterone receptor-negative tumors. No association was observed between the 'Western' pattern or the 'fast-food' pattern. Results were similar for each of these patterns when both premenopausal and postmenopausal breast cancer were considered together. An overall healthy diet during adolescence, similar to the prudent dietary pattern or adherence to the AHEI, may contribute to reducing the risk of breast cancer.

Abstract P3-09-02: Early life residence, fish consumption and risk of breast cancer

Abstract Introduction: Few studies exist on the effect of diet during different periods of life, on breast cancer risk later in life. Great differences existed in food consumption between the capital and rural areas in Iceland in the middle of the 20th century, with very high fish consumption in coastal areas. Objectives: Our aim was to explore the effect of diet and residence during early life and midlife on breast cancer risk later in life. Methods and data: We used data from the Reykjavik Study, a population-based Icelandic cohort of 10049 women born between 1907 and 1935, and examined the association of residence in early life, used as a proxy for dietary habits, and risk of breast cancer. To further explore this association, we also used food frequency data at different periods of life, including adolescence, from the AGES-Reykjavik cohort, a subgroup of the Reykjavik Study, established in 2002. Participants provided information on residence in early life. By linkage with the Icelandic Cancer Registry, information on breast cancer diagnoses was available throughout 2013. Adjustments were made for a series of potential confounders, including residence for dietary analysis. Results: During a mean follow-up of 27.3 years, 744 women were diagnosed with breast cancer. We found a significant inverse association for breast cancer diagnosis among women who lived though the puberty period (20 years or more) in coastal villages compared with women residing in the capital area (HR = 0.74, 95% CI: 0.58, 0.94). In the subgroup analysis, we found that women with high fish consumption in midlife had lower risk of breast cancer in older age, compared with women with lower consumption, (OR = 0.60, 95% CI 0.38, 0,94). However, we did not observe a statistically significant association between high fish intake in adolescence and breast cancer (OR = 0.84, 95% CI 0.62 - 1.13). Conclusions: Our results suggest that high fish consumption in early- to midlife may be associated with reduced risk of breast cancer. Citation Format: Haraldsdottir A, Torfadottir JE, Valdimarsdottir UA, Aspelund T, Tryggvadottir L, Launer LJ, Harris TB, Gudnason V, Steingrimsdottir L. Early life residence, fish consumption and risk of breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-09-02.

Fish, long-chain omega-3 polyunsaturated fatty acid intake and incidence of atrial fibrillation: A pooled analysis of two prospective studies

Whether high intakes of fish and long-chain omega-3 polyunsaturated fatty acids (PUFAs) reduce the risk of atrial fibrillation (AF) remains uncertain. Thus, we aimed to evaluate the associations of total fish, types of fish, and omega-3 PUFA intake with AF incidence in a large prospective study. We used data from the Cohort of Swedish Men and the Swedish Mammography Cohort to examine the associations of fish consumption and long-chain omega-3 PUFA intake with AF incidence. At baseline, information on fish and omega-3 PUFA intakes was available from 72,984 men and women, aged 45-83 years, without cardiac disease. Cases of AF were identified through linkage with the Swedish National Patient Register. Multivariable-adjusted relative risks were estimated with the use of Cox proportional hazards models. Over a follow-up period of 12 years, 6095 participants (3595 men and 2500 women) developed AF. Intakes of total fish, fatty fish (herring/mackerel and salmon/whitefish/char), and long-chain omega-3 PUFAs were not associated with AF incidence after adjustment for other risk factors. However, high consumption of lean fish (cod/saithe/fish fingers) was associated with a lower risk; multivariable relative risk of AF for ≥3 servings/week compared with never consumption was 0.79 (95% confidence interval, 0.65-0.95). These findings do not support a beneficial association of fatty fish or omega-3 PUFA intake with incident AF. The association between lean fish consumption and AF risk warrants further investigation.

Development and Application of a Lifestyle Score for Prevention of Lethal Prostate Cancer.

Several lifestyle factors have been associated with risk of lethal prostate cancer, but little is known about their combined effect. Our objective was to develop and apply a lifestyle score for prevention of lethal prostate cancer. We developed a lifestyle score among 42 701 men in the Health Professionals Follow-up Study (HPFS) followed from 1986 to 2010 and applied it among 20 324 men in the Physicians' Health Study (PHS) followed from 1982 to 2010. One point was given for each of: not currently smoking or quit 10 or more years ago, body mass index under 30 kg/m(2), high vigorous physical activity, high intake of tomatoes and fatty fish, and low intake of processed meat. Diet-only scores (range = 0-3) and total scores (range = 0-6) were calculated. We used multivariable Cox proportional hazards regression to estimate the risk of lethal prostate cancer, adjusting for potential risk factors of lethal prostate cancer. All statistical tests were two-sided. We observed 576 lethal prostate cancer events in HPFS and 337 in PHS. Men with 5-6 vs 0-1 points had a 68% decreased risk of lethal prostate cancer (hazard ratio [HR] = 0.32, 95% confidence interval [CI] = 0.19 to 0.52) in HPFS and a non-statistically significant 38% decreased risk (HR = 0.62, 95% CI = 0.30 to 1.26) in PHS. For dietary factors only, men with 3 vs 0 points had a 46% decreased risk (HR = 0.54, 95% CI = 0.30 to 0.96) in the HPFS and a non-statistically significant 30% decreased risk (HR = 0.70, 95% CI = 0.40 to 1.23) in PHS. Adhering to a healthy lifestyle, defined by not smoking, normal body weight, high physical activity, and a healthy diet, may lower risk of lethal prostate cancer.

Abstract 12418: Fish Consumption and Adipose Tissue Content of Marine n-3 PUFA is Inversely Associated With Myocardial Infarction: A Danish Prospective Cohort Study

Introduction: Several studies have investigated the potential benefits from marine n-3 polyunsaturated fatty acids (PUFA) on cardiovascular disease, generally suggesting a lower risk of coronary heart disease. However, recent trials have questioned these results and clinical guidelines are currently at debate. Hypothesis: This study investigated the association of fish consumption, intake of marine n-3 PUFA and adipose tissue content of marine n-3 PUFA with incident myocardial infarction (MI), expecting to find an inverse relationship. Methods: In a Danish prospective cohort study 57,053 subjects between the age of 50-64 years were enrolled from 1993-97. From national registries we identified all cases of incident MI. Dietary intake of total, fatty and lean fish was assessed using a semi-quantitative food questionnaire, and analyzed in a traditional cohort design. Adipose tissue biopsies were analyzed for all MI-cases and a randomly selected sub-cohort (n=3409). Associations between adipose tissue content of major marine n-3 PUFA and MI were examined using a nested case-cohort design. Results: During a mean follow-up time of 15.9 years, we identified 3,089 cases of incident MI. In both men and women, a high intake of fatty fish (&gt;28 g/day) was inversely related to incident MI. Comparing the highest and lowest quintile, we found a 12 % lower relative risk in men (HR=0.88; 95% CI: 0.77;1.00) and a 24% lower relative risk in women (HR=0.76; 95% CI: 0.61;0.95). Total and lean fish was neutrally associated with MI. Furthermore, high content of EPA and DHA in adipose tissue was negatively associated with incident MI. However, only EPA remained statistically significant after multivariate adjustments with a HR of 0.76 (CI: 0.59;0.98) for men and HR of 0.65 (CI: 0.45;0.94) for women. Conclusions: Incident MI was inversely associated with fatty fish intake and content of EPA in adipose tissue. This study supports the view that consumption of fatty fish may protect against MI.

Prevalence of vitamin D deficiency and its association with nutrition, travelling and clothing habits in an immigrant population in Northern Sweden.

To study prevalence and determinants of vitamin D deficiency in immigrants from Africa and the Middle East living in Umeå, Sweden. Cross-sectional population based. Umeå, Sweden (63° N). Immigrants aged 25-65 years from nine countries in Africa or the Middle East (n=1306) were invited. A total of 111 men and 106 women (16.5%) completed the study. S-25-hydroxyvitamin D3 was measured with HPLC. Anthropometry, medical, socioeconomic and lifestyle data were registered. Vitamin D status was insufficient or deficient in 73% of the participants. Specifically, 12% had vitamin D deficiency (25(OH)D3<25 nmol/l), and only 3.7% had optimal vitamin D status (25(OH)D3 75-125 nmol/l). Mean 25(OH)D3 level was 41.0 nmol/l (± 16.6) with no difference between sexes. Levels of 25(OH)D3 were lower (P=0.030) and vitamin D deficiency was twice as common in immigrants from Africa compared with those from the Middle East. In the multiple regression analysis, vitamin D deficiency was significantly associated with low fatty fish intake (OR 4.31, 95% CI 1.61-11.55), not travelling abroad (OR 3.76, 95% CI 1.18-11.96) and wearing long-sleeved clothes in summer (OR 3.15, 95% CI 1.09-9.12). The majority of immigrants from Africa and the Middle East who live in northern Sweden have vitamin D deficiency or insufficiency. Our results are consistent with sun exposure and a diet with high intake of fatty fish being most important in avoiding vitamin D deficiency.