American Journal of Epidemiology Vol. 142, No. 2: 166-175
Copyright © 1995 by The Johns Hopkins University School of Hygiene and Public Health
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Fish Consumption and Cardiovascular Disease in the Physicians' Health Study: A Prospective Study
1Department of Epidemiology, Harvard School of Public Health Boston, MA.
2Department of Medicine, Channing Laboratory, Harvard Medical School and Brigham and Women's Hospital Boston, MA
3Department of Preventive Medicine, Channing Laboratory, Harvard Medical School and Brigham and Women's Hospital Boston, MA.
4Department of Nutrition, Harvard School of Public Health Boston, MA.
Reprint requests to Dr Martha Clare Morris, Rush Institute on Aging, 1645 W. Jackson Street, Suite 675, Chicago, IL 60612.
The authors examined the association between dietary intake of fish and 
3 fatty acids from seafood and the risk of cardiovascular disease in a prospective cohort study of 21,185 US male physicians who are participants in the Physicians' Health Study. In 4 years of follow-up, there were 281 incident cases of total (fatal and nonfatal) myocardial infarction, 173 cases of stroke, and 121 cardiovascular deaths. There was no evidence for association between dietary intake of fish and any cardiovascular endpoint, including myocardial infarction, stroke, and cardiovascular death. The relative risks of total myocardial infarction, adjusted for age and randomized treatment assignment, for categories of fish intake were: 1.0 for <1 meal/week (referent), 1.6 (95% confidence interval (Cl) 1.1–2.3) for 1 fish meal/week; 1.4 (95% Cl 1.0–2.0) for 2–4 fish meals/week; and 1.2 (95% Cl 0.6–2.2) for 
5 fish meals/week; 2 for trend = 0.9, 
= 0.34. The relative risks were similar for 3 fatty acid intake and for specific types of fish, and did not change after adjustment for history of hypertension, hypercholesterolemia, diabetes mellitus, or angina pectoris, parental history of myocardial infarction before age 60 years, obesity, exercise, smoking, alcohol use, saturated fat intake, and vitamin supplement use. These data do not support the hypothesis that moderate fish consumption lowers the risk of cardiovascular disease.
cardiovascular diseases; diet; fatty acids; omega-3; fish oils; myocardial infarction; stroke
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