American Journal of Epidemiology Vol. 151, No. 10: 999-1006
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health
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Fish Consumption and Coronary Heart Disease Mortality in Finland, Italy, and the Netherlands
1Department of Chronic Diseases Epidemiology, National Institute of Public Health and the Environment Bilthoven, the Netherlands
2Department of Human Nutrition and Epidemiology, Wageningen University Wageningen, the Netherlands
3Division of Nutrition, University of Helsinki Helsinki, Finland
4Institute of Food Science and Nutrition, University of Perugia Perugia, Italy
5Department of Community Health and General Practice, University of Kuopio Kuopio, Finland
6Division of Epidemiology, University of Minnesota Minneapolis, MN
7Division of Public Health Research, National Institute of Public Health and the Environment Bilthoven, the Netherlands
Fish consumption seems to protect against death from coronary heart disease (CHD). If this association is due to n-3 polyunsaturated fatty acids, especially fatty fish may be responsible for this protective effect. The association between total, lean, and fatty fish consumption and the risk of CHD mortality was examined in 1, 088 Finnish, 1, 097 Italian, and 553 Dutch men participants in the Seven Countries Study who were aged 50–69 years and free of CHD around 1970. After 20 years of follow-up, 242 (22.2%) men in Finland, 116(10.6%) men in Italy, and 105 (19.0%) men in the Netherlands had died of CHD. Cox proportional hazards analysis showed no association between total fish consumption and CHD mortality. After adjustments were made for age, body mass index, smoking, energy intake, and relevant dietary variables, the pooled relative risk for the highest quartile of total fish compared with no fish consumption in the three countries was 1.08 (95% confidence interval: 0.76, 1.53). Lean fish consumption also was not associated with CHD mortality in any country. Fatty fish compared with non-fatty-fish consumption was associated with lower CHD mortality; the adjusted, pooled relative risk for fatty fish consumers was 0.66 (95% confidence interval: 0.49, 0.90). These data suggest that especially fatty fish is protective against CHD mortality. Am J Epidemiol 2000; 51: 999–1006.
coronary disease; diet; fatty acids; unsaturated; fishes; mortality
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