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Fish consumption and risk of major chronic disease in men^1,2,3

¹ From the Departments of Nutrition (JKV, DM, SEC, and EBR) and Epidemiology (EBR), Harvard School of Public Health, Boston, MA; the Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (EBR); and the University of Kuopio, School of Public Health and Clinical Nutrition, Research Institute of Public Health, Kuopio, Finland (JKV)

² Supported by grants HL35464 and CA55075 from the National Institutes of Health and grants from the Finnish Cultural Foundation, Helsingin Sanomat Centennial Foundation, Finnish Foundation for Cardiovascular Research, Yrjö Jahnsson Foundation, and University of Kuopio (to JKV).

³ Reprints not available. Address reprint requests to JK Virtanen, University of Kuopio, School of Public Health and Clinical Nutrition, Research Institute of Public Health, PO Box 1627, 70211 Kuopio, Finland. E-mail: jyrki.virtanen{at}uku.fi.

Background: Although fish consumption may reduce specific disease endpoints, such as sudden cardiac death and prostate cancer, the effects of major chronic disease on total burden, reflecting sums of effects on a variety of endpoints and risk pathways, are not well established. Higher n–6 fatty acid consumption has also been hypothesized to reduce the health benefits of n–3 fatty acids in fish.

Objective: The aim was to study the associations of fish and n–3 fatty acid consumption with risk of total major chronic disease (cardiovascular disease, cancer, and death) and to determine whether a high n–6 intake modifies the associations.

Design: Lifestyle and other risk factors were assessed every 2 y and diet every 4 y in 40,230 US male health professionals aged 40–75 y and free of major chronic disease at baseline in 1986. During 18 y of follow-up, 9715 major chronic disease events occurred, including 3639 cardiovascular disease events, 4690 cancers, and 1386 deaths from other causes.

Results: After multivariable adjustment, neither fish nor dietary n–3 fatty acid consumption was significantly associated with risk of total major chronic disease. Compared with fish consumption of <1 serving/mo, consumption of 1 serving/wk and of 2–4 servings/wk was associated with a lower risk of total cardiovascular disease of 15%. No significant associations were seen with cancer risk. Higher or lower n–6 fatty acid intake did not significantly modify the results (P for interaction > 0.10).

Conclusions: Modest fish consumption was associated with a lower risk of total cardiovascular disease, consistent with cardiac mortality benefits but not with total cancer or overall major chronic disease; n–6 fatty acid consumption did not influence these relations.