Fish, Cardiovascular Disease, and Mortality

Fish and shellfish (hereafter referred to as fish) are major sources of the dietary long-chain ω-3 fatty acids eicosapentaenoic acid (20:5n-3) and docosahexaenoic acid (22:6n-3) and also contain other nutrients, such as vitamin D, riboflavin, iodine, calcium, phosphorus, magnesium, potassium, zinc, and iron. The summed results of observational studies of fish intake, randomized clinical tria ls of fish oil supplements, and associated mechanistic and experimental studies suggest that regular fish consumption may decrease the incidence of myocardial infarction (MI) and coronary heart disease (CHD), with more uncertain effects on stroke, total cardiovascular disease (CVD), or other composi te events, such as all-cause mortality. Yet, these summed findings obscure the inconsistent results of individual clinical trials, which have raised uncertainty and controversy about health benefits. Proposed explanatory factors for the heterogeneity have included dose, type of fish (oily vs white), methods for preparation of fish (baked or grilled vs fried), background fish consumption, underlying participant risk, outcome (eg, fatal CHD vs combined CVD events), and even presence of trace contaminants such as mercury or organic pollutants. In addition, associated behaviors of individuals who eat fish (eg, other dietary factors and socioeconomic status) could overestimate benefits in observational studies.
Source: JAMA Internal Medicine - Category: Internal Medicine Source Type: research