The inverse relation between fish consumption and 20-year mortality from coronary heart disease.
Level 3 - non-randomized controlled study
Prospective cohort study with 20-year longitudinal follow-up.
PubMed 3990713 · doi:10.1056/NEJM198505093121901
What was done
Dietary history regarding fish consumption was collected in 1960 from 852 middle-aged men free of coronary heart disease (and their wives) in Zutphen, the Netherlands. The cohort was followed prospectively for 20 years to track deaths from coronary heart disease.
What was found
During 20 years of follow-up, 78 men died from coronary heart disease. An inverse dose-response relationship was observed between baseline fish consumption and coronary heart disease mortality, which persisted after multiple logistic-regression analysis. Coronary heart disease mortality was more than 50 percent lower among men consuming at least 30 g of fish per day compared to non-consumers.
Why it matters
This study provided key early population-level evidence suggesting that habitual fish intake as low as one to two servings per week is associated with reduced long-term coronary heart disease mortality.
Limits
The study included only middle-aged men from a single Dutch town, limiting generalizability to women or diverse populations. Dietary intake was measured only at baseline in 1960, which cannot account for changes in dietary habits over the 20-year follow-up, and observational designs are vulnerable to residual confounding.
Cited by
- supports Three back-to-back papers on omega-3 fatty acids were published in the New England Journal of Medicine on May 9, 1985.