Background It has been hypothesized that a diet containing n-3fatty acids from fish reduces the risk of coronary heart disease,but few large epidemiologic studies have examined this question.
Methods In 1986, 44,895 male health professionals, 40 to 75years of age, who were free of known cardiovascular diseasecompleted detailed and validated dietary questionnaires as partof the Health Professionals Follow-up Study. During six yearsof follow-up, we documented 1543 coronary events in this group:264 deaths from coronary disease, 547 nonfatal myocardial infarctions,and 732 coronary-artery bypass or angioplasty procedures.
Results After controlling for age and several coronary riskfactors, we observed no significant associations between dietaryintake of n-3 fatty acids or fish intake and the risk of coronarydisease. For men in the top fifth of the group in terms of intakeof n-3 fatty acids (median, 0.58 g per day), the multivariaterelative risk of coronary heart disease was 1.12 (95 percentconfidence interval, 0.96 to 1.31), as compared with the menin the bottom fifth (median, 0.07 g per day). For men who consumedsix or more servings of fish per week, as compared with thosewho consumed one serving per month or less, the multivariaterelative risk of coronary disease was 1.14 (95 percent confidenceinterval, 0.86 to 1.51). The risk of death due to coronary diseaseamong men who ate any amount of fish, as compared with thosewho ate no fish, was 0.74 (95 percent confidence interval, 0.44to 1.23), but the risk did not decrease as fish consumptionincreased.
Conclusions Although the possibility of residual confoundingby unmeasured factors cannot be entirely excluded, these datasuggest that increasing fish intake from one to two servingsper week to five to six servings per week does not substantiallyreduce the risk of coronary heart disease among men who areinitially free of cardiovascular disease.
Source Information
From the Departments of Epidemiology (A.A., E.B.R., M.J.S., E.L.G., W.C.W.) and Nutrition (A.A., E.B.R., M.J.S., W.C.W.), Harvard School of Public Health, and the Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School (M.J.S., E.L.G., W.C.W.) — all in Boston.
Address reprint requests to Dr. Ascherio at the Department of Nutrition, Harvard School of Public Health, 665 Huntington Ave., Boston, MA 02115.
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