A study published Clinical Nutrition shows that in middle-aged and older adults with type 2 diabetes, fish consumption may be associated with a lower risk for myocardial infarction (MI) and coronary heart disease-related (CHD) death.

The researchers analyzed data from 2,225 adults aged 45 years and older with type 2 diabetes at baseline from two population-based cohorts: The Swedish Mammography Cohort and the Cohort of Swedish Men, followed between 1998 and 2012. Participants completed food frequency questionnaires, including items assessing specific finfish consumption (herring/mackerel, salmon/whitefish, and cod/saithe) and shellfish. Monthly consumption of fried fish was queried in a separate questionnaire section. Researchers calculated Dietary Approaches to Stop Hypertension (DASH) diet score to estimate overall diet quality.

Participants were followed for first hospitalization or death from MI or stroke, as well as death from any cause during follow-up. Researchers used Cox proportional hazard models to estimate hazard ratios (HR) for MI, stroke, total mortality, and CHD-related mortality by categories of total fish (3 servings per month; 1 to < 2 servings per week; 2–3 servings per week; and 3 servings per week), as well as individual fish and monthly fried fish consumption.

During a mean follow-up of 11.8 years, there were 333 incident MI events and 321 incident stroke events. During a mean of 13.2 years, there were 771 deaths, with CHD as the underlying cause for 154.

In adjusted models, fish consumption was inversely associated with MI incidence, but not with stroke. Compared with adults who consumed three or fewer servings of fish per month, the HR for those who consumed at least three servings of fish per week was 0.6 for MI and 1.04 for stroke.

For total mortality, the HRs were lowest for moderate fish consumption of one to fewer than two servings per week and two to three servings per week versus those who consumed three or fewer monthly servings. For CHD-related mortality, researchers found that one to fewer than two servings per week of total fish consumption was associated with lower risk. Among individual fish, moderate consumption of cod/saithe was associated with total and CHD-related mortality.


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