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Senior Citizen Health & Medicine
Eating Fish Reduces Coronary Death Risk by Stunning
36 Percent
Review in JAMA of past studies says death rate
reduced 17%
 October 18, 2006 Researchers who reviewed all the
previous studies on the health impact of eating fish have concluded that
avoiding modest fish consumption due to confusion regarding risks and
benefits could result in thousands of excess coronary heart disease
deaths annually. They found it reduces risk of coronary death by a
stunning 36 percent and the rate of death by 17 percent.
The report is published today in the Journal of the
American Medical Association (JAMA).
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Fish has been considered a healthy food since the
publication of studies demonstrating its various health benefits.
Several studies have identified two long-chain n-3 polyunsaturated fatty
acids (n-3 PUFAs), eicosapentaenoic acid (EPA) and docosahexaenoic acid
(DHA), as likely playing a role in the associated lower rates of
coronary heart disease with fish consumption.
Conversely, concern has arisen over potential harm
from mercury, dioxins, and polychlorinated biphenyls (PCBs) present in
some fish species. The public is faced with conflicting reports on the
risks and benefits of eating fish, resulting in controversy over the
role of fish consumption in a healthy diet.
Dariush Mozaffarian, M.D., Dr.P.H., and Eric B.
Rimm, Sc.D., of Brigham and Womens Hospital and Harvard Medical School,
Boston, reviewed the scientific evidence for adverse and beneficial
health effects of fish consumption (in this report defined as finfish or
shellfish).
They searched MEDLINE, governmental reports, and
meta-analyses to identify reports published through April 2006
evaluating
(1) intake of fish or fish oil and
cardiovascular risk,
(2) effects of methylmercury and fish oil on early neurodevelopment,
(3) risks of methylmercury for cardiovascular and neurologic outcomes
in adults, and
(4) health risks of dioxins and PCBs in fish. When possible,
meta-analyses were performed to characterize benefits and risks most
precisely.
The researchers found that modest consumption of
fish (e.g., 1 to 2 servings per week), especially species higher in n-3
fatty acids (EPA, DHA), reduces risk of coronary death by 36 percent and
the rate of death by 17 percent, and may favorably affect other clinical
outcomes.
Intake of 250 mg/d of EPA and DHA appears
sufficient for primary prevention. This corresponds to one 6-oz.
serving/wk of wild salmon or similar oily fish, or more frequent intake
of smaller or less n-3 PUFArich servings.
DHA appears beneficial for, and low-level
methylmercury may adversely affect, early neurodevelopment.
Women who are or may become pregnant and nursing
mothers should avoid selected species (shark, swordfish, golden bass,
and king mackerel; locally caught fish per local advisories) and limit
intake of albacore tuna (6 oz./wk) to minimize methylmercury exposure.
However, emphasis must also be placed on adequate
consumption12 oz./wkof other fish and shellfish to provide reasonable
amounts of DHA and avoid further decreases in already low seafood intake
among women (74 percent of women of childbearing age and 85 percent of
pregnant women consume less than 6 oz./wk), the researchers write.
Health effects of low-level methylmercury in adults
are not clearly established; methylmercury may modestly decrease the
cardiovascular benefits of fish intake.
A variety of seafood should be consumed;
individuals with very high consumption (5 servings or more per week)
should limit intake of species highest in mercury levels. Levels of
dioxins and PCBs in fish are low, and potential carcinogenic and other
effects are outweighed by potential benefits of fish intake and should
have little impact on choices or consumption of seafood.
Avoidance of modest fish consumption due to
confusion regarding risks and benefits could result in thousands of
excess coronary heart disease deaths annually and suboptimal
neurodevelopment in children, the authors conclude.
Editor's Note: This study was supported by a grant
from the National Heart, Lung, and Blood Institute, National Institutes
of Health. Please see the article for additional information, including
other authors, author contributions and affiliations, financial
disclosures, funding and support, etc.
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