The relation between fish consumption, death from all causes, and incidence of coronary heart disease: The NHANES I Epidemiologic Follow-up Study

Few published data are available on fish consumption and risk of death in women or blacks. This study assesses the level of fish consumption as a risk factor for death from all causes and selected causes, and incidence of coronary heart disease. Participants were members of the NHANES I Epidemiologic Follow-up Study, a longitudinal cohort study of a national sample. Included in this analysis were 8825 white and black women and men aged 25-74 years when examined in 1971 through 1975 who did not report a history of heart disease at that time. Average follow-up for survivors of 18.8 years (maximum 22.1 years). The main outcomes measured were death tall causes, cardiovascular, noncardiovascular, cancer) and incidence of coronary heart disease. Fish consumption at baseline was obtained from a 3-month food frequency questionnaire. White men aged 25-74 years with fish consumption one time/week had an age-adjusted risk of death only about three quarters that of men never consuming fish. This effect persisted after controlling for multiple risk variables (1 time/week relative risk 0.76, 95% confidence interval 0.63-0.91). No additional reduction in risk was seen for consumption >1 time/ week (adjusted relative risk 0.85, 95% CI 0.68-1.06). Similar bur. nonsignificant trends were seen in white and black women, but not black men. In white men, risk of noncardiovascular death but not cardiovascular death was also significantly reduced in those consuming fish once or more a week. No consistent association of fish consumption and coronary heart disease incidence or mortality was seen. White men consuming fish once a week had significantly lower risk of death over a 22-year follow-up than those never consuming fish. This was mostly attributable to reductions in death from noncardiovascular causes. Similar patterns, though not significant, were seen in women. Further studies are needed to confirm these findings and to elucidate mechanisms for the effect of fish consumption on noncardiovascular mortality. (C) 2000 Elsevier Science Inc. All rights reserved.