Listed in Issue 28


MARCKMANN and GRONBAEK, Research Department of Human Nutrition, Royal Veterinary and Agricultural University, Frederiksberg, Denmark conducted a prospective review (42 references) of all prospective cohort studies examining the relationship between fish intake and coronary heart disease (CHD) mortality.



The authors performed a systematic review of studies based upon individual records of fish or n-3 polyunsaturated fatty acid consumption and death from CHD. Studies were scored according to scientific quality and divided into categories of high, intermediate or insufficient. The main outcome measure was mortality from CHD.


The authors identified 11 studies. The cohorts included a total of 116,764 people. Of the 4 studies of the highest quality, the 2 largest (n = 44,895 and 20,051) were conducted in populations at low risk of CHD, where no protective effective of fish consumption was found. The other, relatively small (n = 852 and 1822) high-quality studies included people at higher risk. These studies both found an inverse relationship between fish consumption and CHD death, suggesting that 40-60 g fish per day is optimal and associated with a reduction in risk of 40-60%. The results of 4 studies of intermediate quality support the finding that fish consumption is inversely associated with CHD mortality in high-risk populations only. There were 3 studies judged to be of insufficient quality to be used in drawing conclusions.


In low-risk populations, fish consumption is not associated with reduced CHD mortality. However in high-risk populations, fish consumption at 40-60 g per day is associated with markedly (40-60%) reduced mortality of CHD. The underlying biochemical mechanisms for these findings are as yet not fully understood.


Marckmann P and Gronbaek M. Fish consumption and coronary heart disease mortality. European Journal of Clinical Nutrition 53(8): 585-90. Aug 1999. @i:48

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