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 w omen 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 cor onary heart disease. Participants were members of the NHANES I Epidemiologi c Follow-up Study, a longitudinal cohort study of a national sample. Includ ed in this analysis were 8825 white and black women and men aged 25-74 year s 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 (maximu m 22.1 years). The main outcomes measured were death tall causes, cardiovas cular, noncardiovascular, cancer) and incidence of coronary heart disease. Fish consumption at baseline was obtained from a 3-month food frequency que stionnaire. 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 nev er consuming fish. This effect persisted after controlling for multiple ris k 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/ wee k (adjusted relative risk 0.85, 95% CI 0.68-1.06). Similar bur. nonsignific ant 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 consi stent association of fish consumption and coronary heart disease incidence or mortality was seen. White men consuming fish once a week had significant ly lower risk of death over a 22-year follow-up than those never consuming fish. This was mostly attributable to reductions in death from noncardiovas cular causes. Similar patterns, though not significant, were seen in women. Further studies are needed to confirm these findings and to elucidate mech anisms for the effect of fish consumption on noncardiovascular mortality. ( C) 2000 Elsevier Science Inc. All rights reserved.