A Quantitative Analysis of Fish Consumption and Coronary Heart Disease Mortality


      Although a rich source of n-3 polyunsaturated fatty acids (PUFAs) that may confer multiple health benefits, some fish contain methyl mercury (MeHg), which may harm the developing fetus. U.S. government recommendations for women of childbearing age are to modify consumption of high-MeHg fish to reduce MeHg exposure, while recommendations encourage fish consumption among the general population because of the nutritional benefits. The Harvard Center for Risk Analysis convened an expert panel (see acknowledgments) to quantify the net impact of resulting hypothetical changes in fish consumption across the population. This paper estimates the impact of fish consumption on coronary heart disease (CHD) mortality and nonfatal myocardial infarction (MI). Other papers quantify stroke risk and the impacts of both prenatal MeHg exposure and maternal intake of n-3 PUFAs on cognitive development.
      This analysis identified articles in a recent qualitative review appropriate for the development of a dose–response relationship. Studies had to satisfy quality criteria, quantify fish intake, and report the precision of the relative risk estimates. Relative risk results were averaged, weighted proportionately by precision. CHD risks associated with MeHg exposure were reviewed qualitatively because the available literature was judged inadequate for quantitative analysis.
      Eight studies were identified (29 exposure groups). Our analysis estimated that consuming small quantities of fish is associated with a 17% reduction in CHD mortality risk, with each additional serving per week associated with a further reduction in this risk of 3.9%. Small quantities of fish consumption were associated with risk reductions in nonfatal MI risk by 27%, but additional fish consumption conferred no incremental benefits.
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      Linked Article

      • Letters to the editor: Risks and Benefits of Seafood Consumption
        American Journal of Preventive MedicineVol. 30Issue 5
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          Konig et al.1 performed a meta-analysis of fish consumption and coronary heart disease (CHD) mortality, and in doing so referred to our recent meta-analysis publication on the same topic.2 We would like to offer a few corrections regarding references made to our previous work. In their discussion, they stated that two studies (Osler et al.3 and Yuan et al.4) included in our previous analyses should not have been included in a meta-analysis because Osler et al.3 did not use the lowest intake group as reference and Yuan et al.
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