Increasing dietary fish intake has contributed to decreasing mortality from CHD among the older population in Hong Kong

Abstract

Objective: To test whether change in the frequency of fish intake at population level would affect the trends of death from CHD and how many CHD events could be prevented in Hong Kong, a population among those with the highest fish consumption and the lowest CHD mortality in the world. Design: Time trends analysis with data from repeated dietary surveys and death registration. Setting: Hong Kong SAR, People's Republic of China. Subjects: A total of 3096 men and women aged 40-69 years who participated in territory-wide surveys in 1995 or 2003 were included in the analysis of changes in dietary fish intake; all adults aged 40-69 years in Hong Kong were included in the analysis of time trends of CHD mortality. Results: Over the period, the frequency of fish intake increased and CHD mortality decreased significantly in the population age group of 50-69 years, while in the age group of 40-49 years little change in both fish intake and CHD mortality was observed. It was estimated that 240 CHD deaths (or 29 % of the total) were avoided among the population aged 40-69 years in 2003, as more than half of the population consumed fish every day in Hong Kong. Conclusions: The time trend of CHD mortality was inversely related to the trend of fish intake. The frequency of fish intake may have a substantial impact on the population for the prevention of CHD deaths in Hong Kong. Keywords Dietary fish intake Coronary heart disease Population impactThe protective effect of dietary fish intake on CHD, partly through the pathway of n-3 PUFA and especially EPA and DHA, has been explored in general populations as well as among CHD patients for almost half a century. The inverse association between fish consumption and CHD has been observed in both Eastern and Western populations (1)(2)(3)(4)(5)(6) . A dose-response relationship between the size of the effect on CHD and the amount of fish consumed or the frequency of dietary fish intake was demonstrated in a meta-analysis of thirteen cohort studies (7) . Dietary fish intake has been recommended in guidelines on CVD prevention by many medical societies around the world (8)(9)(10)(11) . However, whether changes in the frequency of fish intake at population level would affect the trends of CHD, and what proportion or number of CHD deaths could be averted due to the frequency of fish intake in a given population, has not been assessed. The population of Hong Kong is among those with the highest fish consumption and the lowest CHD mortality in the world. The percentage of dietary energy from fish intake in Hong Kong was the third highest and the ageadjusted CHD mortality was the second lowest among those populations with data available in the UN (12) . The population impact of fish intake on CHD mortality in Hong Kong, however, has not been quantitatively estimated. The present report aims to fill this gap by comparing the frequency of daily fish intake and CHD mortality in age-and sex-specific populations between two time points (1995 v. 2003), and estimating the potential populat...

Fish consumption and CHD mortality: an updated meta-analysis of seventeen cohort studies

“…We identified twenty-nine potential studies ( 5 – 7 , 13 – 22 , 29 – 44 ) . Seven studies ( 29 , 31 – 33 , 37 , 43 , 44 ) were excluded because of their incomplete information on RR estimation or fish intake. Two studies ( 18 , 42 ) were excluded because the reference group was not the lowest exposure group.…”

“…We identified twenty-nine potential studies (5)(6)(7)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44) . Seven studies (29,(31)(32)(33)37,43,44) were excluded because of their incomplete information on RR estimation or fish intake. Two studies (18,42) were excluded because the reference group was not the lowest exposure group.…”

Dietary patterns, subclinical inflammation, incident coronary heart disease and mortality in middle-aged men from the MONICA/KORA Augsburg cohort study

“…Fish was found to be protective against death from CHD (He et al, 2004;Zhang et al, 2009), high intakes of saturated fats were found to increase the risk in women, but not in men (Boniface and Tefft, 2002), and oils rich in a-linolenic acid were identified to lower CHD mortality (Zatonski et al, 2008), but results have not always been consistent.…”

The year that passed – 2011

“…We might be accused of discussing 'sour grapes' here, but again, pointing to our earlier editorial about the nude emperor (12) , is it not time to start discussing a 'health impact factor' as a supplement to the above-mentioned impact factor for journals related to human health? It seems evident that papers published in the area of paediatrics as well as in nutrition can have a profound effect on human Bodor et al (2) Research paper 23 50 Moreno et al (3) Research paper 16 44 McLean et al (4) Research paper 14 34 Swinburn et al (5) Policy paper 11 28 Wen et al (6) Research paper 10 19 Zhang et al (7) Research paper 10 19 Psaltopoulou et al (8) Research paper 10 18 Thompson et al (9) Research paper 9 40 Pearson et al (10) Review 9 30 Galvez et al (11) Research paper 8 21…”