Cardiovascular dose-responses of fish consumption
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Original author: Henna Karvonen, Foodfiles Ltd 2006.
Cardiovascular dose-responses of fish consumption describe exposure-response functions of fish consumption to several different health outcomes in human.
Description
Table. Evidence on the cardiovascular health effects of fish. There is quantifiable data on all of the cardiovascular effects mentioned in the table. Therefore for example the American Heart Association recommends at least two weekly portions of fish for cardio-protective effects. Certain measurable cardiovascular health related endpoints like TIA, reconstructive vascular surgery, angioplasty, Intermittent claudication and amputation were not included in the table since quantifiable data is limited.
| Ecological, descriptive and cross-sectional studies | Cohort and case-control studies | Exposure data from cohort and case-control studies | Interventions | Exposure data from interventions | Comments | |
| CVD mortality | +++ | +++ | Fish and fish oil | ++ | Fish oil | Interventions on cardiovascular mortality are secondary prevention trials. Only few interventions have been conducted with fish and there is hardly any data on various fish species. Evidence from fish interventions is limited as treatments generally consist of multiple lifestyle changes. Quantifiable data on protective effects of fish consumption in primary prevention is limited to cohort and case-control studies. |
| Sudden cardiac death | +++ | +++ | Fish and fish oil | ++ | Fish oil | |
| - Ischemic heart disease mortality* | +++ | +++ | Fish and fish oil | ++ | Fish oil | |
| - Non-fatal myocardial infarction | +++ | Fish and fish oil | ++ | Fish oil | The above applies. | |
| Stroke, both fatal and non-fatal | +++ | +++ | Fish and fish oil | ++ | Fish oil | The above applies. Figures for the incidence of non-fatal strokes generally presented combined with the fatal strokes. |
| Risk markers (blood pressure, serum lipids, thrombosis, arrhythmia) | +++ | +++ | Fish and fish oil | +++ | Fish and fish oil | Majority of studies are done with fish oils, not fish. There is quantitative meta-analysis data on dose-response readily available on the effect of fish oil on blood pressure and lipids. Meta-analysis on heart rate shows that fish oils reduce heart rate but there is no evidence on clear dose-response effect. |
* Including myocardial infarction/ coronary heart disease
- No data, + Initial findings, ++ Replicate studies, +++ Plenty of data
References
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He K, Song Y, Daviglus ML, Liu K, Van Horn L, Dyer AR, Greenland P: Accumulated evidence on fish consumption and coronary heart disease mortality: a meta-analysis of cohort studies. Circulation. 2004;109(22):2705-11.
He K, Song Y, Daviglus ML, Liu K, Van Horn L, Dyer AR, Goldbourt U, Greenland P: Fish consumption and incidence of stroke: a meta-analysis of cohort studies. Stroke. 2004;35(7):1538-42.
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Konig A, Bouzan C, Cohen JT, Connor WE, Kris-Etherton PM, Gray GM, Lawrence RS, Savitz DA, Teutsch SM: A quantitative analysis of fish consumption and coronary heart disease mortality. Am J Prev Med. 2005;29(4):335-46.
Morris MC, Sacks F, Rosner B: Does fish oil lower blood pressure? A meta-analysis of controlled trials. Circulation. 1993;88(2):523-33.
Mozaffarian D, Geelen A, Brouwer IA, Geleijnse JM, Zock PL, Katan MB: Effect of fish oil on heart rate in humans: a meta-analysis of randomized controlled trials. Circulation. 2005;112(13):1945-52.
Sommerfield T, Hiatt WR: Omega-3 fatty acids for intermittent claudication. Cochrane Database Syst Rev. 2004;(3):CD003833.
Wang C, Harris WS, Chung M, Lichtenstein AH, Balk EM, Kupelnick B, Jordan HS, Lau J. n-3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review. Am J Clin Nutr. 2006;84(1):5-17.
Whelton SP, He J, Whelton PK, Muntner P: Meta-analysis of observational studies on fish intake and coronary heart disease. Am J Cardiol. 2004;93(9):1119-23.