title: Long-term fish consumption and n-3 fatty acid intake in relation to (sudden) coronary heart disease death: the Zutphen study.
abstract: OBJECTIVE
  To assess the relationship between fish consumption or eicosapentaenoic acid (EPA)+docosahexaenoic acid (DHA) intake from fish, and (sudden) coronary death.
  
  
  RESULTS
  The impact of recent and long-term fish consumption and EPA+DHA intake on (sudden) coronary death was investigated in the Zutphen Study, a cohort of 1373 men born between 1900 and 1920, and examined repeatedly between 1960 and 2000. Hazard ratios were obtained from time-dependent Cox regression models. The associations between long-term fish consumption, EPA+DHA intake, and (sudden) coronary death were stronger than those of recent consumption. Long-term fish consumption was inversely associated (borderline significant) with coronary heart disease (CHD) death; however, the strength of the association decreased from age 50 [HR: 0.32 (95% CI: 0.13-0.80)] until age 80 [HR: 1.34 (0.58-3.12)]. For men with a daily EPA+DHA intake from fish below 250 mg compared with no intake, CHD death risk was reduced to the same extent as for men with a daily intake above 250 mg (P-value for trend: 0.27). Moreover, long-term fatty-fish consumption lowered the risk of sudden coronary death [HR: 0.46 (0.27-0.78)].
  
  
  CONCLUSIONS
  The strength of the association between long-term fish consumption and CHD death decreased with increasing age. Fatty-fish consumption lowered sudden coronary death risk. There was no clear dose-response relationship between EPA+DHA intake and (sudden) coronary death.
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. martinette.streppel@wur.nl
authors.forename: Martinette T
authors.initials: MT
authors.lastname: Streppel
authors.forename: Marga C
authors.initials: MC
authors.lastname: Ocké
authors.forename: Hendriek C
authors.initials: HC
authors.lastname: Boshuizen
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Kok
authors.forename: Daan
authors.initials: D
authors.lastname: Kromhout
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001145:Arrhythmias, Cardiac / Q000401:mortality / Q000517:prevention & control*; D003327:Coronary Disease / Q000401:mortality / Q000517:prevention & control*; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D004281:Docosahexaenoic Acids / Q000008:administration & dosage*; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage*; D005399:Fishes; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models
chemical_list: D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid