Eating fish and risk of type 2 diabetes: A population-based, prospective follow-up study.
OBJECTIVE
To investigate the relation between total fish, type of fish (lean and fatty), and eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intake and risk of type 2 diabetes in a population-based cohort.


METHODS
The analysis included 4,472 Dutch participants aged >or=55 years without diabetes at baseline. Dietary intake was assessed with a semiquantitative food frequency questionnaire. Hazard ratios (relative risk [RR]) with 95% CIs were used to examine risk associations adjusted for age, sex, lifestyle, and nutritional factors.


RESULTS
After 15 years of follow-up, 463 participants developed type 2 diabetes. Median fish intake, mainly lean fish (81%), was 10 g/day. Total fish intake was associated positively with risk of type 2 diabetes; the RR was 1.32 (95% CI 1.02-1.70) in the highest total fish group (>or=28 g/day) compared with that for non-fish eaters (P(trend) = 0.04). Correspondingly, lean fish intake tended to be associated positively with type 2 diabetes (RR highest group [>or=23 g/day] 1.30 [95% CI 1.01-1.68]; P(trend) = 0.06), but fatty fish was not. No association was observed between EPA and DHA intake and type 2 diabetes (RR highest group [>or=149.4 mg/day] 1.22 [0.97-1.53]). With additional adjustment for intake of selenium, cholesterol, and vitamin D, this RR decreased to 1.05 (0.80-1.38; P(trend) = 0.77).


CONCLUSIONS
The findings do not support a beneficial effect of total fish, type of fish, or EPA and DHA intake on the risk of type 2 diabetes. Alternatively, other dietary components, such as selenium, and unmeasured contaminants present in fish might explain our results.
van Woudenbergh
Geertruida J
GJ
Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands. truus.vanwoudenbergh@wur.nl
van Ballegooijen
Adriana J
AJ
Kuijsten
Anneleen
A
Sijbrands
Eric J G
EJ
van Rooij
Frank J A
FJ
Geleijnse
Johanna M
JM
Hofman
Albert
A
Witteman
Jacqueline C M
JC
Feskens
Edith J M
EJ
D000368:Aged; D000818:Animals; D001794:Blood Pressure; D015992:Body Mass Index; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D005399:Fishes; D005518:Food Preferences; D006304:Health Status; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011446:Prospective Studies; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D055105:Waist Circumference
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