Intake of very long chain n-3 fatty acids from fish and the incidence of heart failure: the Rotterdam Study.
OBJECTIVE
Evidence is accumulating for a cardioprotective effect of fish or its n-3 fatty acids, eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA). We examined EPA plus DHA and fish intake in relation to incident heart failure in the population-based Rotterdam Study.


RESULTS
The analysis comprised 5299 subjects (41% men, age approximately 68 years) free from heart failure for whom dietary data were available. During 11.4 years of follow-up, 669 subjects developed heart failure. The relative risk (RR) of heart failure in the top vs. bottom quintile of EPA plus DHA intake was 0.89 (95% CI 0.69-1.14), after adjustment for lifestyle and dietary factors. For fish intakes > or = 20 g/day, the RR was 0.96 (0.78-1.18) compared with no fish intake. In sex-specific analysis, a high EPA plus DHA intake tended to be protective in women (RR = 0.75, 0.54-1.04) but not in men (RR = 1.00, 0.73-1.36). An inverse association for EPA plus DHA was also observed in diabetics (RR = 0.58, 0.32-1.06), which was borderline statistically significant.


CONCLUSIONS
Our findings do not support a major role for fish intake in the prevention of heart failure. The potentially protective effect of EPA plus DHA in diabetic patients, however, warrants further investigation.
Dijkstra
S Coosje
SC
Division of Human Nutrition, Wageningen University, PO Box 8129, 6700 EV Wageningen, The Netherlands.
Brouwer
Ingeborg A
IA
van Rooij
Frank J A
FJ
Hofman
Albert
A
Witteman
Jacqueline C M
JC
Geleijnse
Johanna M
JM
D017677:Age Distribution; D000368:Aged; D015331:Cohort Studies; D016001:Confidence Intervals; D004032:Diet; D019587:Dietary Supplements; D004281:Docosahexaenoic Acids / Q000008:administration & dosage*; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage; D005500:Follow-Up Studies; D006333:Heart Failure / Q000178:diet therapy / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011322:Primary Prevention / Q000379:methods; D011336:Probability; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D017747:Seafood; D017678:Sex Distribution; D013997:Time Factors
D015525:Fatty Acids, Omega-3; D005395:Fish Oils; D004281:Docosahexaenoic Acids