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.
Division of Human Nutrition, Wageningen University, PO Box 8129, 6700 EV Wageningen, The Netherlands.
S Coosje
SC
Dijkstra
Ingeborg A
IA
Brouwer
Frank J A
FJ
van Rooij
Albert
A
Hofman
Jacqueline C M
JC
Witteman
Johanna M
JM
Geleijnse
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