title: A restricted cubic spline approach to assess the association between high fat fish intake and red blood cell EPA + DHA content.
abstract: OBJECTIVE
  Fish, especially fatty fish, are the main contributor to eicosapentaenoic (EPA) and docosahexaenoic (DHA) intake. EPA and DHA concentrations in red blood cells (RBC) has been proposed as a cardiovascular risk factor, with <4% and >8% associated with the lowest and greatest protection, respectively. The relationship between high fat fish (HFF) intake and RBC EPA + DHA content has been little investigated on a wide range of fish intake, and may be non-linear. We aimed to study the shape of this relationship among high seafood consumers.
  
  
  RESULTS
  Seafood consumption records and blood were collected from 384 French heavy seafood consumers and EPA and DHA were measured in RBC. A multivariate linear regression was performed using restricted cubic splines to consider potential non-linear associations. Thirty-six percent of subjects had an RBC EPA + DHA content lower than 4% and only 5% exceeded 8%. HFF consumption was significantly associated with RBC EPA + DHA content (P [overall association] = 0.021) adjusted for sex, tobacco status, study area, socioeconomic status, age, alcohol, other seafood, meat, and meat product intakes. This relationship was non-linear: for intakes higher than 200 g/wk, EPA + DHA content tended to stagnate. Tobacco status and fish contaminants were negatively associated with RBC EPA + DHA content.
  
  
  CONCLUSIONS
  Because of the saturation for high intakes, and accounting for the concern with exposure to trace element contaminants, intake not exceeding 200 g should be considered.
authors.affiliation: AFSSA, French Food Safety Agency, 27 avenue du Général Leclerc, F-94701 Maisons-Alfort, France. veronique.sirot@anses.fr
authors.forename: V
authors.initials: V
authors.lastname: Sirot
authors.forename: C
authors.initials: C
authors.lastname: Dumas
authors.forename: L
authors.initials: L
authors.lastname: Desquilbet
authors.forename: F
authors.initials: F
authors.lastname: Mariotti
authors.forename: P
authors.initials: P
authors.lastname: Legrand
authors.forename: D
authors.initials: D
authors.lastname: Catheline
authors.forename: J-C
authors.initials: JC
authors.lastname: Leblanc
authors.forename: I
authors.initials: I
authors.lastname: Margaritis
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D004281:Docosahexaenoic Acids / Q000097:blood*; D015118:Eicosapentaenoic Acid / Q000097:blood*; D004912:Erythrocytes / Q000737:chemistry*; D005260:Female; D005399:Fishes; D005506:Food Contamination; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D017747:Seafood; D014280:Triglycerides / Q000097:blood
chemical_list: D014280:Triglycerides; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid