title: Fish consumption and risk of non-gallstone-related acute pancreatitis: a prospective cohort study.
abstract: BACKGROUND
  Epidemiologic data on the role of diet in acute pancreatitis are sparse.
  
  
  OBJECTIVE
  We examined the association of total fish consumption, as well as of consumption of fatty fish and lean fish separately, with risk of non-gallstone-related acute pancreatitis.
  
  
  METHODS
  We used data from 2 prospective cohorts, the Cohort of Swedish Men and the Swedish Mammography Cohort, that included 39,267 men and 32,191 women who were aged 45-84 y at the start of a 13-y follow-up period (1998-2010). Fish consumption was assessed by using a food-frequency questionnaire at baseline, and cases of incident non-gallstone-related acute pancreatitis were identified by linkage to the Swedish National Patient Register. HRs were estimated by using Cox proportional hazard models.
  
  
  RESULTS
  During a total follow-up of 860,176 person-years, 320 cases (209 cases in men and 111 cases in women) of incident non-gallstone-related acute pancreatitis were identified. We observed that total fish consumption ≤2.0-3.0 servings/wk was associated with a significantly decreased risk of the disease (P-nonlinearity = 0.017). In comparison with 0.9 servings/wk, multivariable-adjusted HRs were 0.86 (95% CI: 0.76, 0.96), 0.77 (95% CI: 0.62, 0.96), and 0.85 (95% CI: 0.65, 1.10) for 1.4, 2.4, and 3.5 servings/wk, respectively. In the analysis of fatty fish and lean fish, we observed that the consumption of each subtype had a similarly shaped association with risk of non-gallstone-related acute pancreatitis as that observed for total fish consumption, although neither was significant. Multivariable-adjusted HRs were 0.83 for fatty fish (95% CI: 0.65, 1.04) and 0.87 for lean fish (95% CI: 0.69, 1.11) when 0.6-2.0 servings/wk was compared with ≤0.5 servings/wk.
  
  
  CONCLUSIONS
  Our data suggest that the consumption of total fish (fatty fish and lean fish combined) may be associated with decreased risk of non-gallstone-related acute pancreatitis.
authors.affiliation: From the Unit of Nutritional Epidemiology, Institute of Environmental Medicine (VO, NO, OS-A, and AW) and the Unit of Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery (OS-A), Karolinska Institutet, Stockholm, Sweden.
authors.forename: Viktor
authors.initials: V
authors.lastname: Oskarsson
authors.affiliation: From the Unit of Nutritional Epidemiology, Institute of Environmental Medicine (VO, NO, OS-A, and AW) and the Unit of Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery (OS-A), Karolinska Institutet, Stockholm, Sweden.
authors.forename: Nicola
authors.initials: N
authors.lastname: Orsini
authors.affiliation: From the Unit of Nutritional Epidemiology, Institute of Environmental Medicine (VO, NO, OS-A, and AW) and the Unit of Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery (OS-A), Karolinska Institutet, Stockholm, Sweden.
authors.forename: Omid
authors.initials: O
authors.lastname: Sadr-Azodi
authors.affiliation: From the Unit of Nutritional Epidemiology, Institute of Environmental Medicine (VO, NO, OS-A, and AW) and the Unit of Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery (OS-A), Karolinska Institutet, Stockholm, Sweden.
authors.forename: Alicja
authors.initials: A
authors.lastname: Wolk
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D015331:Cohort Studies; D004041:Dietary Fats / Q000008:administration & dosage* / Q000032:analysis / Q000627:therapeutic use; D005260:Female; D005399:Fishes; D005500:Follow-Up Studies; D055951:Functional Food / Q000032:analysis; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000453:epidemiology / Q000517:prevention & control*; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D017747:Seafood / Q000032:analysis; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
chemical_list: D004041:Dietary Fats
keywords: cohort studies; diet; fatty acids; food; inflammation; pancreas; pancreatitis; prospective studies