FISH CONSUMPTION AND MORTALITY FROM ALL CAUSES, ISCHEMIC
HEART DISEASE AND STROKE: AN ECOLOGICAL STUDY
Jianjun Zhang, Satoshi Sasaki, Keiko Amano, Hugo Kesteloot
Chair in Nutritional Epidemiology, School of Public Health, Catholic University of
Leuven, Kapucijnenvoer 35, B-3000 Leuven, Belgium.
Hugo.Kesteloot@med.kuleuven.be
Background: A striking difference exists in all-cause and cardiovascular mortality
and in the amount of fish consumption among populations worldwide.
Objective: The aim of this study was to examine whether there is a significant inverse
relation between fish consumption and mortality from all causes, ischemic heart
disease and stroke at the population level.
Methods: The fish consumption and mortality data in 36 countries were obtained
from FAO and WHO, respectively. The mortality data were age-standardized to 45-74
years and the mean mortality data for the latest available three years, mostly around
1992 or 1993, were analyzed. Since fish consumption and mortality data have a
skewed distribution, they were log-transformed prior to analysis.
Results: There exists an inverse correlation between log fish consumption in 1961-63,
1979-81 and 1989-91 and log all-cause (p<0.01 to p<0.001) and ischemic heart
disease (p<0.05 to p<0.01) mortality rates in both sexes. An inverse correlation
between log fish consumption and log stroke mortality rate was found only for the
period 1961-63 in both sexes (p<0.05). Log fish consumption was independently,
significantly and inversely associated with log all-cause (all p<0.001), ischemic heart
disease (p<0.01 to 0.001) and stroke (p<0.05 to p<0.001) mortality rates in all three
time periods in both sexes, after adjusting for confounding factors. These associations
remained significant even after exclusion of Iceland and Japan, countries with the
highest amount of fish consumption and the lowest all-cause mortality rate.
Conclusions: Fish consumption is associated with a reduced risk from all-cause,
ischemic heart disease and stroke mortality at the population level.
Reference:
Zhang J, S Sasaki, K Amano, H Kesteloot. Fish consumption and mortality from all
causes, ischemic heart disease and stroke: an ecological study. Prev Med 1999; 28:
520-529
Acknowledgement: This study was supported by a grant from the Unilever Chair in
Nutritional Epidemiology.