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Item #14
Increased
Fish Consumption Lowers Heart Disease Risk for Diabetic Women
Risk
of coronary heart disease declined from 70% for women who consumed
fish 1 to 3 times per month to 38%.
Regular
consumption of fish may significantly reduce the risk of heart disease
in women with diabetes.
Several
studies have shown an inverse association between fish consumption and
coronary heart disease or sudden cardiac death risk in the general
population, the authors explain, but limited information is available
about such a link among diabetic patients.
Dr.
Frank Hu and colleagues from Harvard Medical School in Boston,
Massachusetts used data from 5103 female nurses with type 2 diabetes
in the Nurses' Health Study cohort to examine the association between
the intake of fish and omega-3 fatty acids and the risk of coronary
heart disease and overall mortality.
More
frequent fish consumption was associated with a diminishing risk of
coronary heart disease, the authors report. After adjustment for other
cardiovascular risk factors, the relative risk of coronary heart
disease declined from 70% for women who consumed fish 1 to 3 times per
month to 38% for women who ate fish at least 5 times a week.
The
age-adjusted relative risk of total mortality also fell with
increasing fish intake, the report indicates, to 54% among women
consuming fish at least 5 times a week. Increased intake of omega-3
fatty acids was also associated with a significantly lower risk of
coronary heart disease, the researchers note, especially among those
who were not regular users of aspirin. Total mortality risk also fell
with greater omega-3 fatty acid intake.
This
study supports the American Heart Association recommendation of at
least 2 servings of fish per week for both diabetics and nondiabetics.
"Currently
there are no definitive data on fish oil among diabetics. But based on
existing data," Dr. Hu explained, "fish oil supplement
should be beneficial for diabetics, especially for those with high
triglycerides. Fish oil can substantially lower triglycerides."
"Expert
opinion in the dietary field now favors moderate increases in intakes
of plant-derived alpha-linolenic acid based on epidemiological
evidence of benefit for cardiovascular disease risk reduction,"
writes Dr. Scott Grundy from University of Texas Southwestern Medical
Center at Dallas, Texas in a related editorial. "The same is true
for 'increased fish intake,' which likewise is based on
epidemiological evidence."
"American
Heart Association's recent guideline for using fish-oil supplements
for patients with established coronary heart disease is more
problematic," Dr. Grundy said. "Available evidence is
suggestive of benefit in the immediate post-MI period, but a solid
recommendation cannot be made without more definitive controlled
clinical trials." Circulation
1 April 2003
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