Finalists, The Jeremiah and Rose Stamler Research Award for New Investigators Fatty fish consumption and ischemic heart disease mortality in older adults: The Cardiovascular Health Study
OBJECTIVE. To assess whether dietary intake of fatty fish is associated with a reduced risk of ischemic heart disease mortality in older adults. BACKGROUND. Dietary intake of fatty fish has been associated with a reduced risk of fatal ischemic heart disease in middle-aged men and women. This association, however, has not been specifically evaluated in older adults. METHODS. In 3968 men and women ≥ age 65 enrolled in the Cardiovascular Health Study and free of known cardiovascular disease at baseline, dietary intake of fish (fried fish, tuna fish, and other fish) was assessed through a detailed picture-sort food frequency questionnaire. In a subset of 348 persons, dietary intake of tuna and other fish combined (“fatty fish”) correlated with plasma phospholipid levels of combined docosahexaenoic acid (DHA, 22:6 n-3)) and eicosapentaenoic acid (EPA, 20:5 n-3) (r = 0.40, p < 0.001); intake of fried fish did not correlate with plasma phospholipid levels of these long-chain n-3 fatty acids (r = 0.05, p = 0.37). Participants were prospectively followed for a mean period of 6.8 years for death from ischemic heart disease (incident fatal myocardial infarction [MI] plus coronary heart disease death) and nonfatal MI. FINDINGS. Compared to intake of less than one serving of fatty fish per week, intake of at least one serving of fatty fish per week was associated with a 35% lower risk of death from ischemic heart disease (hazard ratio [HR] 0.65; 95% confidence interval [CI] 0.45 to 0.94) but was not associated with a lower risk of nonfatal MI (HR 0.86; 95% CI 0.64 to 1.15), after adjustment for age, gender, diabetes, smoking status, education, and total caloric intake. CONCLUSIONS. These findings suggest that consumption of at least one serving of fatty fish per week is associated with a lower risk of death from ischemic heart disease in persons aged 65 years and older.