Original article| Volume 56, ISSUE 3, P274-279, March 2003

No inverse association between fish consumption and risk of death from all-causes, and incidence of coronary heart disease in middle-aged, Danish adults


      This study investigate the relation between fish consumption, all-cause mortality, and incidence of coronary heart disease (CHD). A total of 4,513 men and 3,984 women aged 30–70 years, sampled randomly from the population in Copenhagen County, Denmark, with initially examination in 1982–1992 was followed until 2000 for all-cause mortality and until 1997 for first admission to hospital or death from CHD. Information on fish consumption was obtained from a self-administered food-frequency questionnaire. Cox proportional hazard analysis gave no evidence for an inverse association between fish consumption and all-cause mortality or incident CHD after adjustment for confounders. Among subjects with a priory-defined high risk of CHD there was a nonsignificant inverse relation between fish intake and CHD morbidity (Hazard Ratio 1.28 (0.92–1.80) for a consumption of fish of less than two times per month or less compared with once a week), but there was relatively few cases in this subgroup. These data provides no evidence for a protective effect of fish consumption on all-cause mortality or incident CHD in the population as a whole, but it cannot be excluded that frequent consumption of fish benefits those at high risk for CHD.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Clinical Epidemiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Marckmann P
        • Grønbæk M
        Fish consumption and coronary heart disease mortality. A systematic review of prospective studies.
        Eur J Clin Nutr. 1999; 53: 585-590
        • Albert C.M
        • Hennekens C.H
        • O'Donnel C.J
        • Ajani U.A
        • Carey V.J
        • Willett W.C
        • Ruskin J.N
        • Manson J.E
        Fish consumption and risk of sudden cardiac death.
        JAMA. 1998; 279: 23-28
        • Ascherio A
        • Rimm E.B
        • Stampfer M.J
        • Giovannucci E.L
        • Willett W.C
        Dietary intake of marine n-3 fatty aids, fish intake and the risk of coronary disease among men.
        N Engl J Med. 1995; 332: 977-982
        • Daviglus M.L
        • Stamler J
        • Orencia A.J
        • Dyer A.R
        • Liu K
        • Greenland P
        • Walsh M.K
        • Morris D
        • Shekelle R.B
        Fish consumption and the 30-year risk of fatal myocardial infarction.
        N Engl J Med. 1997; 336: 1046-1053
        • Kromhout D
        • Bosschieter E.B
        • De Lezenne Coulander C
        The inverse relation between fish consumption and 20-year mortality from coronary heart disease.
        N Engl J Med. 1985; 312: 1205-1209
        • Dolecek T.A
        • Grandits G
        Dietary polyunsaturated fatty acids and mortality in the multiple risk factor intervention trial (MRFIT).
        World Rev Nutr Diet. 1991; 66: 205-216
        • Kromhout D
        • Feskens E.J.M
        • Bowles Carel H
        The protective effect of a small amount of fish on coronary heart disease mortality in an el-derly population.
        Int J Epidemiol. 1995; 24: 340-345
        • Mann J.I
        • Appleby P.N
        • Key T.J
        • Thorogood M
        Dietary determinants of ischaemic heart disease in health conscious individuals.
        Heart. 1997; 78: 450-455
        • Rodriguez B.L
        • Sharp D.S
        • Abbott R.D
        • Burchfiel C.M
        • Masaki K
        • Chyou P.-H
        • Huang B
        • Yano K
        • Curb J.D
        Fish intake may limit the increase in risk of coronary heart disease morbidity and mortality among heavy smokers.
        The Honolulu Heart Program. Circulation. 1996; 94: 952-956
        • Burr M.L
        • Fehily A.M
        • Gilbert J.F
        • Holliday R.M
        • Elwood P.C
        • Rogers S
        • Sweetnam P.M
        • Deadman N.M
        Effects of changes in fat, fish and fibre intakes on death and myocardial reinfarction.
        Lancet. 1989; ii: 757-761
        • Gillum R.F
        • Mussolini M
        • Madams J.H
        The relation between fish consumption, death from all causes, and incidence of coronary heart disease.
        J Clin Epidemiol. 2000; 53: 237-244
        • Oomen Cm Feskens E.J
        • Räsänen L
        • Fidanza F
        • Nissinen A.M
        • Menotti A
        • Kok F.J
        • Kromhout D
        Fish consumption and corornary heart disease mortality in Finland, Italy and the Netherlands.
        Am J Epidemiol. 2000; 151: 999-1006
        • Hu F.B
        • Bronner F
        • Willett W.C
        • Stampfer M.J
        • Rexrode M
        • Albert M
        • Hunter Manson J.E
        Fish and omega-3 fatty acid intake and risk of coronary heart disease in women.
        JAMA. 2002; 287: 1815-1817
        • Salonen J.T
        • Seppänen K
        • Nyyssönen K
        • Korpela H
        • Kauhanen J
        • Kantola M
        • Tuomilehto J
        • Esterbauer H
        • Tatzber F
        • Salonen R
        Intake of mercury from fish, lipid peroxidation, and the risk of myocardial infarction and coronary, cardiovascular, and any death in eastern finnish men.
        Circulation. 1995; 91: 645-655
        • Gerdes L.U
        • Brønnum-Hansen H
        • Madsen M
        • Borch-Johnsen K
        • Jørgensen T
        • Sjøl A
        • Schroll M
        Trends in selected biological risk factors for cardiovascular disease in the Danish MONICA population, 1982–92.
        J Clin Epidemiol. 2000; 53: 427-434
        • Osler M
        • Heitmann B.L
        The validity of a short food frequency and its ability to measue changes in food intake.
        Int J Epidemiol. 1996; 25: 1023-1030
        • GISSI-Prevenzione Investigators
        Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction.
        Lancet. 1999; 354: 447-455