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Hu FB, Bronner L, Willett WC, et al. Fish and Omega-3 Fatty Acid Intake and Risk of Coronary Heart Disease in Women. JAMA. 2002;287(14):1815–1821. doi:10.1001/jama.287.14.1815
Author Affiliations: Departments of Nutrition (Drs Hu, Willett, Stampfer, and Hunter) and Epidemiology (Drs Willett, Stampfer, Hunter, and Manson); Harvard School of Public Health, the Channing Laboratory (Drs Hu, Willett, Stampfer, Hunter, and Manson); the Division of Preventive Medicine (Drs Manson, Rexrode, and Albert); Department of Medicine, Brigham and Women's Hospital, and the Cardiology Division (Dr Albert), Massachusetts General Hospital, Harvard Medical School, Boston, Mass; Department of Psychiatry, Duke University Medical Center, Durham, NC (Dr Bronner).
Context Higher consumption of fish and omega-3 fatty acids has been associated
with a lower risk of coronary heart disease (CHD) in men, but limited data
are available regarding women.
Objective To examine the association between fish and long-chain omega-3 fatty
acid consumption and risk of CHD in women.
Design, Setting, and Participants Dietary consumption and follow-up data from 84 688 female nurses
enrolled in the Nurses' Health Study, aged 34 to 59 years and free from cardiovascular
disease and cancer at baseline in 1980, were compared from validated questionnaires
completed in 1980, 1984, 1986, 1990, and 1994.
Main Outcome Measures Incident nonfatal myocardial infarction and CHD deaths.
Results During 16 years of follow-up, there were 1513 incident cases of CHD
(484 CHD deaths and 1029 nonfatal myocardial infarctions). Compared with women
who rarely ate fish (<1 per month), those with a higher intake of fish
had a lower risk of CHD. After adjustment for age, smoking, and other cardiovascular
risk factors, the multivariable relative risks (RRs) of CHD were 0.79 (95%
confidence interval [CI], 0.64-0.97) for fish consumption 1 to 3 times per
month, 0.71 (95% CI, 0.58-0.87) for once per week, 0.69 (95% CI, 0.55-0.88)
for 2 to 4 times per week, and 0.66 (95% CI, 0.50-0.89) for 5 or more times
per week (P for trend = .001). Similarly, women with
a higher intake of omega-3 fatty acids had a lower risk of CHD, with multivariable
RRs of 1.0, 0.93, 0.78, 0.68, and 0.67 (P<.001
for trend) across quintiles of intake. For fish intake and omega-3 fatty acids,
the inverse association appeared to be stronger for CHD deaths (multivariate
RR for fish consumption 5 times per week, 0.55 [95% CI, 0.33-0.90] for CHD
deaths vs 0.73 [0.51-1.04]) than for nonfatal myocardial infarction.
Conclusion Among women, higher consumption of fish and omega-3 fatty acids is associated
with a lower risk of CHD, particularly CHD deaths.
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