Macro partitioning
High intake of omega-3 fatty acids from fish is positively associated with an increased risk of coronary death in middle-aged male smokers, contradicting the common hypothesis that fish consumption is protective.
For middle-aged male smokers in Finland, high intake of omega-3 fatty acids from fish was associated with an increased risk of coronary death, contrary to general advice. This may be due to high mercury levels in local freshwater fish. Smokers should be aware that the source of fish (seawater vs. freshwater) and potential mercury exposure might negate the perceived benefits of omega-3s.
The intake of omega-3 fatty acids from fish was also directly related to the risk of coronary death in the multivariate model adjusting also for trans-saturated and c/s-monounsaturated fatty acids (relative risk (RR) = 1.30, 95% CI 1.01-1.67) (p for trend = 0.06 for men in the highest quintile of intake compared with the lowest).
Why this rating
Observational study with potential for residual confounding (e.g., mercury exposure mentioned in discussion) and measurement error in dietary assessment of fish intake.
Source
Intake of Fatty Acids and Risk of Coronary Heart Disease in a Cohort of Finnish Men: The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study
P Pietinen et al. · American Journal of Epidemiology · 1997
DOI 10.1093/oxfordjournals.aje.a009047
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