Eating Fish and Risk of Type 2 Diabetes

A population-based, prospective follow-up study

  1. Geertruida J. van Woudenbergh, MSC1,2,
  2. Adriana J. van Ballegooijen, RD1,
  3. Anneleen Kuijsten, PHD1,
  4. Eric J.G. Sijbrands, MD, PHD3,
  5. Frank J.A. van Rooij, DSC2,
  6. Johanna M. Geleijnse, PHD1,
  7. Albert Hofman, MD, PHD2,
  8. Jacqueline C.M. Witteman, PHD2 and
  9. Edith J.M. Feskens, PHD1
  1. 1Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands;
  2. 2Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, the Netherlands;
  3. 3Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands.
  1. Corresponding author: Geertruida J. van Woudenbergh, truus.vanwoudenbergh{at}wur.nl.

Abstract

OBJECTIVE To investigate the relation between total fish, type of fish (lean and fatty), and eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intake and risk of type 2 diabetes in a population-based cohort.

RESEARCH DESIGN AND METHODS The analysis included 4,472 Dutch participants aged ≥55 years without diabetes at baseline. Dietary intake was assessed with a semiquantitative food frequency questionnaire. Hazard ratios (relative risk [RR]) with 95% CIs were used to examine risk associations adjusted for age, sex, lifestyle, and nutritional factors.

RESULTS After 15 years of follow-up, 463 participants developed type 2 diabetes. Median fish intake, mainly lean fish (81%), was 10 g/day. Total fish intake was associated positively with risk of type 2 diabetes; the RR was 1.32 (95% CI 1.02–1.70) in the highest total fish group (≥28 g/day) compared with that for non–fish eaters (Ptrend = 0.04). Correspondingly, lean fish intake tended to be associated positively with type 2 diabetes (RR highest group ]≥23 g/day] 1.30 [95% CI 1.01–1.68]; Ptrend = 0.06), but fatty fish was not. No association was observed between EPA and DHA intake and type 2 diabetes (RR highest group [≥149.4 mg/day] 1.22 [0.97–1.53]). With additional adjustment for intake of selenium, cholesterol, and vitamin D, this RR decreased to 1.05 (0.80–1.38; Ptrend = 0.77).

CONCLUSIONS The findings do not support a beneficial effect of total fish, type of fish, or EPA and DHA intake on the risk of type 2 diabetes. Alternatively, other dietary components, such as selenium, and unmeasured contaminants present in fish might explain our results.

Footnotes

  • The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Received June 8, 2009.
    • Accepted August 2, 2009.
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  1. Published online before print August 12, 2009, doi: 10.2337/dc09-1042 Diabetes Care November 2009 vol. 32 no. 11 2021-2026
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