Abstract

Objective: To investigate the association between fish and seafood intake and new-onset type 2 diabetes.

Research Design and Methods: Population-based prospective cohort (EPIC-Norfolk) study of men and women aged 40–79 years at baseline (1993–1997). Habitual fish and seafood intake (white fish, oily fish, fried fish, shellfish) was assessed using a semi-quantitative food frequency questionnaire and categorised as <1 or ≥1 portions/week. During a median (IQR) follow-up of 10.2 (9.1–11.2) years, there were 725 incident diabetes cases among 21,984 eligible participants.

Results: Higher total fish intake (≥1 vs. <1 portions/week) was associated with a significantly lower risk of diabetes [odds ratio (OR) 0.75 (95% CI 0.58–0.96)], in analyses adjusted for age, sex, family history of diabetes, education, smoking, physical activity, dietary factors (total energy intake, alcohol intake, plasma vitamin C) and obesity (BMI, waist circumference). White fish and oily fish intake were similarly inversely associated with diabetes risk, but the associations were not significant after adjustment for dietary factors (oily fish) or obesity (white fish). Fried fish was not significantly associated with diabetes risk. Consuming ≥1 portions/week of shellfish was associated with an increased risk of diabetes [OR 1.36 (95% CI 1.02 – 1.81)] in adjusted analyses.

Conclusion: Total, white, and oily fish consumption may be beneficial for reducing risk of diabetes, reinforcing the public health message to consume fish regularly. Greater shellfish intake appears to be associated with an increased risk of diabetes, warranting further investigation into cooking methods and mechanisms.