Abstract

Objective: To investigate the relation between total fish, type of fish (lean and fatty), and EPA&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 semi-quantitative food frequency questionnaire. Hazard ratios (RR) with 95% confidence intervals (95% CI) 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/d. 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/d) compared with non-fish eaters (p for trend= 0.04). Correspondingly, lean fish intake tended to be associated positively with type 2 diabetes (RR highest group (≥23 g/d): 1.30 (95% CI 1.01, 1.68), p for trend= 0.06), but fatty fish was not. No association was observed between EPA&DHA intake and type 2 diabetes (RR highest group (≥149.4 mg/d): 1.22 (95% CI 0.97, 1.53)). When additionally adjusted for intake of selenium, cholesterol, and vitamin D this RR decreased to 1.05 (95% CI 0.80, 1.38) (p for trend= 0.77).

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