CLINICAL RESEARCH: DIET AND HEALTH
Fish Consumption Among Healthy Adults Is Associated With Decreased Levels of Inflammatory Markers Related to Cardiovascular Disease
The ATTICA Study
Antonis Zampelas, PhD*,
Demosthenes B. Panagiotakos, PhD*,*,
Christos Pitsavos, MD, PhD, FACC ,
Undurti N. Das, MD, FAMA ,
Christina Chrysohoou, MD, PhD,
Yannis Skoumas, MD and
Christodoulos Stefanadis, MD, PhD, FACC
* Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
UND Life Sciences, Walpole, Massachusetts
Manuscript received January 14, 2005;
revised manuscript received March 12, 2005,
accepted March 15, 2005.
* Reprint requests and correspondence: Dr. Demosthenes B. Panagiotakos, 46 Paleon Polemiston St., Glyfada, Attica, 166 74, Greece (Email: d.b.panagiotakos{at}usa.net).
OBJECTIVES: The aim of this work was to investigate the association between fish consumption and levels of various inflammatory markers among adults without any evidence of cardiovascular disease.
BACKGROUND: Fish consumption has been associated with reduced risk of coronary heart disease, but the mechanisms have not been well understood or appreciated.
METHODS: The ATTICA study is a cross-sectional survey that enrolled 1,514 men (age 18 to 87 years) and 1,528 women (age 18 to 89 years) from the Attica region, Greece. Of them, 5% of men and 3% of women were excluded due to a history of cardiovascular disease. Among others, C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor (TNF)-alpha, serum amyloid A (SAA), and white blood cells (WBC) were measured, and dietary habits (including fish consumption) were evaluated using a validated food frequency questionnaire.
RESULTS: A total of 88% of men and 91% of women reported fish consumption at least once a month. Compared to non-fish consumers, those who consumed >300 g of fish per week had on average 33% lower CRP, 33% lower IL-6, 21% lower TNF-alpha, 28% lower SAA levels, and 4% lower WBC counts (all p < 0.05). Significant results were also observed when lower quantities (150 to 300 g/week) of fish were consumed. All associations remained significant after various adjustments were made.
CONCLUSIONS: Fish consumption was independently associated with lower inflammatory markers levels, among healthy adults. The strength and consistency of this finding has implications for public health and should be explored further.
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Abbreviations and Acronyms
| | BMI = body mass index | | CAD = coronary artery disease | | CRP = C-reactive protein | | FFQ = food frequency questionnaire | | IL = interleukin | | SAA = serum amyloid A | | TNF = tumor necrosis factor | | WBC = white blood cell |
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