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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.

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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