CLINICAL RESEARCH: DIET AND CARDIOVASCULAR DISEASE
Fish,  -3 Polyunsaturated Fatty Acids, and Mortality From Cardiovascular Diseases in a Nationwide Community-Based Cohort of Japanese Men and WomenThe JACC (Japan Collaborative Cohort Study for Evaluation of Cancer Risk) Study
Kazumasa Yamagishi, MD, PhD*, ,
Hiroyasu Iso, MD, PhD, MPH ,*,
Chigusa Date, PhD ,
Mitsuru Fukui, PhD||,
Kenji Wakai, MD, PhD¶,
Shogo Kikuchi, MD, PhD#,
Yutaka Inaba, MD, PhD**,
Naohito Tanabe, MD, PhD,
Akiko Tamakoshi, MD, PhD# for the JACC Study Group
* Department of Public Health Medicine, Graduate School of Comprehensive Human Sciences, and Institute of Community Medicine, University of Tsukuba, Tsukuba, Japan
Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Suita, Japan
Department of Food Sciences and Nutrition, Nara Women's University, Nara, Japan
|| Laboratory of Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan
¶ Department of Preventive Medicine/Biostatistics and Medical Decision Making, Nagoya University Graduate School of Medicine, Nagoya, Japan
# Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Japan
** Division of Public Health, Jissen Women's University, Hino, Japan
Division of Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
Manuscript received January 5, 2008;
revised manuscript received June 11, 2008,
accepted June 14, 2008.
* Reprint requests and correspondence: Dr. Hiroyasu Iso, Public Health, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871 Suita, Japan (Email: iso{at}pbhel.med.osaka-u.ac.jp).
Objectives: The objective of our study was to test the hypothesis that fish or  -3 polyunsaturated fatty acids (PUFA) intakes would be inversely associated with risks of mortality from ischemic heart disease, cardiac arrest, heart failure, stroke, and total cardiovascular disease.
Background: Data on associations of dietary intake of fish and of -3 PUFA with risk of cardiovascular disease among Asian societies have been limited.
Methods: We conducted a prospective study consisting of 57,972 Japanese men and women. Dietary intakes of fish and -3 PUFA were determined by food frequency questionnaire, and participants were followed up for 12.7 years. Hazard ratios and 95% confidence intervals were calculated according to quintiles of fish or -3 PUFA intake.
Results: We observed generally inverse associations of fish and -3 PUFA intakes with risks of mortality from heart failure (multivariable hazard ratio [95% confidence interval] for highest versus lowest quintiles = 0.76 [0.53 to 1.09] for fish and 0.58 [0.36 to 0.93] for -3 PUFA). Associations with ischemic heart disease or myocardial infarction were relatively weak and not statistically significant after adjustment for potential risk factors. Neither fish nor -3 PUFA dietary intake was associated with mortality from total stroke, its subtypes, or cardiac arrest. For mortality from total cardiovascular disease, intakes of fish and -3 PUFA were associated with 18% to 19% lower risk.
Conclusions: We found an inverse association between fish and -3 PUFA dietary intakes and cardiovascular mortality, especially for heart failure, suggesting a protective effect of fish intake on cardiovascular diseases.
Key Words: epidemiology • nutrition • diet • prospective study • population
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Abbreviations and Acronyms
| | CI = confidence interval | | HR = hazard ratio | | IHD = ischemic heart disease | | PUFA = polyunsaturated fatty acids |
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