Virtanen Jyrki K, Mozaffarian Dariush, Chiuve Stephanie E, Rimm Eric B
Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
Am J Clin Nutr. 2008 Dec;88(6):1618-25. doi: 10.3945/ajcn.2007.25816.
Although fish consumption may reduce specific disease endpoints, such as sudden cardiac death and prostate cancer, the effects of major chronic disease on total burden, reflecting sums of effects on a variety of endpoints and risk pathways, are not well established. Higher n-6 fatty acid consumption has also been hypothesized to reduce the health benefits of n-3 fatty acids in fish.
The aim was to study the associations of fish and n-3 fatty acid consumption with risk of total major chronic disease (cardiovascular disease, cancer, and death) and to determine whether a high n-6 intake modifies the associations.
Lifestyle and other risk factors were assessed every 2 y and diet every 4 y in 40,230 US male health professionals aged 40-75 y and free of major chronic disease at baseline in 1986. During 18 y of follow-up, 9715 major chronic disease events occurred, including 3639 cardiovascular disease events, 4690 cancers, and 1386 deaths from other causes.
After multivariable adjustment, neither fish nor dietary n-3 fatty acid consumption was significantly associated with risk of total major chronic disease. Compared with fish consumption of <1 serving/mo, consumption of 1 serving/wk and of 2-4 servings/wk was associated with a lower risk of total cardiovascular disease of approximately 15%. No significant associations were seen with cancer risk. Higher or lower n-6 fatty acid intake did not significantly modify the results (P for interaction > 0.10).
Modest fish consumption was associated with a lower risk of total cardiovascular disease, consistent with cardiac mortality benefits but not with total cancer or overall major chronic disease; n-6 fatty acid consumption did not influence these relations.
尽管食用鱼类可能降低特定疾病终点风险，如心源性猝死和前列腺癌，但对于主要慢性疾病对总疾病负担的影响（反映对多种终点和风险途径的综合影响）尚未明确。也有假设认为，较高的n-6脂肪酸摄入量会降低鱼类中n-3脂肪酸对健康的益处。
研究鱼类和n-3脂肪酸摄入量与主要慢性疾病（心血管疾病、癌症和死亡）风险之间的关联，并确定高n-6摄入量是否会改变这种关联。
1986年，对40230名年龄在40 - 75岁、基线时无主要慢性疾病的美国男性健康专业人员，每2年评估一次生活方式和其他风险因素，每4年评估一次饮食情况。在18年的随访期间，共发生了9715例主要慢性疾病事件，包括3639例心血管疾病事件、4690例癌症以及1386例其他原因导致的死亡。
经过多变量调整后，鱼类或膳食n-3脂肪酸摄入量与主要慢性疾病总风险均无显著关联。与每月食用鱼类少于1份相比，每周食用1份以及每周食用2 - 4份鱼类与总心血管疾病风险降低约15%相关。未发现与癌症风险存在显著关联。较高或较低的n-6脂肪酸摄入量均未显著改变结果（交互作用P>0.10）。
适度食用鱼类与较低的总心血管疾病风险相关，这与对心脏死亡率有益一致，但与总癌症风险或总体主要慢性疾病无关；n-6脂肪酸摄入量并未影响这些关系。
