Stimulated by the Eskimo experiences, a series of epidemiologic studies from other populations have appeared relating fish content in the diet to cardiovascular morbidity and mortality. Interpretation of these studies has been difficult owing in part to vast differences in quality and techniques of data collection and to marked cultural and genetic disparities in the study populations. However, in an early study, Hirai and colleagues reported that residents of a Japanese fishing village, consuming 2.6 g/day of EPA, had reduced heart attack and stroke rates compared with residents of a nearby dairy farming village who consumed only 0.9 g/day of EPA. itat on
Recently, Kromhout et al reported on an ongoing study of risk factors and certain chronic diseases in the residents of the town of Zutphen, the Netherlands. Data on dietary fish consumption of 852 men was correlated with death from coronary heart disease over 20 years of follow-up. Although an inverse dose-response relationship was observed, the study was constrained by incomplete presentation of data on more than 200 men excluded from analysis and by exclusion of approximately one third of the cardiovascular deaths (who were said to have had evidence of coronary heart disease at entry but whose fish consumption data are not presented). This study does, however, suggest that the addition of modest amounts of fish to a Western diet may reduce the risk of death from coronary heart disease.
Confirmatory evidence emerged from the Western Electric Study in the United States in which the 25-year risk of death from coronary heart disease was 20.5% when no fish was eaten but fell to 18.7% at 1-17 g/day offish, 15.5% at 18-34 g/day, and 13.0% at >35 g/day of fish. In a brief report from Sweden an inverse correlation between fish consumption and mortality from heart disease was also noted. In contrast, the Honolulu Heart Study and a recent study from Tromso, Norway, failed to show such a correlation.