Association between fish consumption and mortality risk from overall cardiovascular disease and its subtypes: a 20-year prospective cohort analysis by sex.

purposeTo investigate the association between fish consumption and mortality risk related to cardiovascular disease (CVD) and its subtypes among Korean adults by sex.

methodsA total of 110,134 adults were selected from the Ansan-Ansung and Health Examinees cohorts in the Korean Genome and Epidemiology Study. Fish consumption was assessed using a food frequency questionnaire and categorized into four groups: < 2, 2-4, 4-7, and ≥ 7 servings/week. CVD mortality was determined from 2001 to 2021 death records provided by Statistics Korea. Cox proportional hazards regression was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality across fish consumption. Restricted cubic spline regressions were conducted to examine nonlinear dose-response relationships between weekly fish consumption and CVD mortality.

resultsAmong women, higher fish consumption was associated with a lower risk of CVD mortality (≥ 7 servings/week vs. < 2 servings/week: HR 0.76, 95% CI 0.54-1.07, P trend = 0.029). By CVD subtypes, higher fish consumption showed a significant inverse association with the risk of cerebrovascular disease mortality in women. Among men, fish consumption was not significantly associated with mortality risk related to CVD or its subtypes. A significant nonlinear inverse association with overall CVD mortality was observed in women and women with older ages and higher intake of fruits and vegetables showed a stronger association with overall CVD mortality compared to their counterparts.

conclusionsWe found that higher fish consumption is associated with a reduced risk of CVD mortality in Korean women. Sex-specific dietary strategies may be necessary for the effective prevention and management of CVD.