Eating Fish and Risk of Type 2 Diabetes A population-based, prospective follow-up study

OBJECTIVE — To investigate the relation between total fish, type of fish (lean and fatty), and eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intake and risk of type 2 diabetes in a population-based cohort. RESEARCH DESIGN ANDMETHODS — The analysis included 4,472 Dutch partici-pants aged55 years without diabetes at baseline. Dietary intake was assessed with a semiquan-titative food frequency questionnaire. Hazard ratios (relative risk [RR]) with 95 % CIs were used to examine risk associations adjusted for age, sex, lifestyle, and nutritional factors. RESULTS — After 15 years of follow-up, 463 participants developed type 2 diabetes. Median fish intake, mainly lean fish (81%), was 10 g/day. Total fish intake was associated positively with risk of type 2 diabetes; the RR was 1.32 (95 % CI 1.02–1.70) in the highest total fish group (28 g/day) compared with that for non–fish eaters (Ptrend 0.04). Correspondingly, lean fish intake tended to be associated positively with type 2 diabetes (RR highest group]23 g/day] 1.30 [95% CI 1.01–1.68]; Ptrend 0.06), but fatty fish was not. No association was observed between EPA and DHA intake and type 2 diabetes (RR highest group [149.4 mg/day] 1.22 [0.97–1.53]). With additional adjustment for intake of selenium, cholesterol, and vitamin D, this RR decrease