A pooled analysis of individual participant data of 4 international cohort studies suggested that fish intake of 2 servings weekly is associated with lower risk of major cardiovascular disease (CVD) and mortality among patients with prior CVD. The analysis involved 191 558 participants with a mean age of 54.1 years, 47.9% male. During 9.1 years of follow-up in the biggest cohort with and without CVD, compared with little or no fish intake (≤50 g/month), an intake of 350 g/week or more was not associated with risk of major CVD. By contrast, in the 3 cohorts of patients with vascular disease, the HR for risk of major CVD (HR, 0.84) and total mortality (HR, 0.82) was lowest with intakes of at least 175 g/week (approximately 2 servings/week) compared with 50 g/month or lower, with no further apparent decrease in HR with consumption of 350 g/week or higher. Fish with higher amounts of ω-3 fatty acids were strongly associated with a lower risk of CVD (HR, 0.94; per 5-g increment of intake), whereas other fish were neutral in a cohort of patients with vascular disease. The association between fish intake and each outcome varied by CVD status, with a lower risk found among patients with vascular disease but not in general populations. The findings are consistent with dietary guidelines that recommend fish consumption at least twice a week. Source: https://jamanetwork.com/
