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 AND METHODS - The analysis included 4,472 Dutch participants aged ≥55 years without diabetes at baseline. Dietary intake was assessed with a semiquantitative 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 decreased to 1.05 (0.80 -1.38; Ptrend= 0.77). CONCLUSIONS - The findings do not support a beneficial effect of total fish, type of fish, or EPA and DHA intake on the risk of type 2 diabetes. Alternatively, other dietary components, such as selenium, and unmeasured contaminants present in fish might explain our results.

dx.doi.org/10.2337/dc09-1042, hdl.handle.net/1765/25426
Diabetes Care
Erasmus MC: University Medical Center Rotterdam

van Woudenbergh, G.J, van Ballegooijen, A.J, Kuijsten, A, Sijbrands, E.J.G, van Rooij, F.J.A, Geleijnse, J.M, … Feskens, E.J.M. (2009). Eating fish and risk of type 2 diabetes: A population-based, prospective follow-up study. Diabetes Care, 32(11), 2021–2026. doi:10.2337/dc09-1042