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Fish also good for diabetics: confirming conventional wisdom
One of the marks of good science is that we don't assume. I've said many times, both here at and in lectures that I have given to health professionals worldwide, that while in Algebra if A = B and B = C, then A = C, this is not true in medicine.

Omega-3 supplements may not guard against heart attack
It's a tenet of today's nutrition advice, like eating whole grains or choosing lean meat: omega-3 fatty acids, found in fatty fish as well as plant sources like walnuts, flaxseeds, canola oil, and kidney beans, are good for your heart and have been shown to prevent heart disease.

Mediterranean Diet and Heart Disease
A recent study published in Nutrition, Metabolism & Cardiovascular Diseases looks at the effects of the Mediterranean Diet as a whole and its effects on the rates of heart disease and stroke in middle-aged adults.

Just Tell Me What to Eat!

The step-by-step guide to a Mediterranean Diet

Just Tell Me What to Eat!

Dr. Tim Harlan's best tips and recipes in a six-week plan for you to learn how to follow a Mediterranean-style diet while still eating foods you know and love. Just $15.00 +s/h!

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Fish for your heart: the state of the evidence

multiple types of fresh, uncooked seafood on ice

A team of researchers recently assessed the quality of the available evidence regarding fish consumption and the risk of chronic diseases by performing what is known as an umbrella review, which essentially an overview of reviews. In this case, the authors identified studies that grouped together multiple smaller studies (these are known as meta-analyses) and synthesized their findings (Adv Nutr 2020;11:1123-1133).

The meta-analyses were all prospective cohort studies - that is, studies in which a group of people are identified at the start of the study and their progress is tracked over time. For their article, the authors identified 34 meta-analyses (298 total studies) that reported on fish consumption and the risk of chronic diseases such as death from any cause, heart disease, stroke, heart attack, type 2 diabetes, and cancers.

Using the data in the articles, the authors were able to standardize the amount of fish consumed and synthesize the results in the meta-analyses while also evaluating the quality of the evidence.

It's not surprising that there were no meta-analyses that the authors rated their evidence quality as High - prospective cohort studies can only show association between (for example) fish and heart disease but can't prove conclusively that eating fish prevents heart disease.

That said, the quality of the evidence was rated as Moderate for heart attack, heart failure, stroke, and all-cause mortality - with every increase of 100 grams of fish consumption per day reducing the risk of these diseases by as much as 25%.

The quality of the evidence with respect to high blood pressure, atrial fibrillation, and type 2 diabetes was considered Low, and of 20 different specific cancer types considered, only the evidence showing a reduction in risk of liver cancer with higher fish consumption was considered Moderate.

One thing this umbrella article does not do is look at the different types of fish. The authors note that while they found no association between overall fish intake and type 2 diabetes, consuming more fatty fish seemed to be protective against type 2 diabetes.

What this means for you

More research is being done all the time into all 9 elements of the Mediterranean Diet - both individually and as a pattern. This umbrella review shows us where more research needs to be done - but it also shows us that fish is good for your heart. Try to eat fish at least twice a week, and mix it up: one day salmon, another day shrimp, the next time something else.

First posted: November 3, 2020