Rapid Review Alert December 2, 2010
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ADVANCES
 In EPA & DHA Research
Abstract Details

Objective: To determine if dietary omega-3 fatty acids and fish consumption are associated with increased risk of type 2 diabetes.

Design: This was a prospective study of 36,328 women (mean age: 54.6 y) who participated in the Women's Health Study and who were followed from 1992 to 2008. Incident type 2 diabetes was self-reported and validated primarily through the collection of supplementary information from participants. Information on omega-3 and fish intakes was obtained by using a validated food-frequency questionnaire.

Results: During an average follow-up of 12.4 y, 2370 women developed type 2 diabetes. Marine, but not plant-based omega-3 fatty acids were positively associated with incident type 2 diabetes. From the lowest to highest quintiles of marine omega-3 intake, the multivariable-adjusted hazard ratios (95% CIs) for type 2 diabetes were 1.0 (referent), 1.17 (1.03, 1.33), 1.20 (1.05, 1.38), 1.46 (1.28, 1.66), and 1.44 (1.25, 1.65), respectively (P for trend < 0.0001). A similar association was observed with fish intake, but additional adjustment for docosahexaenoic acid led to the elimination of the association. The relation between marine omega-3 fatty acids and type 2 diabetes was observed in hypertensive and nonhypertensive subjects and in women who reported infrequent fish consumption.

Authors’ Conclusion: Our data suggest an increased risk of type 2 diabetes with the intake of long-chain omega-3 fatty acids, especially with higher intakes (≥0.20 g omega-3/d or ≥2 servings of fish/d). 
Rapid Review Alert
Sudden cardiac death
Omega-3 Fatty Acids and Risk of Type 2 Diabetes
Review of:
Djousse L Gaziano JM Buring JE and Lee IM (27 Oct 2010 Epub ahead of print). Dietary Omega-3 fatty acids and fish consumption and risk of type 2 diabetes. Am J Clin Nutr. doi: 10.3945/ajcn.110.005603 

 

Take-Home Message

  • Observational studies, of which the present study is one, by their very nature fail to establish cause and effect relationships. Thus said, the present study provides no basis for recommending dietary approaches (i.e. reducing long-chain omega-3 fatty acid intake) for the general population to prevent type 2 diabetes.
  • While previous epidemiological studies have reported similar results, until a well-designed, randomized, double-blind, placebo-controlled trial of sufficient duration is conducted, there is no basis to conclude that long-chain omega-3 fatty acid intake increases the risk of type 2 diabetes.
  • Given the demonstrated benefits of long-chain omega-3 fatty acids on multiple risk factors associated with type 2 diabetes, in the absence of credible evidence demonstrating that intake of long-chain omega-3 fatty acids increases the risk of type 2 diabetes, it would be irresponsible to recommend that intake of the long-chain omega-3 fatty acids be reduced.  

Study Limitations (not all-inclusive)
  • Due to the observational nature of the study, there is an increased potential for residual or unmeasured confounding. 
  • Because assessment of dietary omega-3 fatty acids was based on ONLY a single, baseline 128-food-frequency questionnaire, consideration was not given to potential intake changes over time. Fish consumption was obtained through four items on the food-frequency questionnaire. Subjects were asked to report their average consumption over the past year of 1) canned tuna 2) dark-meat fish 3) other fish 4) shrimp, lobster and scallops as a main dish. 
  • There was no consideration given to long-chain omega-3 supplementation. 

Suggested Citation

Global Organization for EPA and DHA Omega-3s (2010). Dietary Omega-3 Fatty Acids and Fish Consumption and Risk of Type 2 Diabetes [Peer commentary on the paper “Dietary Omega-3 Fatty Acids and Fish Consumption and Risk of Type 2 Diabetes” by Djousse L Gaziano JM Buring JE and Lee IM (27 Oct 2010 Epub ahead of print). Am J Clin Nutr. doi: 10.3945/ajcn.110.005603]. 

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