1. www.pronutritionist.net
Intake of Fish and n-3 Fatty Acids
and Future Risk of Metabolic
Syndrome
Baik I et al. J Am Diet Assoc. 2010;110:1018-
1026
Page 1 Baik I et al. J Am Diet Assoc. 2010;110:1018-1026

2. Page 2
Background
• Intake of fish and omega-3 fatty acids is associated with
decreased cardiovascular morbidity and mortality. In fact, high
intake omega-3 fatty acids and low intake of trans-fat may be
more important than PUFA/SFA intake in terms of CV mortality (
Danaei et al 2009)
• High serum triglycerides and sub-clinic inflammation is hallmark
of metabolic syndrome (MetS)
• Omega-3 fatty acids alleviate inflammation processes and
decrease TG levels in vivo
• Omega-3 fatty acids may have an effect on insulin sensitivity
• Effect of omega-3 fatty acids on incidence of metabolic
syndrome has not been substantially evaluated
www.pronutritionist.netBaik I et al. J Am Diet Assoc. 2010;110:1018-1026

3. Methods
• n=5 015, middle aged and older men and women
• Prospective cohort study (Republic of Korea)
• Length: 4 years
• None had MetS at baseline
• Primary outcome: Incident MetS
• Assessment of fish and omega-3 fat intake:
food frequency questionnaire
3 www.pronutritionist.netBaik I et al. J Am Diet Assoc. 2010;110:1018-1026

4. Results (1/3)
• 3 504 completed the study (drop out rate 28 %)
• 9.5 % had fish less than once a week; 67.2 % had fish
1-4 times a week; 12.6 % had fish 5-6 times a week and
10.7 % had fish daily
• Odds ratio (OR) for incident MetS in multivariate
adjustment in men (vs less than once a week) : 0.82,
0.66, 0.43, respectively for 1-4 times a week, 5-6 times a
week and daily intake (p<0.01 for trend)
• Odds ratio (OR) for incident MetS in multivariate
adjustment in women (vs less than once a week) : 1.13 ,
0.91, 1.26 respectively for 1-4 times a week, 5-6 times a
week and daily intake (p=0.94 for trend)
21.12.144 Baik I et al. J Am Diet Assoc. 2010;110:1018-1026

5. Results (2/3)
• Regarding the estimated omega-3 fat intake the
differences in incident MetS did not become statistically
significant for either sex, even if there was the negative
correlation trend among men
• In men, higher intake of fish was strongly correlated with
higher HDL-cholesterol and lower triglycerides
• Men who had highest intake of fish also consumed more
red meat and fat in total
• Dietary fiber and fat intakes were very low, less than 8
and 49 grams respectively, among all the groups
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6. Results (3/3)
6
( p < 0.01 for trend)
www.pronutritionist.netBaik I et al. J Am Diet Assoc. 2010;110:1018-1026
Odds ratio for MetS among men (lowest
vs highest category of fish intake)
57 %
risk
reduction

7. Discussion
• High fish intake was associated with reduced
incidence of metabolic syndrome. Similar results
have been found by Ruidavets et al. 2007 and
Panagiotakos et al 2007
• Diet followed by Koreans in the study differs
substantially from Western diet, being low in fat
and fiber
• I remains unclear why women did not seem to
benefit from high fish intake. Authors propose that
differences in the intake of fish among the women
were too small to detect effects
• Of interest, in this study those who ate most fish,
also had highest red meat intake. Intake of protein
and carbohydrates was not reported in the study
7 www.pronutritionist.netBaik I et al. J Am Diet Assoc. 2010;110:1018-1026