Angling for health: Which fish should you eat?

It’s a rare area of agreement among physicians and nutritionists: Nearly all say that eating fish is good for your health. The major benefit is protection against ventricular arrhythmias, disturbances in the heart’s pumping rhythm that can cause sudden death. People at the highest risk — particularly men with coronary artery disease — get the greatest benefit. Although the evidence is less compelling, eating fish also appears to reduce the risk of nonfatal heart attacks, strokes, atrial fibrillation, and mental decline in old age. According to a 2004 meta-analysis of 11 studies that tracked a total of 222,364 people for an average of 11.8 years, the benefit is substantial, and it increases with increased fish consumption (see Table 1). In all, each 20 grams (about 2/3 ounce) of fish daily is associated with a 7% decline in the risk of dying from coronary artery disease. Protection against stroke shows a similar trend (see Table 1). And men may get extra protection, since a diet that includes regular portions of fish appears to reduce the risk of prostate cancer.

What’s so good about fish? The most important ingredients are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the omega-3 fatty acids found only in fish. Indeed, the GISSI study of 11,324 Europeans with coronary artery disease found that a daily fish oil capsule providing 850 mg of EPA and DHA reduces the risk of cardiac death by 20%. And eating fish is even better than taking fish oil. For one thing, fish contains potentially protective nutrients that are not present in fish oil; the list includes selenium, various antioxidants, and protein. In addition, people who eat fish tend to consume less meat and cheese, and they may complement their fish with other healthful foods like vegetables and brown rice.