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Cod piece: evidence-based eating

In the USA there are about 250,000 sudden cardiac deaths each year, and in over half the cases there was no prior history of heart disease. Only 30% of people with cardiac arrest who reach hospital will be discharged alive. A paper suggests that eating one portion of fish a week reduces the risk of sudden cardiac death substantially [1].

Friday is fish

As part of the Physicians' Health Study male US physicians aged 40 to 84 years in 1982 were studied. Twelve months into the study they filled out detailed questionnaires on how often they ate fish, and of what type. They were then followed up to the end of 1995. Sudden death was defined as death within one hour of symptom onset, a witnessed cardiac arrest, or both, or abrupt collapse not preceded by more than one hour of symptoms that precipitated the terminal event.


There were 20,551 men with eligible data of whom 3% ate fish rarely or never and 11% ate fish more than five times a week. Compared with those who ate fish rarely, eating fish at least once a week reduced the risk of sudden cardiac death by 52% (95% CI 4% to 76%). There was no effect on myocardial infarction or other cardiac endpoint.

Pick the bone out of this

Fish consumption may not reduce heart attacks, but it can improve the chance of surviving one substantially. It doesn't matter what sort of fish, and eating more than one portion a week confers no extra benefit. The mechanism, hypothetically, is some anti-arrhythmic effect of fish fatty acids.


  1. CM Albert, CH Hennekens, CJ O'Donnell et al. Fish consumption and risk of sudden cardiac death. JAMA 1998 279: 23-8.

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