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The Lancet, Volume 348, Issue 9030, Pages 784 - 788, 21 September 1996
doi:10.1016/S0140-6736(96)01391-8Cite or Link Using DOI




There is evidence that populations with a high intake of fish, and specifically fish oils, are at reduced risk of cardiovascular disease. To explore the effect of fish intake, we compared two groups of Bantu villagers in Tanzania; one group live on the shores of Lake Nyasa and their diet includes large amounts of freshwater fish; the other group live in the nearby hills and have a vegetarian diet.


We carried out a cross-sectional study of 622 fish-consuming villagers and 686 vegetarian villagers. 618 (99·4%) and 645 (94·0%), respectively, agreed to take part. Anthropometric and self-reported medical history data were collected by one local physician and a medical assistant, who also measured blood pressure and took blood samples for measurement of plasma lipids. A dietary questionnaire was administered to 25 families (about 15% of the study population) in each village.


After adjustment for age, sex, and alcohol intake the fish-consuming group had lower mean blood pressure than the vegetarian group (123/72 vs 133/76 mm Hg, p<0·001). The frequencies of definite and borderline hypertension (by WHO criteria) were lower in the fish-consuming than in the vegetarian group (2·8 vs 16·4%; 9·7 vs 22·3%, respectively). Plasma concentrations of total cholesterol (mean 3 53 [SD 1·04] vs 4·10 [1·04] mmol/L), triglycerides (0·92 [0·64] vs 1·31 [0·64] mmol/L), and lipoprotein(a) (201 [213] vs 321 [212] mg/L), were all lower (p<0·001) in the fish-consuming group than in the vegetarian group. The proportions of n-3 polyunsaturated fatty acids in plasma lipids were higher (p<0·0001) in the fish-consuming group than in the vegetarian group (eicosapentaenoic acid 2·3 [13] vs 0·7 [0·2]%; docosapentaenoic acid 11 [0·4] vs 0·6 [0·3]%; docosahexaenoic acid 5·7 [1·6] vs 1·5 [1·1]%).


In these villagers, consumption of freshwater fish (300-600 g daily) was associated with raised plasma concentrations of n-3 polyunsaturated fatty acids, lower blood pressure, and lower plasma lipid concentrations.
a Dipartimento di Medicina Clinica e Sperimentale, Università di Padova, Padova, Italy
b Muhimbili Medical Centre, Dar es Salaam University, Dar es Salaam, Tanzania
c Centro Regionale dell'Aterosclerosi, Venezia
d Istituto de Scienze Farmacologiche, Universita di Milano, Milano, Italy
Corresponding Author Information Correspondence to: Dr Paolo Pauletto, Dipartimento di Medicina Clinica e Specimentale, Università di Padova, 35126, Padova, Italy
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