Scientific Alert Note

Are consumers with a medical history of cardiovascular disease eating more fish?

This study exemplifies the need for nutrition education and more effective communication about fish, not only to the people facing lifestyle and chronic diseases, but also to the broader public. European consumers are convinced that eating fish is healthy, but particular emphasis should be made on communicating benefits especially from fatty fish consumption. The study has recently been published in BMC Public Health, and constitutes a part of the research in the SEAFOODplus project 2.3 SEA-INFOCOM.

Authors and affiliation: Zuzanna Pieniak and Wim Verbeke, Ghent University, Belgium

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The purpose of this study was to explore the cross-cultural differences in the frequency of fish intake and in motivations for fish consumption between people from households with (CVD+) or without (CVD-) a medical history of cardiovascular disease, using data obtained in five European countries.

The study has built on the data obtained from the cross-sectional consumer survey, which was carried out in November-December 2004 with representative household samples from Belgium, the Netherlands, Denmark, Poland and Spain. The sample consisted of 4,786 respondents, aged 18-84 and who were responsible for food purchasing and cooking in the household.

In Belgium and in Denmark, people from households with a medical history of cardiovascular diseases consumed fish more frequently as compared to people who have not been confronted with CVD personally or in their close family environment. Surprisingly, the consumption of fatty fish, which is the main source of omega-3 PUFA associated with the prevention of cardiovascular diseases, was on the same level for the two groups in all countries except in Belgium. Despite higher use of medical information sources about fish and higher interest in healthy eating among CVD+ respondents, their objective or factual knowledge about fish was on the same level as among respondents from CVD- households. This suggests that lack of knowledge is among the reasons why fatty fish consumption was not more elevated in the CVD+ group. Clearly, fish consumption traditions and habits – rather than a medical history of CVD and preventative motivations – account for differences between the countries, particularly in fatty fish consumption, which is very obvious in the cases of Spain (with a predominantly lean fish consumption) and Poland.

Only in Belgium, CVD+ consumers reported a significantly higher frequency of total and fatty fish intake which is attributed to these consumers’ highest in health involvement, their higher subjective knowledge and more frequent use of medical sources of information. With regard to Danish CVD+ respondents, their higher frequency of total fish consumption might be due to their highest level of subjective and objective knowledge and their higher health involvement. In Poland, higher use of medical information sources about fish and higher interest in healthy eating did not result in a higher frequency of fish consumption. In Spain, the fish consumption frequency is on a very high level, independently of Spanish consumers’ health-related motivations. Clearly, eating (mainly lean) fish is strongly habitual and a part of the traditional diet in Spain.

Although a number of differences between CVD- and CVD+ subjects with respect to their frequency of fish intake are uncovered, the findings suggest that fish consumption traditions and habits – rather than a medical history of CVD – account for large differences between the countries, particularly in fatty fish consumption. This study exemplifies the need for nutrition education and more effective communication about fish, not only to the people facing lifestyle and chronic diseases, but also to the broader public. Consumers are convinced that eating fish is healthy. Particular emphasis should be on communicating benefits from fatty fish consumption, as the results from this study suggest that people might perceive “fatty” in general as negative and therefore may remain quite sceptical about increasing their consumption of fatty fish.

The complete free online access version of this BMC Public Health article is available at: http://www.biomedcentral.com/1471-2458/8/306