Skip to main content
PMC home page
Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2007 Sep 1;98(5):389–394. doi: 10.1007/BF03405425

Fish Consumption Among Pregnant Women in London, Ontario

Associations with Socio-demographic and Health and Lifestyle Factors

Jessica M Sontrop 18,✉, Kathy N Speechley 18,38,48, M Karen Campbell 18,28,38,48,58, William R Avison 18,38,48,68, Susan E Evers 58
PMCID: PMC6976049  PMID: 17985681

Abstract

Background

Intake of fish and omega-3 fatty acids is inversely related to adverse health outcomes; however, these relationships may be confounded by socio-economic status and health behaviours. This study’s purpose was to describe the socio-demographic, health and lifestyle correlates of fish consumption among pregnant women.

Methods

Pregnant women (n=2394) completed a telephone interview between 10–22 weeks’ gestation (London, Ontario, 2002-5) containing questions on socio-demographic, health and lifestyle variables; dietary intake was measured using a 106-item validated food-frequency questionnaire. Unadjusted and adjusted risk ratios were obtained using a modified Poisson regression model.

Results

Infrequent fish consumption, <1/week, was reported by 32% of women. After adjusting for age and education, infrequent fish consumption was associated with education <high school (RR=1.60; 95% CI 1.30-1.96); age (≤21: RR=1.53; 95% CI 1.17–2.02; 22–25: RR=1.41; 95% CI 1.11-1.78; and 26-34: RR=1.39; 95% CI 1.15-1.69); current smoking status (RR=1.20; 95% CI 1.00–1.43); average exercise duration <30 minutes (never: RR=1.22; 95% CI 1.06-1.39 and 1–29 minutes: RR=1.25; 95% CI 1.08- 1.45); obesity (RR=1.19; 95% CI 1.01–1.41); and not meeting Canadian dietary guidelines for consumption of vegetables and fruit (RR=1.60; 95% CI 1.42–1.79), milk products (RR=1.19; 95% CI 1.05–1.36), and meat and alternatives (RR=1.89; 95% CI 1.69-2.12). Compared to frequent fish consumers, infrequent fish consumers were less likely to be moderate drinkers prior to pregnancy (RR=0.85; 95% CI 0.75-0.96).

Conclusion

Infrequent fish consumption was associated with lower socio-economic status and variables indicative of a less healthy lifestyle; these variables may act as confounders in studies evaluating fish consumption and health outcomes.

MeSH terms: Confounding factors (epidemiology), diet, fatty acids, omega-3, fishes, Pregnancy

Footnotes

Acknowledgements: The authors are grateful to Dr. Guangyong Zou for his assistance with the statistical analysis. This study was supported by a grant from the Canadian Institute of Health Research and Jessica Sontrop was supported by an Ontario Graduate Scholarship in Science and Technology.

References

  • 1.Connor WE. Importance of n-3 fatty acids in health and disease. Am J Clin Nutr. 2000;71(1Suppl):171S–175S. doi: 10.1093/ajcn/71.1.171S. [DOI] [PubMed] [Google Scholar]
  • 2.Raza Shaikh S, Edidin M. Polyunsaturated fatty acids, membrane organization, T cells, and antigen presentation. Am J Clin Nutr. 2006;84:1277–89. doi: 10.1093/ajcn/84.6.1277. [DOI] [PubMed] [Google Scholar]
  • 3.Kris-Etherton PM, Harris WS, Appel LJ, for the Nutrition Committee. Fish Consumption, Fish Oil, Omega-3 Fatty Acids,Cardiovascular Disease Circulation. 2002;106(21):2747–57. doi: 10.1161/01.CIR.0000038493.65177.94. [DOI] [PubMed] [Google Scholar]
  • 4.He K, Rimm EB, Merchant A, Rosner BA, Stampfer MJ, Willett WC, Ascherio A. Fish consumption and risk of stroke in men. JAMA. 2002;288(24):3130–36. doi: 10.1001/jama.288.24.3130. [DOI] [PubMed] [Google Scholar]
  • 5.He K, Song Y, Daviglus ML, Liu K, Van Horn L, Dyer AR, et al. Fish consumption and incidence of stroke: A meta-analysis of cohort studies. Stroke. 2004;35(7):1538–42. doi: 10.1161/01.STR.0000130856.31468.47. [DOI] [PubMed] [Google Scholar]
  • 6.Mozaffarian D, Longstreth WT, Jr., Lemaitre RN, Manolio TA, Kuller LH, Burke GL, Siscovick DS. Fish consumption and stroke risk in elderly individuals: The cardiovascular health study. Arch Intern Med. 2005;165(2):200–6. doi: 10.1001/archinte.165.2.200. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 7.Hodge L, Salome CM, Peat JK, Haby MM, Xuan W, Woolcock AJ. Consumption of oily fish and childhood asthma risk. Med J Aust. 1996;164(3):137–40. doi: 10.5694/j.1326-5377.1996.tb122010.x. [DOI] [PubMed] [Google Scholar]
  • 8.Terry P, Lichtenstein P, Feychting M, Ahlbom A, Wolk A. Lancet. 2001. Fatty fish consumption and risk of prostate cancer; pp. 1764–66. [DOI] [PubMed] [Google Scholar]
  • 9.Leitzmann MF, Stampfer MJ, Michaud DS, Augustsson K, Colditz GC, Willett WC, Giovannucci EL. Dietary intake of n-3 and n-6 fatty acids and the risk of prostate cancer. Am J Clin Nutr. 2004;80(1):204–16. doi: 10.1093/ajcn/80.1.204. [DOI] [PubMed] [Google Scholar]
  • 10.Augustsson K, Michaud DS, Rimm EB, Leitzmann MF, Stampfer MJ, Willett WC, Giovannucci E. A prospective study of intake of fish and marine fatty acids and prostate cancer. Cancer Epidemiol Biomarkers Prev. 2003;12(1):64–67. [PubMed] [Google Scholar]
  • 11.Fernandez E, Chatenoud L, La Vecchia C, Negri E, Franceschi S. Fish consumption and cancer risk. Am J Clin Nutr. 1999;70(1):85–90. doi: 10.1093/ajcn/70.1.85. [DOI] [PubMed] [Google Scholar]
  • 12.Kato I, Akhmedkhanov A, Koenig K, Toniolo PG, Shore RE, Riboli E. Prospective study of diet and female colorectal cancer: The New York University Women’s Health Study. Nutr Cancer. 1997;28(3):276–81. doi: 10.1080/01635589709514588. [DOI] [PubMed] [Google Scholar]
  • 13.Sontrop J, Campbell MK. Omega-3 polyunsaturated fatty acids and depression: A review of the evidence and a methodological critique. Prev Med. 2006;42(1):4–13. doi: 10.1016/j.ypmed.2005.11.005. [DOI] [PubMed] [Google Scholar]
  • 14.Green P, Hermesh H, Monselise A, Marom S, Presburger G, Weizman A. Red cell membrane omega-3 fatty acids are decreased in nondepressed patients with social anxiety disorder. Eur Neuropsychopharmacol. 2006;16(2):107–13. doi: 10.1016/j.euroneuro.2005.07.005. [DOI] [PubMed] [Google Scholar]
  • 15.Eur J Clin Nutr. 2004.
  • 16.Morris MC, Evans DA, Bienias JL, Tangney CC, Bennett DA, Wilson RS, et al. Consumption of fish and n-3 fatty acids and risk of incident Alzheimer disease. Arch Neurol. 2003;60(7):940–46. doi: 10.1001/archneur.60.7.940. [DOI] [PubMed] [Google Scholar]
  • 17.Kalmijn S, Launer LJ, Ott A, Witteman JC, Hofman A, Breteler MM. Dietary fat intake and the risk of incident dementia in the Rotterdam Study. Ann Neurol. 1997;42(5):776–82. doi: 10.1002/ana.410420514. [DOI] [PubMed] [Google Scholar]
  • 18.Morris MC, Evans DA, Tangney CC, Bienias JL, Wilson RS. Fish consumption and cognitive decline with age in a large community study. Arch Neurol. 2005;62:1–5. doi: 10.1001/archneur.62.12.noc50161. [DOI] [PubMed] [Google Scholar]
  • 19.Heude B, Ducimetiere P, Berr C. Cognitive decline and fatty acid composition of erythrocyte membranes–The EVA Study. Am J Clin Nutr. 2003;77(4):803–8. doi: 10.1093/ajcn/77.4.803. [DOI] [PubMed] [Google Scholar]
  • 20.Williams MA, Zingheim RW, King IB, Zebelman AM. Omega-3 fatty acids in maternal erythrocytes and risk of preeclampsia. Epidemiology. 1995;6(3):232–37. doi: 10.1097/00001648-199505000-00007. [DOI] [PubMed] [Google Scholar]
  • 21.Olsen SF, Secher NJ. Low consumption of seafood in early pregnancy as a risk factor for preterm delivery: Prospective cohort study. BMJ. 2002;324(7335):447. doi: 10.1136/bmj.324.7335.447. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 22.Olsen SF, Hansen HS, Sommer S, Jensen B, Sorensen TI, Secher NJ, Zachariassen P. Gestational age in relation to marine n-3 fatty acids in maternal erythrocytes: A study of women in the Faroe Islands and Denmark. Am J Obstet Gynecol. 1991;164(5Pt1):1203–9. doi: 10.1016/0002-9378(91)90683-I. [DOI] [PubMed] [Google Scholar]
  • 23.Oken E, Kleinman KP, Olsen SF, Rich-Edwards JW, Gillman MW. Associations of seafood and elongated n-3 fatty acid intake with fetal growth and length of gestation: Results from a US pregnancy cohort. Am J Epidemiol. 2004;160(8):774–83. doi: 10.1093/aje/kwh282. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 24.Rogers I, Emmett P, Ness A, Golding J. Maternal fish intake in late pregnancy and the frequency of low birth weight and intrauterine growth retardation in a cohort of British infants. J Epidemiol Community Health. 2004;58(6):486–92. doi: 10.1136/jech.2003.013565. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 25.Barberger-Gateau P, Jutand M-A, Letenneur L, Larrieu S, Tavernier B, Berr C. Correlates of regular fish consumption in French elderly community dwellers: Data from the Three-City study. Eur J Clin Nutr. 2005;59:817–25. doi: 10.1038/sj.ejcn.1602145. [DOI] [PubMed] [Google Scholar]
  • 26.Galobardes B, Morabia A, Bernstein MS. Diet and socioeconomic position: Does the use of different indicators matter? Int J Epidemiol. 2001;30(2):334–40. doi: 10.1093/ije/30.2.334. [DOI] [PubMed] [Google Scholar]
  • 27.Johansson LR, Solvoll K, Bjorneboe GE, Drevon CA. Intake of very-long-chain n-3 fatty acids related to social status and lifestyle. Eur J Clin Nutr. 1998;52(10):716–21. doi: 10.1038/sj.ejcn.1600632. [DOI] [PubMed] [Google Scholar]
  • 28.Innis SM, Elias SL. Intakes of essential n-6 and n-3 polyunsaturated fatty acids among pregnant Canadian women. Am J Clin Nutr. 2003;77(2):473–78. doi: 10.1093/ajcn/77.2.473. [DOI] [PubMed] [Google Scholar]
  • 29.Al MD, Badart-Smook A, von Houwelingen AC, Hasaart TH, Hornstra G. Fat intake of women during normal pregnancy: Relationship with maternal and neonatal essential fatty acid status. J Am Coll Nutr. 1996;15(1):49–55. doi: 10.1080/07315724.1996.10718564. [DOI] [PubMed] [Google Scholar]
  • 30.Brown JE, Buzzard IM, Jacobs DR, Jr., Hannan PJ, Kushi LH, Barosso GM, Schmid LA. A food frequency questionnaire can detect pregnancyrelated changes in diet. J Am Diet Assoc. 1996;96(3):262–66. doi: 10.1016/S0002-8223(96)00078-8. [DOI] [PubMed] [Google Scholar]
  • 31.Health Canada. 2005 Canadian Nutrient File. 2005. [Google Scholar]
  • 32.Olsen SF, Hansen HS, Sandstrom B, Jensen B. Erythrocyte levels compared with reported dietary intake of marine n-3 fatty acids in pregnant women. Br J Nutrition. 1994;73:387–95. doi: 10.1079/BJN19950041. [DOI] [PubMed] [Google Scholar]
  • 33.Bonaa KH, Bjerve KS, Nordoy A. Habitual fish consumption, plasma phospholipid fatty acids, and serum lipids: The Tromso study. Am J Clin Nutr. 1992;55(6):1126–34. doi: 10.1093/ajcn/55.6.1126. [DOI] [PubMed] [Google Scholar]
  • 34.Anderson LF, Solvoll K, Drevon CA. Very-longchain n-3 fatty acids as biomarkers for intake of fish and n-3 fatty acid concentrates. Am J Clin Nutr. 1996;64:305–11. doi: 10.1093/ajcn/64.3.305. [DOI] [PubMed] [Google Scholar]
  • 35.Hollingshead AB. Four Factor Index of Social Status. 1975. [Google Scholar]
  • 36.Human ResourcesSkills Development Canada. National Occupation Classification. 2005. [Google Scholar]
  • 37.Health Canada. Canadian Guidelines for Body Weight Classification in Adults. 2006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 38.Health Canada. Canada’s Food Guide to Healthy Eating. 2005. [Google Scholar]
  • 39.Zou G. A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004;159(7):702–6. doi: 10.1093/aje/kwh090. [DOI] [PubMed] [Google Scholar]
  • 40.Davey GK, Spencer EA, Appleby PN, Allen NE, Knox KH, Key TJ. EPIC-Oxford: Lifestyle characteristics and nutrient intakes in a cohort of 33,883 meat-eaters and 31,546 non meat-eaters in the, UK. Public Health Nutr. 2003;6(3):259–69. doi: 10.1079/PHN2002430. [DOI] [PubMed] [Google Scholar]
  • 41.Quatromoni PA, Copenhafer DL, Demissie S, D’Agostino RB, O’Horo CE, Nam BH, Millen BE. The internal validity of a dietary pattern analysis. The Framingham Nutrition Studies. J Epidemiol Community Health. 2002;56(5):381–88. doi: 10.1136/jech.56.5.381. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 42.Fung TT, Rimm EB, Spiegelman D, Rifai N, Tofler GH, Willett WC, Hu FB. Association between dietary patterns and plasma biomarkers of obesity and cardiovascular disease risk. Am J Clin Nutr. 2001;73(1):61–67. doi: 10.1093/ajcn/73.1.61. [DOI] [PubMed] [Google Scholar]
  • 43.Williams DE, Prevost AT, Whichelow MJ, Cox BD, Day NE, Wareham NJ. A cross-sectional study of dietary patterns with glucose intolerance and other features of the metabolic syndrome. Br J Nutr. 2000;83(3):257–66. doi: 10.1017/S0007114500000337. [DOI] [PubMed] [Google Scholar]
  • 44.Fung TT, Willett WC, Stampfer MJ, Manson JE, Hu FB. Dietary patterns and the risk of coronary heart disease in women. Arch Intern Med. 2001;161(15):1857–62. doi: 10.1001/archinte.161.15.1857. [DOI] [PubMed] [Google Scholar]
  • 45.Jacques PF, Tucker KL. Are dietary patterns useful for understanding the role of diet in chronic disease? Am J Clin Nutr. 2001;73(1):1–2. doi: 10.1093/ajcn/73.1.1. [DOI] [PubMed] [Google Scholar]
  • 46.Rifas-Shiman SL, Rich-Edwards JW, Willett WC, Kleinman KP, Oken E, Gillman MW. Changes in dietary intake from the first to the second trimester of pregnancy. Paediatr Perinat Epidemiol. 2006;20(1):35–42. doi: 10.1111/j.1365-3016.2006.00691.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 47.National Marine Fisheries Service. Fisheries of the United States. 2006. [Google Scholar]
  • 48.Welch AA, Lund E, Amiano P, Dorronsoro M, Brustad M, Kumle M, et al. Variability of fish consumption within the 10 European countries participating in the European Investigation into Cancer and Nutrition (EPIC) study. Public Health Nutr. 2002;5(6B):1273–85. doi: 10.1079/PHN2002404. [DOI] [PubMed] [Google Scholar]
  • 49.Flegal KM. Evaluating epidemiologic evidence of the effects of food and nutrient exposures. Am J Clin Nutr. 1999;69(6):1339S–1344S. doi: 10.1093/ajcn/69.6.1339S. [DOI] [PubMed] [Google Scholar]
  • 50.Kelsey J, Whittemore A, Evans A, Thompson W. Methods in Observational Epidemiology. 2nd ed. New York: Oxford University Press; 1996. [Google Scholar]
  • 51.Klebanoff MA, Levine RJ, Morris CD, Hauth JC, Sibai BM, Ben Curet L, et al. Accuracy of self-reported cigarette smoking among pregnant women in the 1990s. Paediatr Perinat Epidemiol. 2001;15(2):140–43. doi: 10.1046/j.1365-3016.2001.00321.x. [DOI] [PubMed] [Google Scholar]
  • 52.Parazzini F, Davoli E, Rabaiotti M, Restelli S, Stramare L, Dindelli M, et al. Validity of selfreported smoking habits in pregnancy: A saliva cotinine analysis. Acta Obstet Gynecol Scand. 1996;75(4):352–54. doi: 10.3109/00016349609033330. [DOI] [PubMed] [Google Scholar]
  • 53.Brunner E, Stallone D, Juneja M, Bingham S, Marmot M. Dietary assessment in Whitehall II: Comparison of 7 d diet diary and food-frequency questionnaire and validity against biomarkers. Br J Nutr. 2001;86(3):405–14. doi: 10.1079/BJN2001414. [DOI] [PubMed] [Google Scholar]
  • 54.Byers T, Marshall J, Fiedler R, Zielezny M, Graham S. Assessing nutrient intake with an abbreviated dietary interview. Am J Epidemiol. 1985;122(1):41–50. doi: 10.1093/oxfordjournals.aje.a114085. [DOI] [PubMed] [Google Scholar]
  • 55.Oken E, Kleinman KP, Berland WE, Simon SR, Rich-Edwards JW, Gillman MW. Decline in fish consumption among pregnant women after a national mercury advisory. Obstet Gynecol. 2003;102(2):346–51. doi: 10.1016/S0029-7844(03)00484-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 56.Craig CL, Cameron C, Bauman A. Socio- Demographic and Lifestyle Correlates of Obesity — Technical Report on the Secondary Analyses Using the 2001–2002 Canadian Community Survey. Ottawa: Canadian Institute for Health Information; 2005. [Google Scholar]
  • 57.Davey Smith G. Health Inequalities. 2003. [Google Scholar]

Articles from Canadian Journal of Public Health = Revue Canadienne de Santé Publique are provided here courtesy of Springer

RESOURCES