Consumption of Forage Fish Could Improve Mortality from Ischemic Heart Disease Globally

by | May 7, 2024 | 2024, Cardiovascular Health, Recent Articles

Written by Chrystal Moulton, Science Writer. Partially replacing red meat consumption with forage fish mainly decreases projected deaths caused by ischemic heart disease.

cardiovascular healthIn 2019, non-communicable diseases accounted for approximately 70% of deaths globally1. Four diseases in particular stood out in the data; diabetes, stroke, colorectal cancer and ischemic heart disease accounted for 44% of deaths with a ischemic heart disease as a leading cause globally. Previous studies attribute consumption of red meat to increased occurrence of non-communicable diseases2,3. The possible solution is partial or complete substitution of red meat consumption with seafood. In particular, forage fish such as herrings, sardines, and anchovies (including salmon but not including lake fish or inland species) could be a viable substitute for red meat. Furthermore, seafood contains DHA, EPA, and other essential micronutrients. In the current study, researchers explored the extent to which forage fish could provide national and global health benefits if used in substitution for red meat4.

To estimate the availability of forage fish as a substitution for red meat by the year 2050, researchers used historical forage fish catch data between 1980-2018. Researchers safely assumed data from that date range could be used to estimate availability of forage fish by 2050. Live catch data was then converted into energy (KCAL) based on USDA data to determine consumption required for meat substitution. From the Food and Agriculture Organization (FAO) of the United Nations researchers estimated fish supply and red meat supply for each country in 2050. The FAO data already provides food projections based on three different scenarios: business as usual, towards sustainability, and stratified societies. Information in the business-as-usual scenario was used as the reference scenario in the current trial. Researchers also categorized red meat into two groups: ruminants (beef and veal, sheep and goat) and non-ruminants (pigmeat). Since forage fish is usually used to feed farm raised salmon and other highly sought after fish species in 1st world countries, researchers converted waste percentages of both fish and red meat to understand the edible proportion that could contribute to energy consumption. Researchers then created 4 scenario models of red meat substitution globally:

  • Scenario 1: Forage fish caught to support local needs. In this scenario, local catch is calculated as a possible substitute for local red meat consumption in a particular country.
  • Scenario 2: substitution with forage fish is prioritized in countries with ruminant consumption above 15 KCAL.
  • Scenario 3: prioritize countries with low fish consumption (below 40 KCAL) for forage fish substitution
  • Scenario 4: calculate forage fish substitution based on red meat consumption on a country specific level. In other words, higher forage fish substitution in countries with high red meat consumption and low forage fish substitution in countries with low red meat consumption.

Population-attributable fractions based on risk, disease, and serving size was calculated to determine health impact of each scenario. Researchers calculated the mortality risk of ischemic heart disease, colorectal cancer, diabetes, and stroke and disability adjusted life years (DALYs) based on the Institute for Health Metrics and Evaluation projections [IHME]. Disease-specific mortality data was also captured from another study for all countries where data was provided between 2020 -21005.

Results from the analysis showed that approximately 3.0×1013 KCAL of forage fish would be available as a substitute for red meat in 2050. However, the total meat consumption in 137 countries projected by the food and agricultural organization was 3.8×1014 kcal. Thus, in 2050 forage fish could only replace 8% of global meat consumption. When comparing against the reference scenario, partially replacing red meat consumption with forage fish mainly decreases projected deaths caused by ischemic heart disease. In scenario one, locally caught forage fish when consumed domestically would reduce ischemic heart disease mortality by more than 30% in countries such as Namibia and Norway. This was also observed in scenario 2 for countries like Mongolia, Argentina Brazil, and other Central Asian and Oceanian countries. Interestingly, in scenario 2, researchers found that in Argentina, Turkmenistan, and Mongolia substitution of red meat with forage fish projected a higher percentage of deaths from diabetes (12- 15%) and colorectal cancer (16- 21%) compared to other countries in the same scenario. In scenario 3 and 4, substitution with forage fish was projected to reduce occurrence of death by less than 20%. As for disability adjusted life years [DALYs], the analysis showed that approximately 90% avoidance of death and disability was attributed to reduction in ischemic heart disease. Stroke and diabetes only contributed 4% to the avoidance of death and DALYs while colorectal cancer contributed 2%. Overall, total deaths avoided between scenario 1 and scenario 3 ranged from 500,000 to 750,000 deaths. Scenario 3 had the most avoided deaths. When analyzing data in the US, researchers proposed that using forage fish as an alternative while reducing red meat consumption could double the number of deaths that could be averted. This is because the EPA and DHA content of forage fish caught in the US is lower compared to other countries like Russia.

In total, the analysis demonstrated that forage fish, when used for direct human consumption, would bring significant benefits to reducing the occurrence of death from ischemic heart disease globally by 2050. By 2050, this change would also potentially reduce total deaths from stroke, colorectal cancer, diabetes, and ischemic heart disease by 2%.

Source: Xia, Shujuan, Jun’ya Takakura, Kazuaki Tsuchiya, Chaeyeon Park, Ryan F. Heneghan, and Kiyoshi Takahashi. “Unlocking the potential of forage fish to reduce the global burden of disease.” BMJ Global Health 9, no. 3 (2024): e013511.

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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Posted May 7, 2024.

Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.

References:

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  2. Micha R, Wallace SK, Mozaffarian D. Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. Circulation. Jun 1 2010;121(21):2271-83. doi:10.1161/circulationaha.109.924977
  3. Bellavia A, Stilling F, Wolk A. High red meat intake and all-cause cardiovascular and cancer mortality: is the risk modified by fruit and vegetable intake? Am J Clin Nutr. Oct 2016;104(4):1137-1143. doi:10.3945/ajcn.116.135335
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