Interactive diabetes case 18: A 61-year-old patient with type 2 diabetes and a recent change in diet (medical nutrition therapy) – B1

ANSWER — 

Correct.

Two or more servings of fish (particularly fatty fish) per week are a beneficial and safe element of the diet of patients with diabetes [1,2].

The Nurses' Health Study investigated the effect of fish and long-chain omega-3 fatty acid intake on the risk of coronary heart disease and total mortality in 5103 female nurses with type 2 diabetes but no evidence of cardiovascular disease or cancer at baseline [3]. This study demonstrated that a higher consumption of fish and long-chain omega-3 fatty acids is associated with a lower incidence of coronary heart disease and total mortality among women with diabetes.

The American Diabetes Association (ADA) endorses the benefits of dietary omega-3 fatty acids in diabetes [4]. The position statement "Nutrition Therapy Recommendations for the Management of Adults With Diabetes" states, "As recommended for the general public, an increase in foods containing long-chain omega-3 fatty acids (EPA and DHA) (from fatty fish)… is recommended for individuals with diabetes because of their beneficial effects on lipoproteins, prevention of heart disease, and associations with positive health outcomes in observational studies. The recommendation for the general public to eat fish (particularly fatty fish) at least two times (two servings) per week is also appropriate for people with diabetes" [2].

The evidence from the general population supports the consumption of fish and fish oils for the prevention of cardiovascular disease and sudden death [5-11]. The evidence in support of this statement, the possible mechanisms of the beneficial effects, and the current recommendations of the American Heart Association (AHA) have been reviewed [7,9,11].