BACKGROUND: Data supporting the inverse correlation of fish or long-chain ω-3 fatty acid (FA) (eicosapentaenoic acid plus docosahexaenoic acid) supplement consumption and coronary heart disease are inconclusive and may be confounded by other dietary and lifestyle factors.

RESULTS: Using the Diabetic Control and Complications Trial (DCCT) database (n = 1,441), correlations between consumption of ω-3 FAs and saturated FAs to dietary variables (kilocalories, macronutrients, sodium, and cholesterol) and to age, gender, exercise level, and tobacco use were tested using Pearson correlation coefficients. Long-chain ω-3 FA intake inversely correlated with consumption of calories (r = −0.16, p <0.0001), percent calories from total fat (r = −0.14, p <0.0001), and percent calories from saturated FAs (r = −0.21, p <0.0001) and directly with dietary fiber intake (grams per 1,000 kcal, r = 0.20, p <0.0001).

CONCLUSION: In the DCCT database, long-chain ω-3 FAs (i.e., fish consumption) inversely correlated with an overall low risk nutritional profile for coronary heart disease. In conclusion, these findings provide evidence that associations observed in studies suggesting a benefit of fish or long-chain ω-3 FAs may be due to a convergence of greater fish intakes with an overall healthier dietary pattern rather than with a specific effect of long-chain ω-3 FAs.