High dietary fish intake reduces the risk of diabetes among individuals with GAD antibodies

Individuals with GAD antibodies are at increased risk of developing LADA. A new study shows that the risk of diabetes is particularly high among those who also have low fish intake. The study includes participants from eight European countries and has recently been published in Diabetes Care. The results support previous findings from the ESTRID Study.

The new study is based on data from EPIC-InterAct, a large multi-center study with information from questionnaires and blood samples for more than 25,000 adults followed for incidence of diabetes between 1991 and 2007. Of these, 2.6% had detectable GAD antibodies at the start of the study, which in itself was associated with 80% increased risk of diabetes. For those who had antibodies and also had low fish consumption or low levels of omega-3 fatty acids from fish in their blood, the risk of diabetes was about 2.5 times higher compared to people without antibodies and with a high intake of fish.

The highest risk of diabetes was seen in individuals with high levels of GAD antibodies and low levels of omega-3 fatty acids; this combination conferred a more than four times increased risk of diabetes compared to individuals without antibodies and with high levels of omega-3 fatty acids.

In a previous publication based on ESTRID, the risk of LADA was about 50% lower among those reporting weekly intake of fatty fish compared to those with less frequent consumption. However, a limitation with this analysis is that it was based on very few LADA cases. Therefore, it is particularly interesting that the new publication provides additional support for a protective effect of fish consumption on the development of autoimmune diabetes, such as LADA. Potential underlying mechanisms include beneficial effects of the omega-3 fatty acids on immune function and inflammation.

First author of the new publication is Josefin Edwall Löfvenborg in the ESTRID Study group. The work is a collaboration with researchers at the universities of Cambridge (U.K.) and Umeå (Sweden).

The publication is available here: Interaction Between GAD65 Antibodies and Dietary Fish Intake or Plasma Phospholipid n-3 Polyunsaturated Fatty Acids on Incident Adult-Onset Diabetes: The EPIC-InterAct Study