Fishing for a Way to Control Diabetes Damage

Diabetes rates have nearly doubled in the US over the last decade, highlighting the importance of finding new ways to minimize complications of this disease. So for the 24 million Americans living with diabetes, recent research suggesting fish may play a role in reducing diabetes-related kidney damage is welcome news.

A fish tale

These results come out of the European Prospective Investigation of Cancer-Norfolk (EPIC-Norfolk) study, a long-term research effort looking at possible connections between nutrition and chronic diseases such as cancer, diabetes, and heart disease. Researchers analyzed diet information and urine samples from 22,384 men and women living in and around Norfolk, England, of whom 517 had diabetes and 21,867 did not. They looked for relationships between the amounts of fish people reported eating and presence of albuminuria.

Albuminuria is a condition in which albumin and other blood proteins are detected in the urine, and is a sign that the kidneys are not functioning properly. It may indicate the presence of permanent kidney damage, a serious complication of long-term diabetes.

Among the study participants with diabetes, those who reported eating more than 2 servings of fish per week had 78% lower risk of macroalbuminuria compared with people who reported eating less than 1 serving of fish per week. Macroalbuminuria refers to very high levels of albumin and other blood proteins in the urine and may indicate more advanced kidney damage.

While these findings don’t prove cause and effect, they are exciting. Lead study author Chee-Tin Christine Lee noted, “Modification of risk factors through lifestyle interventions to limit the progression of albuminuria may have an impact on subsequent complications, save money, and improve patient well-being.” This study underscores the need for additional research on the possible benefits of fish for people living with diabetes.

Fitting in fish

Along with a healthy body weight and regular exercise, eating a few more fish meals each month may help you keep diabetes complications at bay.

• Choose fatty fish that are rich in healthy omega-3 fats, such as wild-caught salmon (in season), lake trout, tuna, herring, and sardines. If you are pregnant or nursing, ask your doctor how much and what types of fish you can safely eat.

• When buying fish, go for quality. Fresh can be delicious but don’t be afraid to try frozen. Newer quick-freeze technology locks in flavor and nutrients.

• Thaw your fish in the refrigerator, never at room temperature or under running water. Do not refreeze thawed fish.

• If you do opt for fresh fish, give it the smell test. Good quality fish will not smell “fishy.”

• Try broiling, sautéing, steaming, grilling, poaching, or baking your fish instead of deep frying.

• Cook fish about ten minutes per inch of thickness. For example, a two-inch thick fish fillet should be cooked for about 20 minutes.

• Stay away from high-fat additions like butter and oil, instead opting for spices for added flavor. Tarragon, rosemary, thyme, dill, lemon, and curry all make great additions to fish.

(Am J Kidney Dis 2008;52:876—86)

Suzanne Dixon, MPH, MS, RD

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