Does eating fish help your heart and your brain?
Two portions of oily fish per week, as part of a varied and plant-rich diet, is a smart choice for most people when it comes to both heart and brain health. However, fish does not work as a standalone protective food.
Oily fish such as salmon, mackerel and tuna appear in many studies as part of a heart-healthy diet. The protective effect is largely due to omega-3 fatty acids. These suppress inflammatory processes, whereas fatty acids from sunflower and corn oil actually promote them1,2.
For the heart, the results are mixed. One analysis shows that 200 mg of omega-3 per day from fish can reduce the risk of sudden cardiac death by around 50%3. A large study with 118,469 participants followed for more than nine years found that people who ate the most fish had 14% fewer cardiovascular events, with fish being one of the most strongly contributing food groups4. However, another study with nearly 30,000 participants followed for nineteen years found NO significant association between eating fish on its own and the risk of heart disease or death5. Fish as a standalone food is therefore not proven to be protective.
The strongest heart-related evidence applies to the Mediterranean diet as a whole, of which fish is a component. Large randomised studies such as PREDIMED, Lyon Heart and CORDIOPREV show that this overall dietary pattern genuinely reduces cardiovascular disease and mortality6,7. Fish eaten as part of a varied, plant-rich diet therefore has the most evidence behind it, not fish as an isolated wonder food.
For the brain, omega-3 is particularly relevant. Brain tissue preferentially absorbs it and requires it for development and maintenance. Deficiencies are linked in multiple studies to cognitive decline in older adults and to sporadic Alzheimer's disease3,2. However, this evidence comes largely from observational studies and animal research. Large human studies demonstrating that eating fish genuinely prevents dementia do not yet exist.
Do pay attention to mercury: large predatory fish such as tuna, swordfish and shark can contain high amounts. For pregnant women this is a real risk, as mercury can harm the brain development of the unborn child2. For most other people, two portions of oily fish per week, preferably smaller species, is safe and likely beneficial.
The evidence consists of observational cohort studies, including one with 118,469 participants and one with approximately 30,000 participants, as well as mechanistic research into omega-3 fatty acids. For the Mediterranean diet as a whole, randomised studies exist (PREDIMED, Lyon Heart, CORDIOPREV), but these concern the overall dietary pattern rather than fish specifically. Large randomised studies linking fish consumption to cognition in humans are still lacking.