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Background: Fish consumption may prevent or improve metabolic health. The aim of this study was to identify associations between fish consumption, both fatty and lean, and metabolic syndrome and its components., Methods: Associations between fish consumption and metabolic syndrome and its components were studied in a large sample from a Norwegian population (N = 23,907), using cross-sectional data from the Tromsø 4 survey (1994-1995). Metabolic syndrome was defined using the JIS definition, and dietary data was collected using food frequency questionnaires (FFQ). Blood samples were taken for biochemical assessments, and anthropometric and blood pressure measurements were carried out according to standard protocols., Results: In this sample from an adult population (aged 26-70 years, mean age 44 years, SD 11.69, 48 % men), a higher fish consumption (≥1/week) was associated with a healthier lipid profile with increased HDL-C and decreased TG. Participants aged 60-70 years consuming fish once a week or more had significantly lower risk of having MetS, compared to those consuming fish less than once a week (OR 0.64, CI 0.45-0.91). When investigating fatty and lean fish separately, only lean fish consumption was associated with a reduced the risk of having MetS. Participants aged 60-70 years consuming lean fish once a week or more, had lower risk of having MetS compared to those consuming lean fish less than once a week (OR 0.65, CI 0.48-0.87). No association was found for consumption of fatty fish, or for lean fish in the age groups <45 or 45-59 years., Conclusions: These results indicates that fatty and lean fish consumption influences MetS risk differently, possibly also related to age. However, further investigation is needed to establish how various fish consumption may influence MetS and its components, particularly when stratified by fatty and lean fish.

Metabolic syndrome (MetS) has a huge impact on public health, and today lifestyle interventions remain the primary mode for MetS therapy. It is therefore important to elucidate the possible preventive effects of diet and foods, and their MetS-related health implications. To examine how fish consumption affects the development and prevalence of MetS, we systematically reviewed cross-sectional, prospective cohort, and intervention studies conducted among adults (humans) and, reporting consumption of fish or seafood as being related to MetS (prevalence or incidence), where MetS was defined via an established definition. The literature search in PubMed identified 502 citations, and after screening, 49 full-text articles were retrieved and assessed for eligibility. After excluding duplicates and those not meeting the inclusion criteria, seven studies from Croatia, Finland, France, Iceland, Iran, Korea, and US were included. Four studies (one follow-up and three cross-sectional) found associations between fish consumption and MetS (three among men, and one among women), suggesting that fish consumption may prevent or improve metabolic health and have a protective role in MetS prevention. This protective role might be related to gender, and men may benefit more from the consumption of fish. However, lack of controlling for potential confounders may also inflict the results. Additional research is required to further explore fish consumption and its potential role in improving or reversing MetS and its components.