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Background:  Higher fish consumption has been reported to be associated with a lower incidence of coronary artery disease (CAD). We hypothesized that higher fish intake may be associated with lower serum low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (L/H) ratios, an atherogenic marker, and healthier lifestyle behaviors. Methods:  This  cross-sectional  study was  conducted  in  2,768  apparently healthy males  receiving no  lipid-modifying therapy and visiting the Health Planning Center of Nihon University Hospital between April and August 2019. Results:  The average number of days of fish intake per week was 2.32  ± 1.31. The L/H ratio decreased significantly as the weekly frequency of fish intake (0-2 days, 3-4 days, or 5-7 days) increased (p  < 0.0001). Multivariable regression analysis after adjustment for age, subject background factors, and cardio-metabolic risk revealed that increased weekly frequency of fish intake was a weak, but significantly independent determinant of a decreased L/H ratio (β = –0.064, p = 0.0008). Furthermore, as the frequency of fish intake per week increased, the proportion of subjects with cigarette smoking decreased (p  = 0.003), the proportion of subjects engaging in habitual aerobic exercises increased (p  < 0.0001), and the sleep duration and alcohol intake of the subjects increased (p  < 0.0001). Conclusions:  These results suggest that a high weekly frequency of fish intake was associated with lower L/H ratios, as well as healthier lifestyle behaviors; thus, it may represent a component of a healthy lifestyle associated with a lower risk of CAD in Japanese males. (HEP. 2020; 47: 507-515.)

Association of Fish Intake with Low-density Lipoprotein Cholesterol/high-density Lipoprotein Cholesterol Ratio in Apparently Healthy Males in Japanese