Centering supper around a fish dish at least twice a week might help people with diabetes lower their risk of kidney disease, a study suggests.

In the November issue of the American Journal of Kidney Diseases, British researchers analyzed the records of more than 22,300 middle-aged and older English men and women who were part of a large European cancer study. They wanted to examine the effect of eating fish on kidney disease.

The study subjects had answered questionnaires about their diet habits, including how much fish they ate a week, and had provided urine samples, which were analyzed for the presence of a protein called albumin, an indicator of kidney damage.

The researchers reported that of the 517 study subjects who had diabetes (most of whom had type 2), those who on average ate less than one serving of fish each week were four times more likely to have albumin in their urine than people with diabetes who ate fish twice a week.

"Protein in the urine is one of the earliest signs of kidney disease, a serious complication of diabetes," says study co-author Amanda Adler, an epidemiologist with the Medical Research Council Epidemiology Unit at Addenbrooke's Hospital in Cambridge.

Adler speculates that the nutrient content of fish may affect kidney function and improve blood glucose control. But what kind of fish makes the biggest health splash wasn't determined.

"We didn't ask about the type of fish people ate, but in this bit of England people eat cod, plaice, haddock, canned tuna. Even fish and chips would have been included," she says.

Susan Spratt, assistant professor of medicine in the division of endocrinology at Duke University Medical Center, says it's too early to recommend diet changes based on the findings, noting that cause and effect are hard to determine in this type of epidemiological study. "People who eat fish might have other healthier habits," she says.

To prove fish could be a kidney disease-fighting factor in diabetes, clinical trials would be required in which people with diabetes ate fish and others did not, she says. "But it wouldn't hurt patients to eat more fish," says Spratt, who recommends fish oil to lower triglycerides in her diabetes patients who do not respond to or tolerate other therapies.

For dinner, stick with low-fat broiled and baked recipes, she says.

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