A systematic review including 11 cohort studies with a total of 116 764 subjects was abstracted in DARE. In the 4 high-quality studies, the two largest were performed in populations at low risk of coronary heart disease. They found no protective effect of fish consumption. The other two high-quality studies were relatively small and included individuals at higher risk. They both found an inverse relationship between fish consumption and coronary hear disease death, suggesting that 40-60 g fish per day is optimal and associated with a risk reduction of 40-60 percent.