# Fish Consumption Frequency in the Adult Population in Poland
## 4 Discussion
In our study, the frequency of consumption of sea and freshwater fish did not differ significantly between men and women. In another Polish study, there were also no differences in the frequency of sea fish consumption between 2018 (before the COVID-19 pandemic) and 2022 (after the pandemic) among men or women. [33]  
We found that the frequency of fish consumption was also influenced by educational level and economic status. A higher educational level and economic status were associated with more frequent fish consumption. Fish prices in Poland are generally higher than meat prices. According to Statistics Poland, in 2019-2020, the price of frequently consumed fish (frozen fillets of hake) was 33-38% higher than the price of frequently consumed pork (loin), and 3.4-3.6 times higher than the price of poultry (disemboweled chicken) [36]. A similar relationship related to educational level and economic status and fish consumption was found in a study conducted in the Netherlands in 2007-2013 [37]. With the increase in education or income level, fish consumption also significantly increased. Educational level also had an influence on fish consumption in a study conducted among 25-65-year-old residents of the Subcaprathinian vovodeship in Poland [38]. Higher-education respondents were much more likely to choose fish than those with lower levels of education. Our study showed fish consumption was influenced by the place of residence; urban dwellers consumed it more often. Such a relationship was not observed in the above-mentioned study from the Subcaprathinian vovodeship [38]. In our study, a higher frequency of fish consumption was associated with better health. In addition, among men, a higher frequency of fish consumption was observed among respondents with a lower BMI. Similar relationships were reported in the NHANES 2011-2016 in the USA [31]. A greater seafood intake frequency was associated with healthier body measurements and blood pressure and dietary intake. Frequent consumption of fish is associated with many health benefits. Beneficial effects of fish consumption are observed in cardiovascular diseases. A meta-analysis by [PERSON] et al. [39] confirmed that two servings of fish per week could reduce the cardiovascular risk by approximately 10%. In a cohort study conducted in Japan, it was shown that a higher frequency of fish intake was associated with a lower neutrophil/lymphocyte ratio (NLR), a marker of systemic inflammation, which may be associated with the development of coronary artery disease events [40]. A study in China found that higher fish consumption (300-450 g/week) reduced the risk of total stroke and ischemic stroke compared to consuming less fish [41]. In a Dutch cohort, consumption of at least 1 portion/week of fatty or lean fish reduced the incidence of ischemic stroke [42]. Frequent fish consumption may be particularly important for people suffering from diseases. In an analysis of four cohort studies, a lower risk of cardiovascular disease and total mortality was found with higher fish consumption (at least 175 g/week) among high-risk subjects or those with vascular disease. No such relationship was observed in the general population without vascular disease [43]. However, the way fish is prepared is important. Studies indicate that non-fried fish consumption may be associated with a reduced risk of overall cardiovascular disease and myocardial infarction; however, fried fish consumption may increase the risk of overall cardiovascular disease and myocardial infarction [44]. High consumption of fish may reduce the risk of depression [45; 46]. The anti-inflammatory properties of long-chain omega-3 polyunsaturated fatty acids contained in fish may be important in preventing depression [47]. The PREDIMED-Plus trial showed that even a moderate intake of fatty fish (about 20-30 g/day) was inversely associated with depression prevalence [48]. The effect of fish consumption on reducing the risk of depression may vary depending on gender.