Dried or salted fish consumption and cardiovascular disease.

Dried/salted fish and total cardiovascular disease (CVD).

Data was provided by one Japanese cohort (Takachi R [33]). A significant protective effect against cardiovascular disease risk was found.

**Prospective studies of dried or salted fish and total cardiovascular disease:**
Author	Cohort name	Cases	End point	Relative Risk (RR)
33) Takachi R (2010)	The JPHC Study	2,066	Risk	HR = 0.86 (0.74-0.99; P = 0.04)

Dried/salted fish and coronary heart disease.

Data was provided by 2 Japanese cohorts, which are both of large size. (Non)significant protective effects were found in both cohorts. A significant protective effect in one cohort was found at the level of 43 g of fish intake/day, which approximates 3 servings/week (Takachi R [33]). A significant protective effect among women in the other cohort was found at dried/salted fish consumption ≥ 3 times/week (Iso H [36]). Among men, the protective effect was nonsignificant.

Conclusion: Protective effects were found in 2 cohorts of large size, but these were not always significant. Suggestive evidence was found for a protective effect of dried/salted fish consumption against coronary heart disease (- 26%). This effect was found at consumption ≥ 3 times/week

**Prospective studies of dried or salted fish and coronary heart disease:**
Author	Cohort name	Cases	End point	Relative Risk (RR)
36) Iso H (2007)	The JACC Study	583 men, and 385 women	IHD mortality	Men: HR = 0.81 (0.64-1.03; P = < 0.10). Women: HR = 0.69 (0.51-0.93; P = < 0.05).
33) Takachi R (2010)	The JPHC Study	338	MI risk	HR = 0.66 (0.44-0.98; P = 0.03)
		Total number of cases: 1,306		Average RR = 0.74

Dried/salted fish and stroke.

Data about 4 different cohorts was found. (Non)significant protective effects against stroke mortality were found among men and women in one Japanese cohort (Iso H [36]). No other associations with total stroke were found of high vs low consumption. But in the European cohort, a significantly increased risk of intracerebral hemorrhage was found, though the trend was not significant (Montonen J [13]).

Conclusion: Inconsistent findings were done. Inconclusive evidence was found for an association between dried or salted fish consumption and stroke.

**Prospective studies of dried or salted fish and total stroke:**
Author	Cohort name	Cases	End point	Relative Risk (RR)
36) Iso H (2007)	The JACC Study	1,160 men, and 967 women	Mortality	Men: HR = 0.84 (0.71-0.99; P = < 0.05). Women: HR = 0.84 (0.70-1.01; P = < 0.10).
33) Takachi R (2010)	The JPHC Study	1,745	Risk	HR = 0.90 (0.77-1.06; P = 0.22)
19) Ross RK (1997)	No cohort name defined	245	Mortality	No significant association
13) Montonen J (2009)	The Finnish Mobile Clinic Health Examination Survey	659	Risk	RR = 1.08 (0.86-1.34; P = 0.44)
		Total number of cases: 4,776		Average RR = 0.90

**Prospective studies of dried/salted fish intake and total cardiovascular disease:**
Author	Cohort name	Subjects	Years of follow-up	Cases	End point	Consumption of	Relative Risk (RR)	Adjustments
33) Takachi R (2010)	The JPHC Study	77,500 subjects (35,730 men and 41,770 women) aged 45-74, and without a history of cancer, CHD, or stroke. (Japan)	1995-98 to 2004	2,066	Cardiovascular disease risk	Dried and salted fish (salted fish [salted codfish or atka mackerel or salmon]; himono [dried and salted Japanese horse mackerel];, and shirasuboshi [dried young sardines])	HR = 0.86 (0.74-0.99; P = 0.04) for the highest vs lowest quintile of consumption. Amount specific data (g): 0.5: HR = 1. 6.4: HR = 0.97 (0.85-1.12). 13: HR = 0.84 (0.72-0.97). 23: HR = 0.88 (0.76-1.02). 43: HR = 0.86 (0.74-0.99). Effect modification: Higher consumption was associated with lower risk of CVD among men (data not shown). No significant interaction was found with smoking status, age, cohort (I or II), BMI, or alcohol intake (no data shown).	Sex, age, BMI, smoking status, alcohol, physical activity, and energy, potassium, and calcium.

Prospective studies of dried/salted fish intake and total cardiovascular disease:

Author

Cohort name

Subjects

Years of follow-up

Cases

End point

Consumption of

Relative Risk (RR)

Adjustments

33) Takachi R (2010)

The JPHC Study

77,500 subjects (35,730 men and 41,770 women) aged 45-74, and without a history of cancer, CHD, or stroke.
(Japan)

1995-98 to 2004

2,066

Cardiovascular disease risk

Dried and salted fish (salted fish [salted codfish or atka mackerel or salmon]; himono [dried and salted Japanese horse mackerel];, and shirasuboshi [dried young sardines])

HR = 0.86 (0.74-0.99; P = 0.04) for the highest vs lowest quintile of consumption.

Amount specific data (g):
0.5: HR = 1.
6.4: HR = 0.97 (0.85-1.12).
13: HR = 0.84 (0.72-0.97).
23: HR = 0.88 (0.76-1.02).
43: HR = 0.86 (0.74-0.99).

Effect modification:
Higher consumption was associated with lower risk of CVD among men (data not shown).
No significant interaction was found with smoking status, age, cohort (I or II), BMI, or alcohol intake (no data shown).

Sex, age, BMI, smoking status, alcohol, physical activity, and energy, potassium, and calcium.

Men:

Women:

HR = 0.81 (0.64-1.03; P = < 0.10) for the highest vs lowest tertile of consumption.

Amount specific data (Frequency of intake):
< 1/w: HR = 1.
1-2/w: HR = 0.85 (0.68-1.06).
≥ 3/w: HR = 0.81 (0.64-1.03).

HR = 0.69 (0.51-0.93; P = < 0.05) for the highest vs lowest tertile of consumption.

Amount specific data (Frequency of intake):
< 1/w: HR = 1.
1-2/w: HR = 0.96 (0.74-1.25).
≥ 3/w: HR = 0.69 (0.51-0.93).

Men:

Women:

HR = 0.84 (0.71-0.99; P = < 0.05) for the highest vs lowest tertile of consumption.

Amount specific data (Frequency of intake):
< 1/w: HR = 1.
1-2/w: HR = 0.88 (0.75-1.02; P = < 0.10).
≥ 3/w: HR = 0.84 (0.71-0.99).

HR = 0.84 (0.70-1.01; P = < 0.10) for the highest vs lowest tertile of consumption.

Amount specific data (Frequency of intake):
< 1/w: HR = 1.
1-2/w: HR = 0.97 (0.82-1.15).
≥ 3/w: HR = 0.84 (0.70-1.01).

Total cerebrovascular disease
(659 cases)

Intracerebral haemorrhage
(80 cases)

Thrombosis or embolia
(364 cases)

RR = 1.08 (0.86-1.34; P = 0.44) for the highest vs lowest quartile of consumption.

Amount specific data (g/d):
0: RR = 1.
2: RR = 1.06 (0.86-1.32).
6: RR = 1.08 (0.86-1.34).
21: RR = 1.08 (0.86-1.34).

No significant interaction was found with sex, BMI, serum cholesterol, and hyptertension.

RR = 1.98 (1.02-3.84; P = 0.06) for the highest vs lowest quartile of consumption.

Amount specific data (g/d):
0: RR = 1.
2: RR = 1.47 (0.75-2.88).
6: RR = 1.32 (0.65-2.67).
21: RR = 1.98 (1.02-3.84).

This association was attenuated after adjustment for sodium: RR = 1.70 (0.84-3.43; P = 0.19).

RR = 0.97 (0.72-1.30; P = 0.82) for the highest vs lowest quartile of consumption.

Amount specific data (g/d):
0: RR = 1.
2: RR = 1.09 (0.82-1.45).
6: RR = 1.05 (0.78-1.41).
21: RR = 0.97 (0.72-1.30).

No significant interaction was found with sex, BMI, serum cholesterol, and hyptertension.

Intracerebral haemorrhages stratified by sex:

Men

Women

RR = 2.08 (0.88-4.88) for the highest vs lowest category of consumption.

RR = 1.82 (0.64-5.18) for the highest vs lowest category of consumption.

Intracerebral haemorrhages stratified by BMI:

Below median
(< 26.1)

Median or higher
(≥ 26.1)

RR = 2.81 (1.04-7.59) for the highest vs lowest category of consumption.

RR = 1.49 (0.65-3.41) for the highest vs lowest category of consumption.

Intracerebral haemorrhages stratified by serum cholesterol:

Below median(< 6.9 mmol/l)

Median or higher
(&ge 6.9 mmol/l)

RR = 1.30 (0.46-3.64) for the highest vs lowest category of consumption.

RR = 2.87 (1.12-7.35) for the highest vs lowest category of consumption.

Intracerebral haemorrhages stratified by hypertension:

No hypertension

Hypertension
(systolic blood pressure ≥ 160 mmHg and diastolic ≥ 95 mmHg, or having antihypertensive medication)

RR = 3.16 (1.39-7.20) for the highest vs lowest category of consumption.

RR = 0.42 (0.09-2.05) for the highest vs lowest category of consumption.

Cardiovascular disease & Diet. A systematic review.

Literature review.

Relating various aspects of our
diet to heart disease and stroke.

Dried or salted fish consumption and cardiovascular disease.

Dried/salted fish and total cardiovascular disease (CVD).

Dried/salted fish and coronary heart disease.

Dried/salted fish and stroke.

Cardiovascular disease & Diet. A systematic review.

Literature review.

Relating various aspects of ourdiet to heart disease and stroke.

Dried or salted fish consumption and cardiovascular disease.

Dried/salted fish and total cardiovascular disease (CVD).

Dried/salted fish and coronary heart disease.

Dried/salted fish and stroke.

Relating various aspects of our
diet to heart disease and stroke.