Total fish consumption and all-cause mortality or survival. Effect modification.
- Level of consumption: Effects probably differ between different levels of intake. For this analysis, four different levels of consumption were considered,
relative to nonconsumption: < 1, 1, 2, and = 3 servings/week.
17 cohorts with 29,006 cases could be included (Table 1) after excluding the debatable results from Hirayama T [7]. Average RR's were 0.98, 0.94, 0.94, and 0.91 for < 1, 1, 2, and ≥ 3 servings/week, respectively. - Gender: Analysis stratified by sex can be found in table 2. Effect sizes were similar for men (13 cohorts: RR = 0.90) and women (10 cohorts: RR = 0.88). One other author did not describe data stratified by gender, but stated that effects were similar for men and women (Yamagishi K [29]).
- Geographic area: Protective effects were stronger among US cohorts (8 cohorts: RR = 0.88) and Asian cohorts (4 cohorts: RR = 0.89) than among European cohorts (17 cohorts: RR = 0.98). Tables 3-5.
- Other possible effect modifiers: No effect modification was found by age (Gillum RF [15]). income or BMI (Tomasallo C [31]).
| Author | Cohort name | Cases | < 1 serving/week | 1 serving/week | 2 servings/week | ≥ 3 servings/week |
|---|---|---|---|---|---|---|
| 32) Manger MS (2010) | The WENBIT | 137 | HR = 1 | HR = 1 | HR = 1 | HR = 0.94 |
| 31) Tamasallo C (2010) | No cohort name defined | 177 captains, and 128 referents | Captains: HR = 1.07 Referents: HR = 0.88 | Captains: HR = 1.00 Referents: HR = 0.60 | Captains: HR = 1.00 Referents: HR = 0.60 | Captains: HR = 1.00 Referents: HR = 0.60 |
| 29) Yamagishi K (2008 | The JACC Study | 7,008 | HR = 1 | HR = 1 | HR = 0.98 | HR = 0.95 |
| 27) Ness AR (2005) | The Boyd Orr Cohort | 1,010 | RR = 0.96 | RR = 0.92 | RR = 0.98 | RR = 0.98 |
| 26) Nakamura Y (2005) | The NIPPON DATA80 | 1,745 | RR = 1 | RR = 0.89 | RR = 0.88 | RR = 0.89 |
| 25) Folsom AR (2004) | The Iowa women's Health Study | 4,653 | RR = 1 | RR = 0.97 | RR = 0.93 | RR = 0.93 |
| 22) Erkkilä AT (2003) | The EUROASPIRE Study | 34 | RR = 0.50 | RR = 0.50 | RR = 0.50 | RR = 0.44 |
| 21) Osler M (2003) | No cohort name defined | 1,329 | HR = 1* | HR = 0.95 | HR = 1.14 | HR = 1.20 |
| 20) Barzi F (2003) | The GISSI-Preventione Trial | 1,660 | OR = 1 | OR = 0.87 | OR = 0.81 | OR = 0.76 |
| 19) Hu FB (2003) | The Nurses' Health Study | 486 | RR = 0.88 | RR = 0.67 | RR = 0.69 | RR = 0.59 |
| 18) Nagata C (2002) | The Takayama Study | 1,163 men, and 899 women | Men: HR = 1 Women: HR = 1 | Men: HR = 1 Women: HR = 1 | Men: HR = 1 Women: HR = 1 | Men: HR = 0.93 Women: HR = 0.94 |
| 17) Yuan JM (2001) | The Shanghai Cohort Study | 2,134 | RR = 1 | RR = 1 | RR = 1 | RR = 0.84 |
| 15) Gillum RF (2000) | The NHANES I Study | 1,236 white men, 277 black men, 1,103 white women, and 285 black women | White men: RR = 0.88 Black men: RR = 1.01 White women: RR = 1.02 Black women: RR = 0.77 | White men: RR = 0.76 Black men: RR = 1.05 White women: RR = 1.02 Black women: RR = 0.79 | White men: RR = 0.85 Black men: RR = 1.11 White women: RR = 0.90 Black women: RR = 0.82 | White men: RR = 0.85 Black men: RR = 1.11 White women: RR = 0.90 Black women: RR = 0.82 |
| 13) Whiteman D (1999) | The OXCHECK Study | 477 | RR = 1 | RR = 1.16 | RR = 1.16 | RR = 1.11 |
| 12) Albert CM (1998) | The Physician's Health Study | 1,652 | RR = 0.90 | RR = 0.71 | RR = 0.70 | RR = 0.72 |
| 11) Mann JI (1997) | The Oxford Vegetarian Study | 389 | DRR = 97 | DRR = 96 | DRR = 96 | DRR = 96 |
| 7) Hirayama T | No cohor name defined | 55,523 men, and 23,544 women | Men: RR = 0.81* Women: RR = 0.92* | Men: RR = 0.78 Women: RR = 0.87 | Men: RR = 0.78 Women: RR = 0.87 | Men: RR = 0.76 Women: RR = 0.83 |
| 2) Daviglus ML (1997) | The Chicago Western Electric Study | 1,042 | RR = 1.02 | RR = 1.02 | RR = 0.98 | RR = 0.85 |
| Total number of cases: 84,529 | Average RR = 0.90 | Average RR = 0.86 | Average RR = 0.86 | Average RR = 0.83 | ||
| Excluding data from Hirayama T [7]: | Total number of cases: 29,006 | Average RR = 0.98 | Average RR = 0.94 | Average RR = 0.94 | Average RR = 0.91 |
| Author | Cohort name | Cases | Relative Risk among men | Relative Risk among women |
|---|---|---|---|---|
| 29) Iso H (2007) | The JACC Study | 9,534 men 6,444 women | HR = 0.94 (0.89-0.99; P = < 0.05) | HR = 0.94 (0.88-1.00; P = < 0.05) |
| 28) Iestra J (2006) | The HALE | Not defined | HR = 0.79 (0.59-1.06) | HR = 1.04 (0.57-1.89) |
| 25) Folsom AR (2004) | The Iowa Women's Health Study | 4,653 women | - | RR = 0.93 (0.83-1.05; P = 0.15) |
| 21) Osler M (2003) | No cohort name defined | 826 men 503 women | HR = 1.01 (0.80-1.28; P = 0.08) for the highest vs third quartile of consumption (reference group: HR = 0.80) | HR = 1.21 (0.90-1.63; P = 0.06) for the highest vs third quartile of consumption (reference group: HR = 1.03) |
| 19) Hu FB (2002) | The Nurses' Health Study | 4,121 women | - | RR = 0.68 (0.57-0.82; P = < 0.001) |
| 18) Nagata C (2002) | The Takayama Study | 1,163 men 899 women | HR = 0.94 (0.78-1.12; P = 0.50) | HR = 0.86 (0.70-1.05; P = 0.17) |
| 17) Yuan JM (2001) | The Shanghai Cohort Study | 2,134 men | RR = 0.79 (0.69-0.91; P = 0.01) | - |
| 15) Gillum RF (2000) | The NHANES I Study | 1,236 white men 277 black men 1,103 white women 285 black women | White men: RR = 0.85 (0.68-1.06) Black men: RR = 1.11 (0.68-1.81) | White women: RR = 0.90 (0.71-1.15) Black women: RR = 0.82 (0.52-1.28) |
| 12) Albert CM (1998) | The Physician's Health Study | 1,652 men | RR = 0.73 (0.55-0.96; P = 0.45) | - |
| 10) Salonen JT (1995) | The KIHD Study | 78 men | RR = 1.10 (0.69-1.74; P = 0.69) | - |
| 8) Dolecek TA (1992) | The MRFIT | 522 men | RR = 0.75 (P = < 0.10) | - |
| 7) Hirayama T (1990) | No cohort name defined | 31,979 men 23,544 women | RR = 1.35 (1.20-1.52). for low vs high consumption. | RR = 1.25 (1.13-1.39) for low vs high consumption. |
| 5) Nube M (1987) | No cohort name defined | 742 men 448 women | A protective effect | An increased risk |
| 4) Lapidus L (1986) | No cohort name defined | 75 women | - | No significant association |
| 3) Vollset SE (1985) | No cohort name defined | 2,587 men | No significant association (P = 0.44) | |
| 2) Daviglus ML (1997) | The Chicago Western Electric Study | 1,042 men | RR = 0.85 (0.64-1.10; P = 0.18) | - |
| 1) Fraser GE (1997) | The Adventist Health Study | 451 men 936 women | HR = 0.89 (0.58-1.38) | HR = 0.99 (0.73-1.33) |
| Total number of cases: 50,894 men 42,488 women | Average RR = 0.80 | Average RR = 0.83 | ||
| Excluding data from Hirayama T [7]: | Total number of cases: 18,915 men 18,944 women | Average RR = 0.90 | Average RR = 0.88 |
| Author | Cohort name | Cases | Relative Risk (RR) |
|---|---|---|---|
| 31) Tomasallo C (2010) | No cohort name defined | 177 captains, and 128 referents | Captains: HR = 1.00 (0.63-1.58). Referents: HR = 0.60 (0.38-0.95; P = < 0.05). |
| 25) Folsom AR (2004) | The Iowa Women's Health Study | 4,653 | RR = 0.93 (0.83-1.05; P = 0.15) |
| 19) Hu FB (2002) | The Nurses' Health Study | 4,121 | RR = 0.68 (0.57-0.82; P = < 0.001) |
| 15) Gillum RF (2000) | The NHANES I | 1,236 white men, 277 black men, 1,103 white women, and 285 black women | White men: RR = 0.85 (0.68-1.06). Black men: RR = 1.11 (0.68-1.81). White women: RR = 0.90 (0.71-1.15). Black women: RR = 0.82 (0.52-1.28). |
| 12) Albert CM (1998) | The Physician's Health Study | 1,652 | RR = 0.73 (0.55-0.96; P = 0.45) |
| 8) Dolecek TA (1992) | The MRFIT | 522 | RR = 0.75 (P = < 0.10) |
| 2) Daviglus ML (1997) | The Chicago Western Electric Study | 1,042 | RR = 0.85 (0.64-1.10; P = 0.18) |
| 1) Kahn HA (1984) | The Adventist Health Study | 5,971 | OR = 1.04 |
| Total number of cases: 21,167 | Average RR = 0.88 |
| Author | Cohort name | Cases | Relative Risk (RR) |
|---|---|---|---|
| 33) Tognon G (2010) | The PPSW | 630 | HR = 0.96 (0.82-1.13) |
| 32) Manger MS (2010) | The WENBIT | 137 | HR = 0.95 (0.58-1.55; P = 0.98) |
| 30) González S (2008) | No cohort name defined | 83 | RR = 1.14 (0.85-1.53; P = 0.38) |
| 27) Ness AR (2005) | The Boyd Orr Cohort | 1,010 | RR = 0.98 (0.79-1.20; P = 0.8) |
| 24) Trichopoulou A (2005) | The EPIC-elderly Study (subjects without CHD) | 4,047 | MR = 1.00 (0.97-1.04) |
| 24) Trichopoulou A (2005) | The Greek part of the EPIC Study (subjects with CHD) | 131 | MR = 0.97 (0.81-1.15) |
| 22) Erkkilä AT (2003) | The EUROASPIRE Study | 34 | RR = 0.37 (0.14-1.00; P = 0.059) |
| 21) Osler M (2003) | No cohort name defined | 1,329 | HR = 1.06 (0.88-1.28; P = 0.02) for the highest vs third quartile of consumption (reference group: HR = 0.88) |
| 20) Barzi F (2003) | The GISSI-Preventione Trial | 1,660 | OR = 0.76 (0.62-0.94; P = 0.0003) |
| 16) Fortes C (2000) | No cohort name defined | 53 | RR = 0.89 (0.46-1.74) |
| 13) Whiteman D (1999) | The OXCHECK Study | 477 | RR = 1.06 (0.71-1.59) |
| 11) Mann JI (1997) | The Oxford Vegetarian Study | 389 | DRR = 96 (76-121) |
| 10) Salonen JT (1995) | The KIHD Study | 78 | RR = 1.10 (0.69-1.74; P = 0.69) |
| 9) Kromhout D (1995) | No cohort name defined | 187 | RR = 0.96 (0.72-1.30) |
| 5) Nube M (1987) | No cohort name defined | 742 men, and 448 women | Men: A protective effect. Women: An increased risk. |
| 4) Lapidus L (1986) | No cohort name defined | 75 | No significant association |
| 3) Vollset SE (1985) | No cohort name defined | 2,587 | No significant association (P = 0.44) |
| Total number of cases: 14,097 | Average RR = 0.98 |
| Author | Cohort name | Cases | Relative Risk (RR) |
|---|---|---|---|
| 29) Yamagishi K (2008) | The JACC Study | 7,008 | HR = 0.92 (0.85-1.00; P = 0.08) |
| 26) Nakamura Y (2005) | The NIPPON DATA80 | 1,745 | RR = 1.00 (0.77-1.29; P = 0.98) for the highest vs second quintile of consumption (reference group: RR = 1.12) |
| 18) Nagata C (2002) | The Takayama Study | 1,163 men, and 899 women | Men: HR = 0.94 (0.78-1.12; P = 0.50). Women: HR = 0.86 (0.70-1.05; P = 0.17). |
| 17) Yuan JM (2001) | The Shanghai Cohort Study | 2,134 | RR = 0.79 (0.61-0.91; P = 0.01) |
| 7) Hirayama T (1990) | No cohort name defined | 31,979 men, and 23,544 women | Men: RR = 1.35 (1.20-1.52) for low vs high consumption. Women: RR = 1.26 (1.13-1.39) for low vs high consumption. |
| Total number of cases: 68,472 | Average RR = 0.79 | ||
| Excluding data from Hirayama T [7]: | Total number of cases: 12,949 | Average RR = 0.89 |