Fish consumption and all-cause mortality: a meta-analysis of cohort studies

BACKGROUND/OBJECTIVES: Although fish consumption may have an influence on specific mortality of major chronic diseases, the relationship between fish consumption and all-cause mortality remains inconsistent. SUBJECTS/METHODS: We performed a systematic search of publications using PubMed and Web of science up to 31 December 2014. Summary relative risk (RR) for the highest versus lowest category of fish consumption on risk of all-cause mortality was calculated by using a random effects model. Potential nonlinear relation was tested by modeling fish intake using restricted cubic splines with three knots at fixed percentiles of the distribution. RESULTS: Twelve prospective cohort studies with 672 389 participants and 57 641 deaths were included in this meta-analysis. Compared with the lowest category, the highest category of fish intake was associated with about a 6% significantly lower risk of all-cause mortality (RR = 0.94, 95% confidence interval (CI): 0.90, 0.98; I-2 = 39.1%, P = 0.06). The dose-response analysis indicated a nonlinear relationship between fish consumption and all-cause mortality. Compared with never consumers, consumption of 60 g of fish per day was associated with a 12% reduction (RR = 0.88, 95% CI: 0.83, 0.93) in risk of total death. CONCLUSIONS: These results imply that fish consumption was associated with a reduced risk of all-cause mortality.