Meta-Analysis of observational studies on fish intake and coronary heart disease

doi:10.1016/j.amjcard.2004.01.038

The American Journal of Cardiology

Volume 93, Issue 9, 1 May 2004, Pages 1119-1123

https://doi.org/10.1016/j.amjcard.2004.01.038 Get rights and content

Abstract

Fish consumption has been associated with a lower risk of coronary heart disease (CHD) in some but not all studies. We conducted a meta-analysis of observational studies to determine if fish consumption is associated with lower fatal and total CHD. English language articles published before May 2003 were searched. In all, 19 observational studies (14 cohort and 5 case-control) in which there was a group that consumed fish on a regular basis and a comparison group that consumed little or no fish were included. With use of a standardized protocol and data extraction form, information on study design, sample size, participant characteristics, duration of follow-up, assessment of end points, and consumption of fish was abstracted. Using a random effects model, we pooled data from each study. Fish consumption versus little to no fish consumption was associated with a relative risk of 0.83 (95% confidence interval 0.76 to 0.90; p <0.005) for fatal CHD and a relative risk of 0.86 (95% confidence interval 0.81 to 0.92; p <0.005) for total CHD. The results indicate that fish consumption is associated with a significantly lower risk of fatal and total CHD. These findings suggest that fish consumption may be an important component of lifestyle modification for the prevention of CHD.

Section snippets

Selection of studies

A comprehensive literature search of the MEDLINE database (1966 through April 2003) was conducted using the following Medical Subject Headings (MeSH): fishes, fatty acids, omega-3, fish products, fish oils, coronary disease, and myocardial infarction. In addition, a manual search of citations from relevant original studies and review articles was performed. Only studies that were published as full-length, English language manuscripts were considered. Initially, 57 articles were identified and

Characteristics of participants and study design

Characteristics for the 19 studies and their participants are presented in TABLE 1, TABLE 2. The studies published between 1985 and 2003 evaluated the experience of 228,864 participants. All of the studies were conducted in adults (aged 22 to 87 years). Nine studies included only men and 2 studies included only women, and the remaining studies included men and women (n = 8). Fish oil supplementation was reported in 1 study, but no more than 4% of the participants in this study took fish oil as

Discussion

The present meta-analysis included 19 observational studies with 228,864 participants, representing a large and diverse population sample. Overall, the results of the study suggest that fish consumption is associated with an approximately 20% reduction in the risk of fatal CHD and a 10% reduction in total CHD. The apparent disparity in risk reduction between fatal and total CHD may merely reflect much of the information for the 2 outcomes derived from different studies. Alternatively, the

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Meta-Analysis of observational studies on fish intake and coronary heart disease

Abstract

Section snippets

Selection of studies

Characteristics of participants and study design

Discussion

J Clin Epidemiol

J Clin Epidemiol

Dietary intake of marine n-3 fatty acids, fish intake, and the risk of coronary disease among men

N Engl J Med

Fish consumption and cardiovascular disease in the physicians' health studya prospective study

Am J Epidemiol

Association between certain foods and risk of acute myocardial infarction in women

BMJ

Fish and omega-3 fatty acid intake and risk of coronary heart disease in women

JAMA

Fish intake may limit the increase in risk of coronary heart disease morbidity and mortality among heavy smokers. The Honolulu Heart Program

Circulation

Case-control study of nonfatal myocardial infarction in relation to selected foods in Japanese men and women

Jpn Circ J

n-3 Polyunsaturated fatty acids, fish, and nonfatal acute myocardial infarction

Circulation

Fish consumption and risk of sudden cardiac death

JAMA

Fish consumption and the 30-year risk of fatal myocardial infarction

N Engl J Med

The inverse relation between fish consumption and 20-year mortality from coronary heart disease

N Engl J Med

The protective effect of a small amount of fish on coronary heart disease mortality in an elderly population

Int J Epidemiol