Abstract
Epidemiological studies on the impact of fish consumption on coronary heart disease (CHD) incidence have shown inconsistent results. In addition, in terms of CHD mortality, although previous meta-analyses showed that fish consumption reduces the risk of CHD, six newly incorporated studies show that fish consumption has no impact on CHD. Therefore, the results still need to be verified. The purpose of this study is to quantitatively evaluate the impact of fish consumption on CHD incidence and mortality. Relevant studies were identified from PubMed, Web of Science, and Embase databases up to October 2019. The multivariate-adjusted relative risks (RRs) for the highest versus the lowest fish consumption categories and the 95% confidence intervals were computed with a random-effect model. A restricted cubic spline regression model was used to assess the dose–response relationship between fish consumption and CHD incidence and mortality. Forty prospective cohort studies were incorporated into research. Among them, 22 studies investigated the association between fish consumption and CHD incidence (28,261 cases and 918,783 participants), and the summary estimate showed that higher fish consumption was significantly associated with a lower CHD incidence [RR: 0.91, 95% CI: (0.84, 0.97); I2 = 47.4%]. Twenty-seven studies investigated the association between fish consumption and CHD mortality (10,568 events and 1,139,553 participants), and the summary estimate showed that higher fish intake was significantly associated with a lower CHD mortality [RR: 0.85, 95% CI: (0.77, 0.94); I2 = 51.3%]. The dose–response analysis showed that the CHD incidence and mortality were reduced by 4%, respectively, with a 20 g/day increment in fish consumption. This meta-analysis indicates that fish consumption is associated with a lower CHD incidence and mortality.
Highlights
Coronary heart disease (CHD) remains a major cause of mortality throughout the world [1].About 17.8 million people died from cardiovascular disease worldwide in 2017
The results showed that an increase in fish intake by 20 g/d is associated with a 4% [relative risks (RRs) = 0.96, 95% confidence intervals (CIs): (0.95, 0.97)] reduction in CHD incidence
The results showed that an increase in fish intake by 20 g/d is associated with a 4% [RRs = 0.96, 95% CI: (0.95, 0.98)] reduction in CHD mortality
Summary
Coronary heart disease (CHD) remains a major cause of mortality throughout the world [1]. About 17.8 million people died from cardiovascular disease worldwide in 2017. 8.9 million people were killed by CHD [2]. Many studies have shown that hypertension, diabetes, unhealthy diet, dyslipidemia, abdominal obesity, smoking, and psychosocial stress are the major risk factors for CHD [3,4]. In addition to preventing coronary heart disease by reducing these risk factors, the potential role of dietary factors has received increasing attention. Many studies in recent years have shown that adherence to healthier dietary patterns is helpful for CHD prevention [5]
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