Current Level of Fish Consumption is Associated with Mortality in Chinese but not US Adults: New Findings From Two Nationwide Cohort Studies With 14 and 9.8 Years of Follow-Up

Abstract

Scope: Whether dietary fish consumption is linked to mortality remains unclear. We aim to investigate the association of fish consumption with mortality in Chinese and US nationwide populations.

Methods and results: We utilize data from China Health and Nutrition Survey (CHNS, n = 14 117) and National Health and Nutrition Examination Survey (NHANES, n = 33 221) including NHANES III conducted in 1988-1994 and continuous NHANES 1999-2010. Cox proportional hazards regression is used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During a median follow-up of 14 and 9.8 years for CHNS and NHANES, 1007 and 5209 deaths are documented, respectively. Among Chinese adults, increased fish intake is significantly associated with decreased total mortality. The multivariable-adjusted HRs (95% CIs) across increasing categories of fish intake are 0.45 (0.36-0.56), 0.72 (0.60-0.86), and 0.70 (0.59-0.85) (p trend < 0.0001). However, fish intake is not associated with total mortality among US adults (p trend = 0.21). We only detected a borderline inverse association between fish intake and stroke mortality (p trend = 0.05), whereas a positive association with diabetes mortality in the third category of fish intake in NHANES.

Conclusion: In these two nationwide cohort studies, fish consumption is associated with a reduced risk of total mortality for Chinese but not US populations.

Keywords: China Health and Nutrition Survey; National Health and Nutrition Examination Survey; fish consumption; mortality; nationwide cohort.