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Health issues and nutrition in the elderly

Association of fish consumption with risk of all-cause and cardiovascular disease mortality: an 11-year follow-up of the Guangzhou Biobank Cohort Study

European Journal of Clinical Nutrition volume 76, pages 389–396 (2022)Cite this article

Subjects

Abstract

Background

Whether fish consumption is associated with all-cause, cardiovascular (CVD), ischemic heart disease (IHD) and stroke mortality remains inconclusive. We examined the association of fish consumption with all-cause, cardiovascular (CVD), ischemic heart disease (IHD) and stroke mortality in older men and women in south China.

Methods

A total of 18,215 participants including men and women without CVD at baseline (2003–2006) from Guangzhou Biobank Cohort Study (GBCS) were included and followed up till December 2017. Deaths were identified through record linkage with the Death Registry. Information on fish consumption was obtained using a food frequency questionnaire.

Results

During an average follow-up of 11.4 (standard deviation = 2.1) years, 2,697 deaths occurred, including 917 total CVD, 397 IHD and 374 stroke deaths. After adjusting for potential confounders, compared with fish consumption of 0–3 servings/week (i.e., 0–21 g/day, one serving = 50 g), consumption of 4–6 servings/week (29–43 g/day) showed significantly lower risks of all-cause and CVD mortality (hazards ratio (HR) and 95% confidence interval (CI): 0.85 (0.76, 0.95) and 0.77 (0.64, 0.93), respectively), but the reduced risk of IHD mortality (HR (95% CI): 0.80 (0.60, 1.07)) was not significant. Consumption of 7–10 servings/week or higher showed no association with all-cause, CVD, IHD, and stroke mortality.

Conclusions

Moderate fish consumption of 4–6 servings/week (29–43 g/day) was associated with lower all-cause and CVD mortality risk. Our findings support the current general advice on regular fish consumption also in middle-aged and older adults.

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Fig. 1: Multivariate-adjusted HR and 95% CI for associations of fish consumption (servings/week) with all-cause mortality on 18,215 participants in GBCS by subgroups of covariates.

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Data availability

Ethical approval in place allows us to share data on request. Please direct such requests to the Guangzhou Biobank Cohort Study Data Access Committee (gbcsdata@hku.hk).

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Acknowledgements

The Guangzhou Biobank Cohort Study investigators include: Guangzhou No. 12 Hospital: WS Zhang, M Cao, T Zhu, B Liu, CQ Jiang (Co-principal investigator (PI)); The University of Hong Kong: CM Schooling, SM McGhee, GM Leung, R Fielding, TH Lam (Co-PI); The University of Birmingham: P Adab, GN Thomas, KK Cheng (Co-PI).

Funding

This work was funded by the National Science Foundation of China (81941019). The Guangzhou Biobank Cohort Study was funded by the University of Hong Kong Foundation for Educational Development and Research (SN/1 f/HKUF-DC; C20400.28505200), the Health Medical Research Fund (Grant number: HMRF/13143241) in Hong Kong; the Guangzhou Public Health Bureau (201102A211004011) and the Natural Science Foundation of Guangdong (2018A030313140).

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Authors and Affiliations

  1. School of Public Health, Sun Yat-sen University, Guangzhou, China

    Meng Yun Shao & Lin Xu

  2. Guangzhou No.12 Hospital, Guangzhou, China

    Chao Qiang Jiang, Wei Sen Zhang, Feng Zhu, Ya Li Jin & Tai Hing Lam

  3. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China

    Jean Woo

  4. Institute of Applied Health Research, University of Birmingham, Birmingham, UK

    Kar Keung Cheng

  5. School of Public Health, the University of Hong Kong, Hong Kong, China

    Tai Hing Lam & Lin Xu

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Contributions

MYS, CQJ, LX, THL, WSZ, FZ, YLJ, JW, KKC and THL have substantial contributions to conception and design, acquisition of funding, data and interpretation of data; MYS and LX analysed the data, MYS, LX, THL and CQJ drafted the article, THL, LX, and CQJ revised it critically for important intellectual content, and all authors contributed to final approval of the paper.

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Correspondence to Chao Qiang Jiang, Tai Hing Lam or Lin Xu.

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The Guangzhou Medical Ethics Committee of the Chinese Medical. Association approved the study, and all participants gave written, informed consent before participation.

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Shao, M.Y., Jiang, C.Q., Zhang, W.S. et al. Association of fish consumption with risk of all-cause and cardiovascular disease mortality: an 11-year follow-up of the Guangzhou Biobank Cohort Study. Eur J Clin Nutr 76, 389–396 (2022). https://doi.org/10.1038/s41430-021-00968-5

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