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Intakes of fish and polyunsaturated fatty acids and mild-to-severe cognitive impairment risks: a dose-response meta-analysis of 21 cohort studies.

Abstract

BACKGROUND

The intake of fish and polyunsaturated fatty acids (PUFAs) may benefit cognitive function. However, optimal intake recommendations for protection are unknown.

OBJECTIVE

We systematically investigated associations between fish and PUFA intake and mild-to-severe cognitive impairment risk.

DESIGN

Studies that reported risk estimates for mild cognitive impairment (MCI), cognitive decline, dementia, Alzheimer disease (AD), or Parkinson disease (PD) from fish, total PUFAs, total n-3 (ω-3) PUFAs, or at least one n-3 PUFA were included. Study characteristics and outcomes were extracted. The pooled RR was estimated with the use of a random-effects model meta-analysis. A dose-response analysis was conducted with the use of the 2-stage generalized least-squares trend program.

RESULTS

We included 21 studies (181,580 participants) with 4438 cases identified during follow-up periods (2.1-21 y). A 1-serving/wk increment of dietary fish was associated with lower risks of dementia (RR: 0.95; 95% CI: 0.90, 0.99; P = 0.042, I(2) = 63.4%) and AD (RR: 0.93; 95% CI: 0.90, 0.95; P = 0.003, I(2) = 74.8%). Pooled RRs of MCI and PD were 0.71 (95% CI: 0.59, 0.82; P = 0.733, I(2) = 0%) and 0.90 (95% CI: 0.80, 0.99; P = 0.221, I(2) = 33.7%), respectively, for an 8-g/d increment of PUFA intake. As an important source of marine n-3 PUFAs, a 0.1-g/d increment of dietary docosahexaenoic acid (DHA) intake was associated with lower risks of dementia (RR: 0.86; 95% CI: 0.76, 0.96; P < 0.001, I(2) = 92.7%) and AD (RR: 0.63; 95% CI: 0.51, 0.76; P < 0.001, I(2) = 94.5%). Significant curvilinear relations between fish consumption and risk of AD and between total PUFAs and risk of MCI (both P-nonlinearity < 0.001) were observed.

CONCLUSIONS

Fishery products are recommended as dietary sources and are associated with lower risk of cognitive impairment. Marine-derived DHA was associated with lower risk of dementia and AD but without a linear dose-response relation.

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    Authors+Show Affiliations

    Zhang Y
    ,

    Department of Food Science and Nutrition, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, China; and.

    Chen J
    ,

    Department of Food Science and Nutrition, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, China; and.

    Qiu J
    ,

    Department of Nutrition, and.

    Li Y
    ,

    Department of Epidemiology and Health Statistics, Zhejiang University School of Medicine, Hangzhou, China.

    Wang J
    ,

    Department of Epidemiology and Health Statistics, Zhejiang University School of Medicine, Hangzhou, China.

    Jiao J

    Department of Nutrition, and jingjingjiao@zju.edu.cn.

    Source

    MeSH

    Alzheimer Disease
    Animals
    Cognition Disorders
    Cognitive Dysfunction
    Dementia
    Diet
    Dietary Fats, Unsaturated
    Dietary Supplements
    Fatty Acids, Omega-3
    Fishes
    Humans
    Risk Factors
    Seafood
    Severity of Illness Index

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    26718417

    Citation

    Zhang, Yu, et al. "Intakes of Fish and Polyunsaturated Fatty Acids and Mild-to-severe Cognitive Impairment Risks: a Dose-response Meta-analysis of 21 Cohort Studies." The American Journal of Clinical Nutrition, vol. 103, no. 2, 2016, pp. 330-40.
    Zhang Y, Chen J, Qiu J, et al. Intakes of fish and polyunsaturated fatty acids and mild-to-severe cognitive impairment risks: a dose-response meta-analysis of 21 cohort studies. Am J Clin Nutr. 2016;103(2):330-40.
    Zhang, Y., Chen, J., Qiu, J., Li, Y., Wang, J., & Jiao, J. (2016). Intakes of fish and polyunsaturated fatty acids and mild-to-severe cognitive impairment risks: a dose-response meta-analysis of 21 cohort studies. The American Journal of Clinical Nutrition, 103(2), pp. 330-40. doi:10.3945/ajcn.115.124081.
    Zhang Y, et al. Intakes of Fish and Polyunsaturated Fatty Acids and Mild-to-severe Cognitive Impairment Risks: a Dose-response Meta-analysis of 21 Cohort Studies. Am J Clin Nutr. 2016;103(2):330-40. PubMed PMID: 26718417.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Intakes of fish and polyunsaturated fatty acids and mild-to-severe cognitive impairment risks: a dose-response meta-analysis of 21 cohort studies. AU - Zhang,Yu, AU - Chen,Jingnan, AU - Qiu,Jieni, AU - Li,Yingjun, AU - Wang,Jianbing, AU - Jiao,Jingjing, Y1 - 2015/12/30/ PY - 2015/09/21/received PY - 2015/11/30/accepted PY - 2016/1/1/entrez PY - 2016/1/1/pubmed PY - 2016/6/14/medline KW - Alzheimer disease KW - cognitive impairment KW - dementia KW - fish KW - polyunsaturated fatty acids SP - 330 EP - 40 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 103 IS - 2 N2 - BACKGROUND: The intake of fish and polyunsaturated fatty acids (PUFAs) may benefit cognitive function. However, optimal intake recommendations for protection are unknown. OBJECTIVE: We systematically investigated associations between fish and PUFA intake and mild-to-severe cognitive impairment risk. DESIGN: Studies that reported risk estimates for mild cognitive impairment (MCI), cognitive decline, dementia, Alzheimer disease (AD), or Parkinson disease (PD) from fish, total PUFAs, total n-3 (ω-3) PUFAs, or at least one n-3 PUFA were included. Study characteristics and outcomes were extracted. The pooled RR was estimated with the use of a random-effects model meta-analysis. A dose-response analysis was conducted with the use of the 2-stage generalized least-squares trend program. RESULTS: We included 21 studies (181,580 participants) with 4438 cases identified during follow-up periods (2.1-21 y). A 1-serving/wk increment of dietary fish was associated with lower risks of dementia (RR: 0.95; 95% CI: 0.90, 0.99; P = 0.042, I(2) = 63.4%) and AD (RR: 0.93; 95% CI: 0.90, 0.95; P = 0.003, I(2) = 74.8%). Pooled RRs of MCI and PD were 0.71 (95% CI: 0.59, 0.82; P = 0.733, I(2) = 0%) and 0.90 (95% CI: 0.80, 0.99; P = 0.221, I(2) = 33.7%), respectively, for an 8-g/d increment of PUFA intake. As an important source of marine n-3 PUFAs, a 0.1-g/d increment of dietary docosahexaenoic acid (DHA) intake was associated with lower risks of dementia (RR: 0.86; 95% CI: 0.76, 0.96; P < 0.001, I(2) = 92.7%) and AD (RR: 0.63; 95% CI: 0.51, 0.76; P < 0.001, I(2) = 94.5%). Significant curvilinear relations between fish consumption and risk of AD and between total PUFAs and risk of MCI (both P-nonlinearity < 0.001) were observed. CONCLUSIONS: Fishery products are recommended as dietary sources and are associated with lower risk of cognitive impairment. Marine-derived DHA was associated with lower risk of dementia and AD but without a linear dose-response relation. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/26718417/Intakes_of_fish_and_polyunsaturated_fatty_acids_and_mild_to_severe_cognitive_impairment_risks:_a_dose_response_meta_analysis_of_21_cohort_studies_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.115.124081 DB - PRIME DP - Unbound Medicine ER -