TABLE 4.
Prospective association between the cumulative average of fish intake and risk of newly diagnosed chronic pulmonary disease according to ALA intake1
| Women |
Men |
Total |
||||||
| Fish intake (servings/wk) | n | Person-years | aHR (95% CI) | n | Person-years | aHR (95% CI) | n | aHR (95% CI) |
| ALA intake less than the median | ||||||||
| <1 | 90 | 135,987 | 1.00 (referent) | 29 | 76,506 | 1.00 (referent) | 119 | 1.00 (referent) |
| 1–2.4 | 171 | 266,056 | 1.09 (0.84, 1.42) | 43 | 104,943 | 1.03 (0.63, 1.66) | 214 | 1.08 (0.85, 1.35) |
| 2.5–3.9 | 56 | 108,624 | 1.03 (0.73, 1.46) | 11 | 44,137 | 0.72 (0.35, 1.47) | 67 | 0.96 (0.71, 1.32) |
| ≥4 | 27 | 58,166 | 0.94 (0.60, 1.47) | 10 | 35,068 | 0.84 (0.39, 1.79) | 37 | 0.92 (0.62, 1.34) |
| P | — | — | — | — | — | — | — | 0.79 |
| I2 | — | — | — | — | — | — | — | 0.0 |
| ALA intake greater than or equal to the median | ||||||||
| <1 | 87 | 119,568 | 1.00 (referent) | 21 | 74,199 | 1.00 (referent) | 108 | 1.00 (referent) |
| 1–2.4 | 186 | 256,341 | 1.02 (0.79, 1.33) | 34 | 106,634 | 1.03 (0.59, 1.81) | 220 | 1.02 (0.81, 1.30) |
| 2.5–3.9 | 80 | 119,054 | 1.00 (0.73, 1.37) | 13 | 44,385 | 0.99 (0.48, 2.03) | 93 | 1.00 (0.75, 1.33) |
| ≥4 | 26 | 73,303 | 0.55 (0.35, 0.86) | 5 | 34,961 | 0.54 (0.20, 1.47) | 31 | 0.55 (0.36, 0.83) |
| P | — | — | — | — | — | — | — | 0.97 |
| I2 | — | — | — | — | — | — | — | 0.0 |
Multivariate HRs were adjusted for age, smoking, pack-years of smoking, pack-years squared of smoking, secondhand tobacco exposure (only in the NHS), race-ethnicity, physician visit, US region, spouse's highest educational attainment (only in the NHS), menopausal status (only in the NHS), BMI, physical activity, multivitamin use, and energy intake. The median value for ALA intake was 1.02 g/d in women and 1.01 g/d in men. P values are a test for between-study heterogeneity (≥4 servings/wk compared with <1 serving/wk). I2 is the degree of heterogeneity between studies expressed as a percentage of total variance (≥4 servings/wk compared with <1 serving/wk). The interaction between ALA and fish intakes was borderline significant in women (P = 0.08) and NS in men (P = 0.33). aHR, adjusted HR; ALA, α-linolenic acid; NHS, Nurses’ Health Study.