Table 2.
Characteristics of cohort studies included in the meta-analysis of fish consumption and CHD mortality.
| Study Source (Year), Country |
Age (Gender) | Subjects (Cases) | Follow-Up Period | Fish Intake Category | Exposure Measure | Outcome Measure | Covariates Adjusted |
|---|---|---|---|---|---|---|---|
| Kromhout [55] (1985), The Netherlands |
40–59 (M) |
852 (78) |
20 y | 0 g/d; 1–14 g/d; 15–29 g/d; 30–44 g/d; ≥45 g/d | Interview | ICD-8 (codes 410–413) | Age, systolic blood pressure, serum total cholesterol, cigarette smoking, subscapular skinfold thickness, physical activity, energy intake, dietary cholesterol, prescribed diet and occupation |
| Ascherio [34] (1995), USA |
40–75 (M) |
44,895 (264) |
6 y | <1/mo; 1–3/mo; 1/wk; 2–3/wk; 4–5/wk; ≥6/wk | FFQ | Based on medical records and autopsy report, ICD codes are not available | Age, body mass index, smoking habits, alcohol consumption, history of hypertension, history of diabetes, history of hypercholesterolemia, family history of myocardial infarction before 60 y of age and profession |
| Rodriguez [56] (1996), USA |
45–68 (M) |
534 (-) |
23 y | <2/wk; >2/wk | Interview | Based on death certificates, supplemented with the State Department of Health | Age, years lived in Japan, total calories/d, alcohol intake, physical activity, years smoked, hypertension, and serum cholesterol, glucose, and uric acid levels for past and current smokers separately |
| Daviglus [57] (1997), USA |
40–55 (M) |
1822 (430) |
30 y | 0 g/d; 1–17 g/d; 18–34 g/d; ≥35 g/d | Interview | ICD-8 (codes 410–414) | Age, education, religion, systolic pressure, serum cholesterol, no. of cigarettes smoked per day, BMI, diabetes, ECG abnormalities, daily intakes of energy, cholesterol, SFA, MUFA, PUFA, total protein, carbohydrate, alcohol, Fe, thiamin, riboflavin, niacin, vitamin C, b-carotene and retinol |
| Mann [58] (1997), UK |
16–79 (both) |
10,802 (64) |
13.3 y | Never, <1/wk, ≥1/wk | FFQ | ICD-9 (codes 410–414) | Age, sex, smoking and social class |
| Albert [35] (1998), USA |
40–84 (M) |
20,551 (308) |
11 y | 1/mo; 1–3/mo; 1–2/wk; 2–5/wk; ≥5/wk | FFQ | ICD-9 (codes 410–414) | Age, aspirin, -carotene treatment assignment, evidence of cardiovascular disease before 12-mo questionnaire, body mass index, smoking status, history of diabetes, history of hypertension, history of hypercholesterolemia, alcohol consumption, vigorous exercise, and vitamin E, vitamin C, and multivitamin use |
| Oomen [32] (2000), Finland |
50–69 (M) |
1088 (242) |
20 y | 0–19 g/d; 20–39 g/d; ≥40 g/d | Interview based on Burke’s diet history method | ICD-8 (codes 410–414, 795) | Age, body mass index, cigarette smoking, intake of energy, vegetables, fruits, alcohol, meat, butter, and margarine |
| Oomen [32] (2000), Italy |
50–69 (M) |
1097 (116) |
20 y | 0 g/d; 1–19 g/d; 20–39 g/d; ≥40 g/d | Interview based on Burke’s diet history method | ICD-8 (codes 410–414, 795) | Age, body mass index, cigarette smoking, intake of energy, vegetables, fruits, alcohol, meat, butter, and margarine |
| Oomen [32] (2000), The Netherlands |
50–69 (M) |
553 (109) |
20 y | 0 g/d; 1–19 g/d; ≥20 g/d | Interview based on Burke’s diet history method | ICD-8 (codes 410–414, 795) | Age, body mass index, cigarette smoking, intake of energy, vegetables, fruits, alcohol, meat, butter, and margarine |
| Yuan [59] (2001), China |
45–64 (M) |
18,244 (187) |
12 y | <30 g/wk; 30–<60 g.wk; 60–<100 g/wk; 100–<150 g/wk; ≥150 g/wk | FFQ | ICD-9 (codes 410–414) | Age, total energy intake, level of education, body mass index, current smoker, average no. of cigarettes smoked per day, no. of alcoholic drinks consumed per week, history of diabetes, and history of hypertension |
| Hu [37] (2002), USA |
34–50 (F) |
84,688 (484) |
16 y | <1/mo; 1–3/mo; 1/wk; 2–4/wk; ≥5/wk | FFQ | Based on medical records, death certificate and autopsy report; ICD codes are not available | Age, time periods, smoking status, body mass index, alcohol intake, menopausal status and postmenopausal hormone use, vigorous to moderate activity, No. of times aspirin was used per week, multivitamin use, vitamin E supplement use, and history of hypertension, hypercholesterolemia, diabetes, intake of trans-fat, the ratio of polyunsaturated fat to saturated fat, and dietary fiber |
| Osler [39] (2003), Denmark |
30–70 (both) |
7389 (247) |
11 y | ≤1/mo; 2/mo; 1/wk; ≥2/wk | Self-administered questionnaire | ICD-8 (codes 410–414) | Familial predisposition, smoking status, physical activity, alcohol, educational status, healthy diet score, total cholesterol, and body mass index |
| Mozaffarian [38] (2003), USA |
≥66 (both) |
3910 (247) |
9.3 y | ≤1/mo; 1–3/mo; 1/wk; 2/wk; ≥3/wk | FFQ | Based on medical records and death certificate. ICD codes are not available | Age, gender, education, diabetes, smoking, body mass index, systolic blood pressure, LDL cholesterol, HDL cholesterol, triglycerides, C-reactive protein, saturate fat, alcohol, beef/pork, fruit and vegetables |
| Folsom [60] (2004), USA |
55–69 (F) |
41,836 (922) |
14 y | <0.5/wk; 0.5–<1/wk; 1–1.5/wk; <1.5–>2.5/wk; ≥2.5/wk | FFQ | ICD-9 (codes 410–414,429.2) or ICD-10 (codes I20–I25, I51.6) |
Age, energy intake, educational level, physical activity level, alcohol consumption, smoking status, pack-years of cigarette smoking, age at first live birth, oestrogen use, vitamin use, BMI, waist:hip ratio, diabetes, hypertension, intakes of whole grains, fruit and vegetables, red meat, cholesterol and saturated fat |
| Nakamura [61] (2005), Japan |
≥30 (both) |
8879 (142) |
19 y | <1/wk; 1–2/wk; 0.5/d; 1/d; ≥2/d | Self-administered questionnaire | ICD-9 or ICD10 | Age, sex, cigarette smoking and alcohol intake, hypertension, body mass index, diabete. serum total cholesterol concentration |
| Jarvinen [62] (2006), men, Finland |
30–79 (M) |
2775 (335) |
21.5 y | ≤11 g/d; 12–21 g/d; 22–35 g/d; 36–62 g/d; ≥63 g/d | Interview | ICD-9 (codes 410–414) | Age, energy intake, area, BMI, serum cholesterol, blood pressure, smoking, occupation and diabetes |
| Jarvinen [62] (2006), women, Finland |
30–79 (F) |
2445 (163) |
21.5 y | ≤8 g/d; 9–15 g/d; 16–24 g/d; 25–40 g/d; ≥41 g/d | Interview | ICD-9 (codes 410–414) | Age, energy intake, area, BMI, serum cholesterol, blood pressure, smoking, occupation and diabetes |
| Iso [40] (2006), Japan |
40–59 (both) |
41,578 (62) |
11 y | Median intake: 23 g/d; 51 g/d; 78 g/d; 114 g/d; 180 g/d | FFQ | ICD-10(I21–I23, I46, and I50) | Age; sex; cigarette smoking; alcohol intake; body mass index; histories of hypertension and diabetes; medication use for hypercholesterolemia; education level; sports at leisure time; quintiles of dietary intake of fruits, vegetables, saturated fat, monounsaturated fat, n6 polyunsaturated fat, cholesterol, and total energy |
| Yamagish [63] (2008), Japan |
40–79 (both) |
57,972 (419) |
12.7 y | 0–27 g/d; 27–39 g/d; 39–53 g/d; 53–72 g/d; 72–229 g/d | FFQ | ICD 10 (codes I20–I25) | Age, gender, energy, history of hypertension and diabetes mellitus, smoking status, alcohol consumption, BMI, mental stress, walking, sports, education level, total energy, and dietary intakes of cholesterol, saturated and n-6 polyunsaturated fatty acids, vegetables and fruit |
| Kaushik [64] (2008), Australia |
≥49 (both) |
2683 (287) |
12 y | <1/wk; 1/wk; ≥2/wk | FFQ | Based on the Australian National Death Index (NDI) database | Age, gender, mean arterial blood pressure, body-mass index, smoking status, glucose, cholesterol, white cell count, platelet count, qualification level, self-rated health, past history of myocardial infarction and stroke, total vegetable and fat intake |
| Tomasallo [65] (2010), USA |
Mean 48.5 (both) |
940 (26) |
12 y | ≤1/mo; >1/mo–<1/wk; ≥1/wk | Interview | ICD-9 (codes 410–414) or ICD-10 (codesI20–25) |
Sex, age, BMI and income at study baseline |
| Goede [42] (2010), The Netherlands |
20–65 (both) |
21,342 (82) |
11.3 y | <3.3 g/d; 3.3–7.3 g/d; 7.4–14.0 g/d; >14 g/d | FFQ | ICD-9 (codes 410–414) or ICD-10 (codes I20–I25) |
Age, gender, BMI, total energy intake, ethanol intake, cigarette smoking, social economic status, vitamin or mineral supplement use, use of drugs for hypertension or hypercholesterolaemia, family history of CVD, SFA, fruit and vegetables |
| Kuhn [48] (2013), Germany |
35–65 (both) |
48,315 (117) |
8.1 y | <7.5 g/d; 7.5–14.5 g/d; 14.5–21.5 g/d; 21.5–31.1 g/d; >31.1 g/d | FFQ | ICD-10 (I21) | Age, gender, energy intake, alcohol intake, BMI, waist circumference, physical activity, educational attainment, smoking and prevalent diabetes mellitus. |
| Takata [66] (2013), China |
40–74 (both) |
134,296 (476) |
11.2 y | median intake: 10.6 g/d; 24.7 g/d; 38.8 g/d; 59.3 g/d; 106.2 g/d | FFQ | ICD-9 (codes 410–414) | Age, total energy intake, income, occupation, education, comorbidity index, physical activity level, red meat intake, poultry intake, total vegetable intake, total fruit intake, smoking history, and alcohol consumption |
| Engeset [67] (2015), men, Italy; Spain; UK; The Netherlands; Greece; Sweden; Denmark; Norway; Germany; France | 35–70 (M) |
143,183 (2215) |
16 y | median intake:1.9 g/d; 10.8 g/d; 21.1 g/d; 34.2 g/d; 76.2 g/d | FFQ | ICD-10 (I20-25) | Energy from fat, energy from carbohydrates and proteins, dietary fibres, red meat, processed meat, vegetables, fruit, alcohol intake, body mass index, physical activity, smoking, education. |
| Engeset [67] (2015), women, Italy; Spain; UK; The Netherlands; Greece; Sweden; Denmark; Norway; Germany; France | 35–70 (F) |
337,352 (1050) |
16 y | median intake:1.9 g/d; 10.8 g/d; 21.1 g/d; 34.2 g/d; 76.2 g/d | FFQ | ICD-10 (I20-25) | Energy from fat, energy from carbohydrates and proteins, dietary fibres, red meat, processed meat, vegetables, fruit, alcohol intake, body mass index, physical activity, smoking, education. |
| Gammelmark [51] (2016), men, Danish |
50–64 (M) |
25,913 (424) |
17 y | 0–8 g/d; >8–13 g/d; > 13–18 g/d; >18–28 g/d; >28 g/d | FFQ | ICD-8 (410.00-410.99) or ICD-10 (I21.0-I21.9) | Smoking, BMI, waist circumference, physical activity, alcohol intake, educational level, history of diabetes mellitus, hypercholesterolaemia, hypertension, total energy intake, intake of fruits and vegetables and intake of nuts |
| Gammelmark [51] (2016), women, Danish |
50–64 (F) |
28,991 (156) |
17 y | 0–6 g/d; >6–10 g/d; >10–15 g/d; >15–23 g/d; >23 g/d | FFQ | ICD-8 (410.00-410.99) or ICD-10 (I21.0-I21.9) | Smoking, BMI, waist circumference, physical activity, alcohol intake, educational level, menopausal status, history of diabetes mellitus, hypercholesterolaemia, hypertension, total energy intake, intake of fruits and vegetables and intake of nuts |
| Farvid [68] (2017), Iran |
36–85 (both) |
42,403 (762) |
11 y | median intake: 0 g/d; 0.85 g/d; 5.1 g/d; 16.15 g/d | FFQ | ICD-10 (I20-52) | Gender; age; ethnicity; education; marital status; residency; smoking; opium use; alcohol; BMI; systolic blood pressure; occupational physical activity; family history of cancer; wealth score; medication; and energy intake. |
| Wallin [69] (2018), Swedish |
45–84 (both) |
2225 (154) |
14 y | ≤3/mo; 1–<2/wk; 2–3/wk; >3/wk |
FFQ | ICD-10 (I20-25) | Age, sex, time since diabetes diagnosis, BMI, physical activity, education, cigarette smoking, total energy intake, alcohol, history of high cholesterol, history of hypertension and DASH diet component score |
FFQ, Food-frequency questionnaire; BMI, body mass index; ICD, International Classification of Diseases; F, female; M, male; y, year; HDL, High Density Lipoprotein; LDL, Low Density Lipoprotein; ECG, electrocardiogram; SFA, Saturated fatty acids; MUFA, Saturated fatty acids; PUFA, Polyunsaturated fatty acids; CVD, cerebrovascular disease; DASH, Dietary Approaches to Stop Hypertension; wk, week; mo, month; d, day.