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. 2020 Dec 2;371:m4141. doi: 10.1136/bmj.m4141

Table 4.

Hazard ratios (95% confidence intervals) for total coronary heart disease associated with replacement of one serving per day of total, unprocessed, and processed red meat with one serving per day of each type of fish, stratified by follow-up period (<2000, ≥2000)

Overall <2000 ≥2000
Hazard ratio (95% CI) P value Hazard ratio (95% CI) P value Hazard ratio (95% CI) P value
Total red meat
Dark meat fish 0.89 (0.67 to 1.20) 0.45 1.10 (0.78 to 1.56) 0.57 0.56 (0.33 to 0.95) 0.03
Tuna 1.03 (0.84 to 1.25) 0.79 1.08 (0.84 to 1.39) 0.55 0.97 (0.70 to 1.35) 0.85
Other fish* 1.20 (0.95 to 1.51) 0.12 1.03 (0.77 to 1.38) 0.85 1.59 (1.08 to 2.35) 0.02
Unprocessed red meat
Dark meat fish 0.88 (0.65 to 1.18) 0.39 1.10 (0.77 to 1.58) 0.59 0.54 (0.31 to 0.92) 0.02
Tuna 1.01 (0.82 to 1.24) 0.95 1.08 (0.83 to 1.40) 0.59 0.93 (0.66 to 1.31) 0.67
Other fish* 1.18 (0.93 to 1.49) 0.17 1.02 (0.75 to 1.39) 0.88 1.54 (1.04 to 2.29) 0.03
Processed red meat
Dark meat fish 0.84 (0.62 to 1.14) 0.27 1.05 (0.73 to 1.49) 0.81 0.52 (0.30 to 0.90) 0.02
Tuna 0.98 (0.79 to 1.20) 0.81 1.02 (0.79 to 1.33) 0.87 0.92 (0.65 to 1.29) 0.62
Other fish* 1.14 (0.90 to 1.45) 0.28 0.97 (0.71 to 1.32) 0.85 1.53 (1.03 to 2.29) 0.04

Models were adjusted for age, year of questionnaire return, race or ethnicity (white, black, Asian, other), marital status (married, divorced, widowed, never married), living arrangement (lives with family, lives alone, other), profession (dentist, pharmacist, optometrist, podiatrist, veterinarian), work status (full time, part time, retired), smoking status (never smoker, former smoker, current 1-14 cigarettes/d, current 15-24 cigarettes/d, current ≥25 cigarettes/d), physical activity(<3, 3-8.9, 9-17.9, 18-26.9, and ≥27 in metabolic equivalents of task/wk), body mass index;(<21, 21-22.9, 23-24.9, 25-26.9, 27-29.9, 30-32.9, 33-34.9, 35-39.9, ≥40), alcohol intake (0, 0.1-4.9, 5.0-9.9, 10-14.9, or ≥15.0 g/d), multivitamin use (yes, no), aspirin use (yes, no), family history of early coronary heart disease or stroke (diagnosis <60 years; yes, no), and total energy intake (fifths), and intakes of poultry, dark meat fish, tuna, other fish, egg, high fat dairy, low fat dairy, combined plant protein sources of nuts, legumes, and soy, whole grains, fruit, vegetables, and coffee, and glycemic index.

*

Included other types of fish such as cod, haddock, and halibut in addition to store bought breaded fish, fish cakes, fish pieces, and fish sticks.