TABLE 3.
Quantitative synthesis and evidence grading for meta‐analyses evaluating the associations between unsaturated fatty acids intake and risk of mental disorders1
| Study, year (ref) | Mental disorders | Composition | No. of studies (participants, n) | Effect metrics | Random-effects summary estimate (95% CI) | Random-effects P | I 2, % | 95% Prediction interval | Egger's test P | Largest study estimate (95% CI) | Significant studies | Grading | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| O/E | P | ||||||||||||
| Kosti et al., 2022 (63) | Dementia | Higher intake of fish | 9 (45,643) | RR | 0.798 (0.688, 0.925) | 0.003 | 0.0 | (0.563, 1.129) | 0.08 | 0.84 (0.71, 1.00) | 4/3.50 | 0.74 | Weak |
| Alzheimer disease | Higher intake of fish | 8 (444,022) | RR | 0.737 (0.626, 0.867) | <10−3 | 0.0 | (0.479, 1.134) | 0.71 | 0.69 (0.60, 0.80) | 5/6.49 | — | Suggestive | |
| Zhu et al., 2021 (62) | Alzheimer disease | Higher intake of total n–3 PUFAs | 4 (11,977) | RR | 0.883 (0.662, 1.177) | 0.396 | 60.7 | (0.370, 2.11) | 0.12 | 1.07 (0.91, 1.25) | 1/0.41 | 0.35 | Not significant |
| Higher intake of total n–6 PUFAs | 2 (3427) | RR | 0.826 (0.549, 1.241) | 0.358 | 55.9 | — | — | 0.76 (0.55, 1.06) | 0/1.69 | — | Not significant | ||
| Higher intake of PUFAs | 3 (8084) | RR | 0.905 (0.741, 1.105) | 0.326 | 0.0 | (0.584, 1.403) | 0.68 | 1.09 (0.79, 1.50) | 0/0.43 | — | Not significant | ||
| Higher intake of MUFA | 4 (8899) | RR | 1.154 (0.800, 1.664) | 0.442 | 64.50 | (0.380, 3.507) | 0.78 | 0.91 (0.77, 1.07) | 1/0.56 | 0.45 | Not significant | ||
| Higher intake of DHA | 3 (3892) | RR | 0.778 (0.477, 1.267) | 0.313 | 76.20 | (0.003, 185.619) | 0.67 | 0.73 (0.57, 0.95) | 2/1.66 | 1.00 | Not significant | ||
| Higher intake of EPA | 3 (3892) | RR | 0.888 (0.658, 1.198) | 0.436 | 45.08 | (0.046, 16.999) | 0.15 | 0.74 (0.57, 0.95) | 1/1.58 | — | Not significant | ||
| Qu et al., 2019 (50) | Parkinson disease | Higher intake of total n–3 PUFAs | 3 (300,321) | RR | 0.763 (0.487, 1.194) | 0.236 | 62.2 | (0.006, 104.092) | 0.50 | 0.93 (0.76, 1.14) | 1/0.39 | 0.34 | Not significant |
| Higher intake of total n–6 PUFAs | 3 (300,321) | RR | 0.990 (0.667, 1.468) | 0.959 | 55.9 | (0.015, 66.907) | 0.29 | 1.23 (1.02, 1.49) | 1/1.29 | — | Not significant | ||
| Higher intake of PUFAs | 4 (326,686) | RR | 0.864 (0.592, 1.261) | 0.449 | 74.0 | (0.173, 4.320) | 0.18 | 1.23 (1.02, 1.49) | 2/1.57 | 0.65 | Not significant | ||
| Higher intake of MUFA | 5 (327,054) | RR | 1.033 (0.865, 1.235) | 0.719 | 0.0 | (0.774, 1.380) | 0.24 | 1.13 (0.94, 1.55) | 0/1.00 | — | Not significant | ||
| Higher intake of ALA | 3 (300,513) | RR | 0.726 (0.480, 1.099) | 0.130 | 64.6 | (0.008, 70.002) | 0.22 | 0.93 (0.77, 1.13) | 1/0.39 | 0.34 | Not significant | ||
| Higher intake of LA | 3 (300,513) | RR | 0.930 (0.614, 1.409) | 0.732 | 65.6 | (0.009, 94.012) | 0.05 | 1.23 (1.02, 1.49) | 1/1.33 | — | Not significant | ||
| Higher intake of AA | 2 (299,985) | RR | 1.426 (0.753, 2.700) | 0.277 | 80.1 | — | — | 1.08 (0.90, 1.30) | 1/0.36 | 0.32 | Not significant | ||
| Higher ratio of n–3 to n–6 PUFAs | 2 (299,985) | RR | 0.890 (0.754, 1.051) | 0.170 | 0.0 | — | — | 0.87 (0.73, 1.04) | 0/0.82 | — | Not significant | ||
| Grosso et al., 2016 (44) | Depression | Higher intake of total n–3 PUFAs | 8 (25,923) | RR | 0.873 (0.722, 1.055) | 0.160 | 30.9 | (0.569, 1.339) | 0.86 | 0.74 (0.58, 0.95) | 2/4.57 | — | Not significant |
| Higher intake of EPA and DHA | 7 (77,143) | RR | 0.782 (0.667, 0.918) | 0.003 | 50.4 | (0.508, 1.206) | 0.63 | 0.65 (0.53, 0.80) | 3/6.35 | — | Weak | ||
| Higher intake of fish | 21 (200,422) | RR | 0.780 (0.688, 0.885) | <10−3 | 61.4 | (0.489, 1.244) | 0.90 | 0.76 (0.64, 0.91) | 8/15.08 | — | Suggestive | ||
| Zhang et al., 2016 (15) | Alzheimer disease | Higher intake of PUFAs | 2 (6844) | RR | 0.872 (0.334, 2.278) | 0.779 | 27.9 | — | — | 1.07 (0.82, 1.39) | 0/0.15 | — | Not significant |
| Higher intake of DHA | 3 (6476) | RR | 0.546 (0.242, 1.233) | 0.145 | 90.53 | (<0.001, >1000) | 0.11 | 1.10 (0.93, 1.31) | 2/0.31 | 0.03 | Not significant | ||
| Dementia | Higher intake of PUFAs | 2 (6844) | RR | 0.870 (0.355, 2.131) | 0.760 | 25.09 | — | — | 1.04 (0.83, 1.29) | 0/0.12 | — | Not significant | |
| Higher intake of DHA | 2 (5661) | RR | 0.804 (0.511, 1.263) | 0.344 | 90.81 | — | — | 1.00 (0.89, 1.14) | 1/0.10 | 0.10 | Not significant | ||
| Mild cognitive impairment | Higher intake of PUFAs | 3 (3386) | RR | 0.714 (0.607, 0.841) | <10−3 | 0.0 | (0.248, 2.056) | 0.70 | 0.72 (0.61, 0.85) | 1/1.05 | — | Suggestive | |
| Parkinson disease | Higher intake of DHA | 4 (141,551) | RR | 1.001 (0.974, 1.029) | 0.931 | 0.0 | (0.943, 1.063) | 0.51 | 1.01 (0.97, 1.04) | 0/0.20 | — | Not significant | |
| Tsai et al., 2014 (41) | Suicide | Higher intake of total n–3 PUFAs | 3 (205,357) | RR | 1.463 (0.950, 2.251) | 0.084 | 10.1 | (0.057, 37.437) | 0.97 | 1.47 (0.88, 2.44) | 0/0.55 | — | Not significant |
| Higher intake of total n–6 PUFAs | 3 (205,357) | RR | 0.887 (0.562, 1.401) | 0.607 | 0.0 | (0.0459, 17.149) | 0.44 | 0.82 (0.45, 1.51) | 0/0.71 | — | Not significant | ||
| Higher intake of EPA and DHA | 3 (205,357) | RR | 1.241 (0.681, 2.263) | 0.481 | 58.2 | (0.002, 786.970) | 0.21 | 0.80 (0.49, 1.28) | 0/0.29 | — | Not significant | ||
| Higher intake of ALA | 3 (205,357) | RR | 1.068 (0.734, 1.556) | 0.730 | 0.0 | (0.093, 12.222) | 0.01 | 1.27 (0.78, 2.06) | 0/0.30 | — | Not significant | ||
| Higher intake of LA | 3 (205,357) | RR | 0.664 (0.418, 1.056) | 0.084 | 0.0 | (0.033, 13.410) | 0.12 | 0.54 (0.29, 1.02) | 0/2.35 | — | Not significant | ||
| Higher intake of AA | 3 (205,357) | RR | 1.190 (0.824, 1.718) | 0.354 | 0.0 | (0.110, 12.895) | 0.27 | 1.09 (0.67, 1.77) | 0/0.21 | — | Not significant | ||
| Higher intake of fish | 3 (205,357) | RR | 0.818 (0.283, 2.364) | 0.711 | 73.7 | (<0.001, >1000) | 0.71 | 0.55 (0.31, 0.96) | 0/2.39 | — | Not significant | ||
1
All summary estimates were recalculated based on a random-effects model using the method of DerSimonian and Laird. The 95% prediction interval and Egger's test were not evaluated if available studies were <3. For excess of significance, the P value was not evaluated if the observed number of studies was smaller than expected. AA, arachidonic acid; ALA, α-linolenic acid; E, expected number of studies with positive finding; LA, linoleic acid; MD, mean difference; O, observed number of studies with positive finding; ref, reference; SMD, standardized mean difference.