Clinical research study
Association between fish consumption and all-cause and cause-specific mortality in Japan: NIPPON DATA80, 1980–99

https://doi.org/10.1016/j.amjmed.2004.12.016Get rights and content

Purpose

Although high consumption of fish may be one of the contributing factors for Japanese longevity, no epidemiological study using Japanese data has tested this hypothesis.

Subjects and methods

The relationship between fish consumption and all-cause as well as cause-specific mortality was analyzed using the database of NIPPON DATA80. At baseline in 1980, history, physical, and blood biochemical measurement and a nutritional survey by the food-frequency method were performed in randomly selected community-based subjects aged 30 years and over in Japan. After exclusion of subjects with significant comorbidities at baseline, we followed 3 945 men and 4 934 women for 19 years. Men and women were analyzed comprehensively. Age- and sex-adjusted and multivariate adjusted relative risk for all-cause or cause-specific mortality was calculated using a Cox proportional hazards model with delayed entry.

Results

During 19 years of followup, there were 1 745 deaths. Subjects were divided into 5 groups according to fish consumption frequency. The multivariate Cox analyses showed that relative risks for subjects who ate fish more than twice daily compared with those of subjects who ate 1 to 2 times weekly were 0.99 (95% confidence intervals: 0.77–1.27) for all-cause, 1.26 (0.70–2.29) for stroke, 0.92 (0.20–4.23) for cerebral hemorrhage, 1.09 (0.48–2.43) for cerebral infarction, and 0.91 (0.35–2.35) for coronary heart disease mortality.

Conclusion

Our results did not provide evidence in support of the fish hypothesis, perhaps because the majority of the Japanese subjects in the study ate fish more than the threshold level shown to be beneficial in the previous studies.

Section snippets

Subjects

The subjects in this cohort were participants in the 1980 National Survey on Circulatory Disorders.29 A total of 10 546 community-based subjects aged 30 years and over in 300 randomly selected health districts throughout Japan participated in the survey, which consisted of history-taking, physical examinations, blood tests, and a self-administered questionnaire on lifestyle, including an essential nutritional survey by the food-frequency method. In the previous study, the cohort was followed

Baseline characteristics

The baseline characteristics in each fish consumption category for men and women combined are shown in Table 1. Relatively few subjects (6% and 3% of the total subjects) were in the more than twice per day or less than once per week groups. Except for these two extreme categories, there were more than 2 200 subjects in each category. The mean age was higher and there were more subjects with hypertension and diabetes in these two extreme categories. Among the subjects who ate fish more than twice

Discussion

Although the majority of the prospective cohort studies have found an inverse association between fish consumption and risk of coronary heart disease or all-cause mortality7, 10, 12, 13, 14, 15, 17, 18 (Table 3), the 4 cohort studies did not find such associations8, 9, 11, 16 (Table 3). One of these was the study on the Japanese American population living in Hawaii, and the authors speculated that almost everyone in the study population ate some fish regularly and their consumption level might

Acknowledgments

This study was supported by a grant-in-aid from the Ministry of Health and Welfare under the auspices of the Japanese Association for Cerebro-cardiovascular Disease Control, a Research Grant for Cardiovascular Diseases (7A-2) from the Ministry of Health, Labor and Welfare, and a Health and Labor Sciences Research Grant (Comprehensive Research on Aging and Health: H11-Chouju-046, H14-Chouju-003).

References (53)

  • H. Iso et al.

    Serum fatty acids and fish intake in rural Japanese, urban Japanese, Japanese American and Caucasian American men

    Int J Epidemiol

    (1989)
  • Y. Kagawa et al.

    Eicosapolyenoic acids of serum lipids of Japanese islanders with low incidence of cardiovascular disease

    J Nutr Sci Vitaminol

    (1982)
  • D. Kromhout et al.

    The inverse relation between fish consumption and 20-year mortality from coronary heart disease

    N Engl J Med

    (1985)
  • S.E. Vollset et al.

    Fish consumption and mortality from coronary heart disease

    N Engl J Med

    (1985)
  • J.D. Curb et al.

    Fish consumption and mortality from coronary heart disease

    N Engl J Med

    (1985)
  • S.E. Norell et al.

    Fish consumption and mortality from coronary heart disease

    Br Med J

    (1986)
  • A. Ascherio et al.

    Dietary intake of marine n-3 fatty acids, fish intake, and the risk of coronary disease among men

    N Engl J Med

    (1995)
  • M.L. Daviglus et al.

    Fish consumption and the 30-year risk of fatal myocardial infarction

    N Engl J Med

    (1997)
  • C.M. Albert et al.

    Fish consumption and risk of sudden cardiac death

    JAMA

    (1998)
  • J.M. Yuan et al.

    Fish and shellfish consumption in relation to death from myocardial infarction among men in Shanghai, China

    Am J Epidemiol

    (2001)
  • F.B. Hu et al.

    Fish and omega-3 fatty acid intake and risk of coronary heart disease in women

    JAMA

    (2002)
  • D. Mozaffarian et al.

    Cardiac benefits of fish consumption may depend on the type of fish meal consumedthe Cardiovascular Health Study

    Circulation

    (2003)

  • Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarctionresults from the GISSI-Prevenzione trial

    Lancet

    (1999)
  • A. Gramenzi et al.

    Association between certain foods and risk of acute myocardial infarction in women

    Br Med J

    (1990)
  • D.S. Siscovick et al.

    Dietary intake and cell membrane levels of long-chain n-3 polyunsaturated fatty acids and the risk of primary cardiac arrest

    JAMA

    (1995)
  • E. Guallar et al.

    Mercury, fish oils, and the risk of myocardial infarction

    N Engl J Med

    (2002)

    • Cited by (0)

    *

    For a list of the investigators and members of the NIPPON DATA80 Research Group, please see the appendix of reference 28.

    View full text
    Copyright © 2005 Elsevier Inc. All rights reserved.