Fish, long chain omega-3 polyunsaturated fatty acids consumption, and risk of all-cause mortality: a systematic review and dose-response meta-analysis from 23 independent prospective cohort studies

Asia Pac J Clin Nutr. 2017;26(5):939-956. doi: 10.6133/apjcn.072017.01.


Background and objectives: The consumption of fish and long chain omega-3 polyunsaturated fatty acids (n-3 PUFA) may influence the risk of all-cause mortality, but the findings have been inconsistent. The current systematic review and meta-analysis is to clarify the association between fish and long chain n-3 PUFA consumption with risk of all-cause mortality.

Methods and study design: Studies published before March 2017 were identified through electronic searches using PubMed, Scopus and Web of Science database. We included prospective cohort studies that reported relative risks with 95% CI of all-cause mortality for fish and long chain n-3 PUFA consumption. Results were combined using a random effects model.

Results: Twenty-three prospective cohorts with a total of 1,035,416 participants were included. Twenty-two pooled studies involving 985,126 participants indicated that fish intake was associated with 6% (RR: 0.94; 95% CI: 0.90, 0.98) reduction in risk of all-cause mortality. Six studies with 430,579 participants investigated the association between long chain n-3 PUFA and all-cause mortality risk, the relative risk for highest versus lowest category was 0.86 (95% CI: 0.80, 0.93). Doseresponse analysis suggested that the risk of all-cause mortality was reduced by 7% (RR: 0.93; 95% CI: 0.88, 0.99) for every 0.2 g per day increment in long chain n-3 PUFA consumption.

Conclusions: Current meta-analysis indicates that both fish and long chain n-3 PUFA consumption are inversely associated with risk of all-cause mortality. These findings could have public health implications with regard to lowering risk of all-cause mortality through dietary interventions.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Animals
  • Diet / mortality*
  • Diet / statistics & numerical data*
  • Fatty Acids, Unsaturated / administration & dosage*
  • Fatty Acids, Unsaturated / chemistry
  • Fishes*
  • Food Analysis*
  • Humans
  • Mortality
  • Risk Factors


  • Fatty Acids, Unsaturated