Fish consumption and risk of depression: Epidemiological evidence from prospective studies

Asia Pac Psychiatry. 2018 Dec;10(4):e12335. doi: 10.1111/appy.12335. Epub 2018 Sep 20.


Introduction: The evidence on the association of fish or omega-3 fatty acid intake with depression is inconsistent. We conducted a systematic review and meta-analysis of prospective cohort studies to examine this association.

Methods: Database searches in PubMed and Web of Science were conducted to identify relevant articles published up to April 2018, which were supplemented by hand-searches of reference lists of the retrieved articles. Using a random-effects model, we calculated pooled relative risks (RR) of depression in relation to consumption of fish or omega-3 fatty acids after adjusting for potential confounders.

Results: A total of 10 prospective cohort studies with 6672 cases of depression among 109 764 participants were included in the meta-analysis. The pooled adjusted RR of depression for the highest vs lowest category of fish consumption was 0.89 (95% CI: 0.80-0.99). The pooled adjusted RR of depression for the highest vs lowest category of omega-3 intake was 0.87 (95% CI: 0.74-1.04). In the dose-response analysis, the pooled adjusted RRs for an increment of 1 serving/week of fish consumption and 500 mg/day of omega-3 fatty acid intake were 0.89 (95% CI: 0.75-1.04) and 0.99 (95% CI: 0.94-1.04), respectively. There was no evidence of heterogeneity.

Discussion: Our findings provide quantitative evidence for a modest inverse association between fish or omega-3 fatty acid intake and risk of depression, especially in women. These findings from the observational studies need to be confirmed through large randomized clinical trials of fish consumption or omega-3 fatty acid intake and risk of depression.

Keywords: depression; depressive disorder; fish; meta-analysis; omega-3 fatty acids.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Animals
  • Depression / epidemiology*
  • Depressive Disorder / epidemiology*
  • Fatty Acids, Omega-3*
  • Female
  • Fishes*
  • Humans
  • Male
  • Prospective Studies*
  • Seafood / statistics & numerical data*


  • Fatty Acids, Omega-3