Fish and Marine Omega-3 Polyunsatured Fatty Acid Consumption and Incidence of Type 2 Diabetes: A Systematic Review and Meta-Analysis

Table 1

Characteristics of included studies regarding fish/seafood, fish, and LC n-3 PUFA intake and risk of type 2 diabetes.

(a)  

Fish/seafood	Ethnicity	Age	Follow-up years	Fish/seafood type	Fish/seafood consumption (highest versus lowest) (range)	Number of participants	Quartile	Adjustment for T2D risk factors	Quality score (0–12)	Adjusted RR (95% CI)
Nanri et al. 2011^A	Japan	40–59	10	Total fish/seafood	166.6 g/d versus 35.9 g/d (130.7 g/d)	52680	4	Age, BMI, family history of diabetes mellitus, total physical activity, vegetable, fruit, and meat	11	0.84 (0.62–1.15)
Villegas et al. 2011^B	China	40–74	4.1–8.9	Total fish/shellfish	99.2 g/d versus 14.0 g/d (85.2 g/d)	116129	5	Age, BMI, physical activity, family history of diabetes, and dietary pattern (vegetable, fruit, and meat)	11	0.87 (0.78–0.97)
Patel et al. 2009^C	Norwich, England	40–79	7.5	Total fish/seafood	>14.28 g/d versus <14.28 g/d (14.28 g/d)	21984	2	Age, BMI, family history of diabetes, and physical activity	7	0.76 (0.59–0.96)
Patel et al. 2012^K	Europe	55–63	6.9	Total fish/seafood	>51.8 g/d versus <15 g/d	24813	4	Age, BMI, physical activity, fruit, and vegetable intake	8	0.99 (0.86–1.15)
Montonen et al. 2005^J	Finland	40–69	23	Total fish	>0 versus 0 g/d	4304	4	Age, BMI, and family history of diabetes	6	0.96 (0.71–1.29)
Schulze et al. 2003^D	US	26–46	8	Total fish	>28.57 g/d versus <14.28 g/d (28.57 g/d)	91246	N/A	Age, BMI, physical activity, and family history of diabetes	8	1.04 (0.82–1.32)
Djoussé et al. 2011^E	US	>45	12.4	Total fish/seafood	56.14 g/d versus 6.71 g/d (49.43 g/d)	36328	5	Age, BMI, parental history of diabetes, physical activity, and meat	8	1.49 (1.30–1.70)
Djoussé et al. 2011^F	US	>65	15	Total fish	>71.43 g/d versus <3.3 g/d (71.43 g/d)	2831	5	Age, BMI, and physical activity	6	1.07 (0.35, 3.33)
Kaushik et al. 2009^G	US	26–78	14.5–18.5	Total fish (finfish)	>71.43 g/d versus <3.3 g/d (78.57 g/d)	195204	5	Physical activity, family history of diabetes mellitus, and BMI	7	1.22 (1.08–1.38)
Van Woudenbergh et al. 2009^H	Dutch	>55	12	Total fish/seafood	35.6 g/d versus 0 g/d (35.6 g/d)	4472	4	Age	5	1.32 (1.02–1.70)

(b)  

Fish	Ethnicity	Age	Follow-up years	Fish type	Fish consumption	Number of participants	Quartile	Adjustment for T2D risk factors	Quality score	Adjusted RR (95% CI)
Nanri et al. 2011^A	Japan	40–59	10	Fresh fish	95.4 g/d versus 13.6 g/d (81.8 g/d)	52680	4	Age, BMI, family history of diabetes mellitus, physical activity, vegetable, fruit, and meat	11	0.91 (0.73–1.13)
Villegas et al. 2011^B	China	40–74	4.1–8.9	Fish	79.6 g/d versus 9.6 g/d (70 g/d)	116156	5	Age, BMI, physical activity, family history of diabetes, and dietary pattern (vegetable, fruit, and meat)	11	0.90 (0.80–1.01)
Kaushik et al. 2009^G	US	26–78	14.5–18.5	Finfish	>71.43 g/d versus <3.3 g/d (78.57 g/d)	195204	5	Physical activity, family history of diabetes, and BMI	7	1.22 (1.08–1.38)
Montonen et al. 2005^J	Finland	40–69	23	Total fish	>0 versus 0 g/d	4304	4	Age, BMI, and family history of diabetes	6	0.96 (0.71–1.29)
Patel et al. 2009^C	Norwich, England	40–79	7.5	White fish, oily fish	>14.28 g/d versus <14.28 g/d (14.28 g/d)	21984	2	Age, BMI, family history of diabetes, and physical activity	7	0.90 (0.79–1.03)
Patel et al. 2012^K	Europe	55–63	6.9	Total fish	>34.9 g/d versus <2.9 g/d	24813	4	Age, BMI, physical activity, fruit, and vegetable intake	8	1.06 (0.92–1.22)
Van Woudenbergh et al. 2009^H	Dutch	>55	12	Lean fish, fatty fish	46.3 g/d versus 0 (46.3 g/d)	4472	4	Age	5	1.16 (0.89–1.51)

(c)  

LC n-3 PUFA	Ethnicity	Age	Follow-up years	LC n-3 PUFA type	LC n-3 PUFA consumption	Number of participants	Quartile	Adjustment for T2D risk factors	Quality score	Adjusted RR (95% CI)
Villegas et al. 2011^B	China	40–74	4.1–8.9	EPA, DHA	0.2 g/d versus 0.02 g/d (0.18 g/d)	64193	5	Age, BMI, physical activity, family history of diabetes, and dietary pattern (vegetable, fruit, and meat)	11	0.85 (0.76–0.95)
Brostow et al. 2011^I	Singapore, Chinese	45–74	6	EPA, DHA	0.6 g/d versus 0.11 g/d (0.49 g/d)	43175	5	Age, BMI, and physical activity	7	0.93 (0.77–1.11)
Kaushik et al. 2009^G	US	26–78	14.5–18.5	EPA, DHA	0.46 g/d versus 0.07 g/d (0.37 g/d)	195204	5	Physical activity, family history of diabetes, and BMI	7	1.24 (1.09–1.41)
Djoussé et al. 2011^E	US	>45	12.4	EPA, DHA	0.39 g/d versus 0.05 g/d (0.34 g/d)	36328	5	Age, BMI, parental history of diabetes, physical activity, and meat	8	1.45 (1.32–1.59)
Djoussé et al. 2011^F	US	>65	15	EPA, DHA	>0.56 g/d versus <0.17 g/d (0.6 g/d)	3088	4	Age, BMI, and physical activity	6	1.04 (0.67–1.61)
Van Woudenbergh et al. 2009^H	Dutch	>55	12	EPA, DHA	0.237 g/d versus 0.024 g/d (0.21 g/d)	4472	3	Age	5	1.22 (0.97–1.53)

A–I: A: T2D was assessed by Japanese criteria [12]; B: T2D was assessed by ADA criteria [13]; C: T2D was assessed by other resource and hospital records [16]; D: T2D was assessed by NDDG criteria [17]; E: T2D was assessed by ADA criteria [14]; F: T2D was assessed by medication use and fasting/nonfasting glucose level in plasma [20]; G: T2D was assessed by NDDG criteria [15]; H: T2D was assessed by ADA/WHO criteria [18]; I: T2D was self-reported [19]; J: T2D was assessed by physician according to diabetic criteria [22]; K: T2D was assessed by multiple sources [21].