Intakes of fish and polyunsaturated fatty acids and mild-to-severe cognitive impairment risks: a dose-response meta-analysis of 21 cohort studies
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Background The intake of fish and polyunsaturated fatty acids (PUFAs) may benefit cognitive function. However, optimal intake recommendations for protection are unknown.Objective We systematically investigated associations between fish and PUFA intake and mild-to-severe cognitive impairment risk.Design Studies that reported risk estimates for mild cognitive impairment (MCI), cognitive decline, dementia, Alzheimer disease (AD), or Parkinson disease (PD) from fish, total PUFAs, total n-3 (ω-3) PUFAs, or at least one n-3 PUFA were included. Study characteristics and outcomes were extracted. The pooled RR was estimated with the use of a random-effects model meta-analysis. A dose-response analysis was conducted with the use of the 2-stage generalized least-squares trend program.Results We included 21 studies (181,580 participants) with 4438 cases identified during follow-up periods (2.1-21 y). A 1-serving/wk increment of dietary fish was associated with lower risks of dementia (RR: 0.95; 95% CI: 0.90, 0.99; P = 0.042, I(2) = 63.4%) and AD (RR: 0.93; 95% CI: 0.90, 0.95; P = 0.003, I(2) = 74.8%). Pooled RRs of MCI and PD were 0.71 (95% CI: 0.59, 0.82; P = 0.733, I(2) = 0%) and 0.90 (95% CI: 0.80, 0.99; P = 0.221, I(2) = 33.7%), respectively, for an 8-g/d increment of PUFA intake. As an important source of marine n-3 PUFAs, a 0.1-g/d increment of dietary docosahexaenoic acid (DHA) intake was associated with lower risks of dementia (RR: 0.86; 95% CI: 0.76, 0.96; P < 0.001, I(2) = 92.7%) and AD (RR: 0.63; 95% CI: 0.51, 0.76; P < 0.001, I(2) = 94.5%). Significant curvilinear relations between fish consumption and risk of AD and between total PUFAs and risk of MCI (both P-nonlinearity < 0.001) were observed.Conclusions Fishery products are recommended as dietary sources and are associated with lower risk of cognitive impairment. Marine-derived DHA was associated with lower risk of dementia and AD but without a linear dose-response relation.
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In a 2016 dose-response meta-analysis of 21 cohort studies, increased intakes of fish or dietary DHA were inversely associated with the risks of dementia and Alzheimer's disease.
“In a 2016 dose-response meta-analysis of 21 cohort studies, the authors reported that increased intakes of fish or dietary DHA were inversely associated with the risks of dementia and AD [82].”
From Role of n-3 long-chain polyunsaturated fatty acids in human nutrition and health: Review of recent studies and recommendations (2021) · cites this paper as [82]
A 100 mg/day incremental increase in DHA intake was associated with a 14% lower risk of dementia and a 37% lower risk of Alzheimer's disease.
“Specifically, a 100 mg/day incremental increase in DHA intake was associated with a 14% lower risk of dementia and a 37% lower risk of AD.”
From Role of n-3 long-chain polyunsaturated fatty acids in human nutrition and health: Review of recent studies and recommendations (2021) · cites this paper as [82]
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Nutrition and longevity—From mechanisms to uncertainties
Ekmekcioglu, C. (2020) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2019.1676698 · Cited by 87 · see citing works
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- Authors
- Zhang, Y., Chen, J., Qiu, J., Li, Y., Wang, J., & Jiao, J.
- Affiliations
- Zhejiang University (CN)
- Corresponding author
- Jiao, Jingjing
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2016-02
- Volume
- 103
- Issue
- 2
- Pages
- 330-340
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2212256215
- Cited by
- 330
- References
- 77
- Citations by year
- 2026: 14 · 2025: 31 · 2024: 34 · 2023: 23 · 2022: 40 · 2021: 39 · 2020: 47 · 2019: 28 · 2018: 36 · 2017: 29 · 2016: 9
- FWCI
- 3.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (31201307)
- Zhejiang Provincial Natural Science Foundation of China (LY14C200008)
- Fundamental Research Funds for the Central Universities (2015QNA7014)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- fish consumption, polyunsaturated fatty acids, omega-3 fatty acids, docosahexaenoic acid, cognitive impairment, mild cognitive impairment, dementia, Alzheimer's disease, Parkinson's disease, cognitive decline, dose-response relationship, dietary intake, neuroprotection, n-6 PUFA
- MeSH terms
- Alzheimer Disease, Animals, Cognition Disorders, Dementia, Diet, Dietary Fats, Unsaturated, Fishes, Humans, Risk Factors, Severity of Illness Index, Fatty Acids, Omega-3, Seafood, Dietary Supplements, Cognitive Dysfunction
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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