Association of fish consumption with risk of all-cause and cardiovascular disease mortality: an 11-year follow-up of the Guangzhou Biobank Cohort Study

Background: Whether fish consumption is associated with all-cause, cardiovascular (CVD), ischemic heart disease (IHD) and stroke mortality remains inconclusive. We examined the association of fish consumption with all-cause, cardiovascular (CVD), ischemic heart disease (IHD) and stroke mortality in older men and women in south China. Methods: A total of 18,215 participants including men and women without CVD at baseline (2003–2006) from Guangzhou Biobank Cohort Study (GBCS) were included and followed up till December 2017. Deaths were identified through record linkage with the Death Registry. Information on fish consumption was obtained using a food frequency questionnaire. Results: During an average follow-up of 11.4 (standard deviation = 2.1) years, 2,697 deaths occurred, including 917 total CVD, 397 IHD and 374 stroke deaths. After adjusting for potential confounders, compared with fish consumption of 0–3 servings/week (i.e., 0–21 g/day, one serving = 50 g), consumption of 4–6 servings/week (29–43 g/day) showed significantly lower risks of all-cause and CVD mortality (hazards ratio (HR) and 95% confidence interval (CI): 0.85 (0.76, 0.95) and 0.77 (0.64, 0.93), respectively), but the reduced risk of IHD mortality (HR (95% CI): 0.80 (0.60, 1.07)) was not significant. Consumption of 7–10 servings/week or higher showed no association with all-cause, CVD, IHD, and stroke mortality. Conclusions: Moderate fish consumption of 4–6 servings/week (29–43 g/day) was associated with lower all-cause and CVD mortality risk. Our findings support the current general advice on regular fish consumption also in middle-aged and older adults.