Fish and long-chain ω-3 polyunsaturated fatty acid (LCω3PUFA) intake in relation to the risk of cardiovascular diseases have been well studied. However, studies that directly link fish consumption or LCω3PUFA intake to the risk of metabolic syndrome (MetS) are sparse and the results are inconsistent. We reviewed literature through December 2014 and used random-effects or fixed-effects models, as appropriate, to pool the associations of fish or LCω3PUFA intake with the risk of MetS. Nine independent cross-sectional samples (seven cross-sectional studies) and three independent prospective cohorts (two prospective cohort studies) were identified as eligible for this meta-analysis. By pooling data from the prospective cohorts (7860 participants and 1671 incident cases), a significant inverse association between fish consumption and incidence of MetS was found. The pooled RR (95% CI) was 0.71 (0.58, 0.87), comparing the highest to the lowest category of fish consumption, and 0.94 (0.90, 0.98) for one serving/week increment. Consistent results were found for LCω3PUFA intake. Non-significant inverse association of fish or LCω3PUFA intake with risk of MetS was found when pooling the cross-sectional studies. By quantitatively summarizing the literature, a modest inverse association between fish or LCω3PUFA intake and risk of MetS cannot be excluded.
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