Department of Food and Nutrition, Kyung Hee University, Seoul, South Korea.
Asia Pac Psychiatry. 2018 Dec;10(4):e12335. doi: 10.1111/appy.12335. Epub 2018 Sep 20.
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.
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.
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.
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.
鱼类或ω-3 脂肪酸摄入与抑郁症之间关联的证据并不一致。我们进行了一项系统综述和前瞻性队列研究的荟萃分析，以检验这种关联。
在 PubMed 和 Web of Science 数据库中进行检索，以确定截至 2018 年 4 月发表的相关文章，并通过检索文章的参考文献进行补充。使用随机效应模型，我们计算了调整潜在混杂因素后，与鱼类或ω-3 脂肪酸摄入相关的抑郁发生的 pooled relative risks（RR）。
共有 10 项前瞻性队列研究，包括 109764 名参与者中有 6672 例抑郁症，纳入荟萃分析。最高与最低鱼类摄入量组别的抑郁 pooled adjusted RR 为 0.89（95% CI：0.80-0.99）。最高与最低ω-3 摄入量组别的抑郁 pooled adjusted RR 为 0.87（95% CI：0.74-1.04）。在剂量反应分析中，每周增加 1 份鱼类摄入量和 500mg/dω-3 脂肪酸摄入量的 pooled adjusted RRs 分别为 0.89（95% CI：0.75-1.04）和 0.99（95% CI：0.94-1.04），无异质性。
我们的研究结果为鱼类或ω-3 脂肪酸摄入与抑郁症风险之间存在适度的负相关提供了定量证据，尤其是在女性中。这些观察性研究的结果需要通过大型随机临床试验来证实，即通过鱼类摄入或ω-3 脂肪酸摄入与抑郁症风险来进行。
