Zhu Ning, Li Yusheng, Jin Xiaoyan, Chen Mei, Wang Linfeng, Cao Chao
Department of Respiratory and Critical Care Medicine, Key Laboratory of Respiratory Disease of Ningbo, The First Affiliated Hospital of Ningbo University, Ningbo, China.
Medical Department of Ningbo University, Ningbo, China.
BMC Nutr. 2025 Aug 4;11(1):158. doi: 10.1186/s40795-025-01139-6.
This cross-sectional study examined the association between fish consumption and serum cotinine levels, a biomarker of tobacco exposure, among adults in the United States.
Data were obtained from the National Health and Nutrition Examination Survey (NHANES) conducted between 2001 and 2018. A total of 32,766 participants were included after applying eligibility criteria. Fish consumption frequency was assessed via dietary questionnaires, and serum cotinine levels were measured using validated high-performance liquid chromatography-tandem mass spectrometry. Multiple linear regression and restricted cubic spline (RCS) models were used to evaluate the association between fish consumption and serum cotinine levels, adjusting for potential confounders.
Higher fish consumption was significantly associated with lower serum cotinine levels across all models. Participants who consumed ≥ 6 fish meals per month had significantly lower serum cotinine levels compared to non-consumers (β = -0.20, 95% CI: -0.30 to -0.10; P < 0.001) after adjustment for confounding variables. RCS analysis revealed a non-linear relationship, with an inflection point at 4.53 meals per month (P for nonlinearity < 0.01). Stratified analyses by smoking status showed similar inverse associations among never smokers, former smokers, and current smokers, with no significant interaction observed (P for interaction = 0.218).
In this nationally representative sample of U.S. adults, higher fish consumption was independently associated with lower serum cotinine levels. These findings provide novel epidemiological evidence linking dietary habits to tobacco exposure biomarkers and suggest a potential role for fish consumption in supporting healthier lifestyle behaviors.
这项横断面研究调查了美国成年人中鱼类消费与血清可替宁水平（烟草暴露的生物标志物）之间的关联。
数据来自2001年至2018年进行的美国国家健康与营养检查调查（NHANES）。在应用纳入标准后，共纳入了32766名参与者。通过饮食问卷评估鱼类消费频率，并使用经过验证的高效液相色谱 - 串联质谱法测量血清可替宁水平。使用多元线性回归和受限立方样条（RCS）模型来评估鱼类消费与血清可替宁水平之间的关联，并对潜在混杂因素进行调整。
在所有模型中，较高的鱼类消费量均与较低的血清可替宁水平显著相关。在调整混杂变量后，每月食用≥6次鱼类餐食的参与者与非消费者相比，血清可替宁水平显著降低（β = -0.20，95% CI：-0.30至-0.10；P < 0.001）。RCS分析显示存在非线性关系，每月4.53餐时有一个拐点（非线性P < 0.01）。按吸烟状况进行的分层分析显示，从不吸烟者、曾经吸烟者和当前吸烟者中均存在类似的负相关，未观察到显著的交互作用（交互作用P = 0.218）。
在这个具有全国代表性的美国成年人样本中，较高的鱼类消费量与较低的血清可替宁水平独立相关。这些发现提供了将饮食习惯与烟草暴露生物标志物联系起来的新的流行病学证据，并表明鱼类消费在支持更健康的生活方式行为方面可能发挥的作用。
