Fish intake and mortality in Japan, a high fish-consuming country: a systematic review and dose-response meta-analysis of cohort studies.

Authors

Kaori Yokoi, Hyeon-Ki Kim, Ayaka Kato, Kohsuke Hayamizu, Yosuke Yamada, Haruki Momma

Published in

European journal of clinical nutrition. Oct 23, 2026. Epub Oct 23, 2026.

Abstract

Fish consumption has been linked to decreased mortality risk in several prospective studies. However, most existing evidence is based on multi-regional analyses, and the dose-response relationship in populations with high habitual fish intake remains insufficiently characterised. We conducted a systematic review and meta-analysis of prospective cohort studies among Japanese adults to assess the associations between fish consumption and all-cause and cause-specific mortality and to investigate potential dose-response relationships in a high-fish-intake population. We systematically searched the MEDLINE and Ichushi-Web databases. Prospective cohort studies conducted in Japan that reported hazard ratios or relative risks for fish intake and mortality outcomes were included. The protocol was registered a priori in the PROSPERO database (CRD42025635066). Random-effects models were used to calculate pooled estimates by comparing the highest and lowest intake categories. Dose-response relationships were evaluated using generalised least-squares trend estimation and restricted cubic spline models. A total of 113 articles were assessed for eligibility, and 16 studies met the inclusion criteria, and nine were eligible for meta-analysis. Higher fish intake was linked to lower all-cause mortality (HR 0.94, 95% CI 0.89-0.98) and cardiovascular disease mortality (HR 0.85, 95% CI 0.80-0.91), with low heterogeneity. According to the GRADE framework, the certainty of evidence was rated low. Visual inspection suggested that mortality risk reduced with increasing fish intake up to approximately 100 g/day, after which the decline slowed, implying a plateau effect at higher intake levels. Among Japanese adults, high fish consumption was associated with a lower risk of all-cause and cardiovascular disease mortality. Further research is required to clarify the dose-response relationship in populations with high fish consumption.

PMID:
42918810
Bibliographic data and abstract were imported from PubMed on 24 Oct 2026.

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