An exploration of the role of a fish-oriented diet in cognitive decline: a systematic review of the literature

Ling-Feng Zeng _, Ye Cao, Wei-Xiong Liang, Wen-Hu Bao, Jian-Ke Pan, Qi Wang, Jun Liu, Hao-Dong Liang, Hui Xie, Yan-Ting Chai, Zi-Tong Guan, Qian Cao, Xiao-Yan Li, Lei Yang, Wei-Hua Xu, Sui-Qing Mi and Ning-Sheng Wang

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Oncotarget. 2017; 8:39877-39895. https://doi.org/10.18632/oncotarget.16347

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Ling-Feng Zeng1,2,*, Ye Cao3,*, Wei-Xiong Liang2,*, Wen-Hu Bao4, Jian-Ke Pan2, Qi Wang2, Jun Liu2, Hao-Dong Liang2, Hui Xie2, Yan-Ting Chai1, Zi-Tong Guan4, Qian Cao2, Xiao-Yan Li2, Lei Yang1, Wei-Hua Xu1, Sui-Qing Mi1 and Ning-Sheng Wang1

1 Institute of Clinical Pharmacology, Guangzhou University of Chinese Medicine, Guangzhou, China

2 The 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China

3 Department of Clinical Research/National Clinical Trials Institute, Sun Yat-sen University Cancer Center, Guangzhou, China

4 World Federation of Chinese Medicine Societies, Beijing, China

* These authors have contributed equally to this work

Correspondence to:

Jun Liu, email:

Qi Wang, email:

Keywords: cognitive disorders; dementia of Alzheimer type; fish-oriented dietary intake; risk factors; meta-analysis

Received: November 10, 2016 Accepted: February 07, 2017 Published: March 17, 2017


Epidemiological studies have presented inconsistent evidence of the correlation between a fish-oriented dietary intake (FDI) and the risk of cognitive decline. To address these controversies, we performed this systematic review of prospective studies published in December 2016 and earlier using PubMed, Embase, and Web of Science. Two independent researchers conducted the eligibility assessment and data extraction; all discrepancies were solved by discussion with a third researcher. The pooled relative risks (RRs) focused on the incidence of events were estimated with 95% confidence intervals (CIs). Overall, nine studies containing 28,754 subjects were analyzed. When the highest and lowest categories of fish consumption were compared, the summary RR for dementia of Alzheimer type (DAT) was 0.80 (95%CI = 0.65–0.97); i.e., people with a higher intake of fish had a 20% (95%CI = 3–35%) decreased risk of DAT. Additionally, the dose-response synthesized data indicated that a 100-g/week increase in fish intake reduced the risk of DAT by an additional 12% (RR = 0.88, 95%CI = 0.79–0.99). Non-significant results were observed for the risk of dementia of all causes (DAC) and mild cognitive impairment (MCI). Limited evidence involving heterogeneity was found within subgroups or across studies. In conclusion, this review confirmed that a higher intake of fish could be correlated with a reduced risk of DAT. Further research, especially prospective studies that specifically quantify FDI, will help find a more accurate assessment of the different levels of dietary intake.

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