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Table 2 Characteristics of studies on fish consumption and metabolic syndrome (MetS), organized by study design (intervention, prospective, cross-sectional)

From: Fish consumption and its possible preventive role on the development and prevalence of metabolic syndrome - a systematic review

Reference Country/design Aim Population Diet Adjustments Results adjusted OR (95% CI) incidence/prevalence of MetS
Ramel et al., 2009[10] Iceland RCT, part of SEAFOODplus YOUNG study 8w parallel intervention Investigate whether cod consumption increases weight loss and CVD risk factors n = 126, 20–40 y, overweight healthy, no gender distribution given Energy-restricted diets (−30%), identical macronutrient composition, different amounts of cod (control group: no seafood, group 1: 150 g cod 3x/w, group 2: 150 g cod 5x/w) In linear model with waist (baseline anthropometric measure, gender, diet group), and with blood variables (baseline anthropometric measure, weight loss, gender, diet group) No association
Baik et al., 2010[11] Korea 3 y follow up Korean Genome Epidemiology Study Investigate effect of fish and n-3 fatty acid intake on incidence of MetS n = 3504, 40–69 y 52% men, free of MetS and CVD at baseline FFQ Average fish intake was grouped (<1/week, 1-4/week, 5-6/week and daily) Age, BMI, income, occupation, marital status, education, smoking, alcohol, physical activity, dietary intake (energy, fat, fibre, red meat, dairy products, sweetened carbonated beverage, multivitamin), health (diabetes, hypertension, menopausal status, postmenopausal hormone use) Men: Average daily intake of fish (40–70 g) reduced the risk of having MetS, compared with eating fish less than once a week OR 0.43 (0.23-0.83) Women: No associations
Kouki et al., 2011[12] Finland Cross-sectional, DR’s EXTRAStudy Studie associations between food items and nutrients versus the risk of having MetS n = 1 334, 57–78 y 50% men Representative population sample 4-day food record Consumption of fish divided into tertiles (<18.5, 18.5–59.5, (>59.5 g/day) a, Age, alcohol consumption, smoking b, Further for education, VO2max Men: the middle and highest tertile had almost half the risk of having MetS, compared to lowest tertile. a, t2: 0.51 (0.33–0.77) t3: 0.53 (0.35–0.81)b, t2: 0.52 (0.32–0.83) t3: 0.63 (0.40–1.00)Women: No association
Lai et al., 2013[13] Cross-sectional National Heart, Lung, and Blood Institute Family Heart Study Assess association between dietary omega-3 fatty acids and MetS prevalence n = 4941, mean age (SD) 52.1 (13.9) y 46% men FFQ (fish consumption classified as 0, 1, 2, ≥3 servings/ week) Age, gender, race, alcohol intake, smoking, exercise, TV watching, energy intake, multivitamin use, fruits/vegetables intake, fibre intake, risk group No association
Pasalic et al. 2011[14] Croatia Cross-sectional Investigate prevalence of MetS, and influence of lifestyle habits between continental and Mediterranean–Adriatic centres n = 320, 70–90 y, 44% men FFQ Consumption of fish grouped into never/rarely or monthly Centres No association
Ruidavets et al., 2007[15] France Cross-sectional Analyse relation between food groups and frequency of IRS n = 912, 100% men 45–64 years randomly selected 3-day food record fish consumption divided into tertiles Age, centre, physical activity, education, smoking habits, alcohol consumption, drugs (hypertension, dyslipidaemia), energy intake (without alcohol), dieting, and diet quality index A negative association between fish intake and prevalence of MetS OR 0.57 (0.38-0.86), when comparing highest tertile to lowest
Zaribaf et al., 2014[16] Iran Cross-sectional Association between fish consumption and metabolic syndrome and its components n = 420, 100% women, >30 y FFQ fish consumption divided into tertiles Age, energy intake, physical activity, socioeconomic status, medication use, marital, menopausal status, dietary intake (red meat, grains, fruits, vegetables, legume, nuts, dairy products, fibre, oils), BMI Individuals in the highest tertile of fish intake were less likely to have MetS, compared to those in the lowest tertile OR 0.04 (0.004–0.61)
  1. BMI: Body Mass Index; CI: confidence interval; CVD: cardiovascular disease; FFQ: Food Frequency Questionnaire; DBP: diastolic blood pressure; IRS: insulin resistance syndrome; MetS: metabolic syndrome; OR: odds ratio; RCT: randomized clinical trial; SBP: systolic blood pressure; WC: waist circumference.