Dietary intake of fish, n-3 polyunsaturated fatty acids, and risk of inflammatory bowel disease: a systematic review and meta-analysis of observational studies

  • Hadis Mozaffari
  • Elnaz Daneshzad
  • Bagher Larijani
  • Nick Bellissimo
  • Leila AzadbakhtEmail author



Fish consumption and dietary intake of n-3 polyunsaturated acids (PUFAs) may be associated with inflammatory bowel disease (IBD). We aimed to conduct a systematic review and summarize published articles on the association between fish consumption and dietary intake of n-3 PUFAs with the risk of IBD.


PubMed, Scopus, and Web of Science databases were used to conduct a comprehensive search and identify eligible literature published prior to January 2019. Fixed-effects model or random-effects models (DerSimonian–Laird method) were applied to pool the effect sizes. Cochrane Q test was used to trace the potential source of heterogeneity across studies.


12 studies (5 prospective and 7 case–control) were included in the systematic review, which ten of them were eligible for inclusion in the meta-analysis. Studies were included a total sample size of 282610 participants which 2002 of them were cases of IBD [1061 Crohn’s disease (CD) and 937 ulcerative colitis (UC)]. A negative association was found between fish consumption and the incidence of CD (pooled effect size: 0.54, 95%CI: 0.31–0.96, P = 0.03). There was no relationship between total dietary n-3 PUFAs intake and IBD (pooled effect size: 1.17, 95%CI: 0.80–1.72, P = 0.41). A significant inverse association was observed between dietary long-chain n-3 PUFAs and the risk of UC (pooled effect size: 0.75, 95%CI: 0.57–0.98, P = 0.03). Moreover, no association was found between α-Linolenic acid (ALA) and IBD (pooled effect size: 1.17, 95%CI: 0.63–2.17, P = 0.62).


Findings showed a negative association between fish consumption and the risk of CD. Moreover, there was a significant inverse association between dietary long-chain n-3 PUFAs and the risk of UC.


Fish Omega-3 Inflammatory bowel disease Meta-analysis 



This study was supported by National Institute for Medical Research Development (Grant and Ethics Number: 977288).

Author contributions

LA and HM designed the study. Searching processes, data extraction, statistical analysis, and manuscript drafting performed by HM and reviewed by ED, BL, NB, and LA. LA supervised all the study processes and checked the search strategy processing and statistical analysis. The final version of the manuscript was approved by all authors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Supplementary material

394_2019_1901_MOESM1_ESM.docx (646 kb)
Supplementary material 1 (DOCX 645 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Hadis Mozaffari
    • 1
  • Elnaz Daneshzad
    • 1
  • Bagher Larijani
    • 2
  • Nick Bellissimo
    • 3
  • Leila Azadbakht
    • 1
    • 4
    Email author
  1. 1.Department of Community Nutrition, School of Nutritional Science and DieteticsTehran University of Medical SciencesTehranIran
  2. 2.Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
  3. 3.School of NutritionRyerson UniversityTorontoCanada
  4. 4.Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran

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