Data linking fish, polyunsaturated fatty acids intake and mortality are lacking and conflicting. We aim to use data from the China Health and Nutrition Survey (CHNS) and National Health and Nutrition Examination Survey (NHANES) to investigate the associations of fish and polyunsaturated fatty acids (PUFA) intake with mortality in Chinese and US populations. The study findings will be informative for addressing the role of fish and specific PUFA in human health and improve basis for dietary recommendations.

Data from the China Health and Nutrition Survey (CHNS, from 1989 to 2011) and National Health and Nutrition Examination Survey (NHANES), including NHANES III conducted in 1988-1994 and continuous NHANES 1999-2010 were used to investigate the associations of fish and polyunsaturated fatty acids intake with mortality.The following variables were used:

1. Demographics: age, sex, race/ethnicity, residence
2. Socioeconomic variables: education, marital status,
3. Dietary variables: Intakes of fish, polyunsaturated fatty acids, total energy, vegetables, fruits, red meat and saturated fat
4. Clinical assessments: hypertension, diabetes, cancer, cardiovascular disease (CVD), family history of CVD

Inclusion Criteria:

• Adults aged ≥20 with complete data on diet and follow-up time

Exclusion Criteria:

• Missing information for mortality
• Cardiovascular disease
• Cancer

CHNS is an ongoing, large-scale, household-based cohort starting in 1989. The survey used a multi-stage, random cluster process to draw a sample of 9 provinces and municipal cities, which take up about half of Chinese population. NHANES is also a nationally-representative study of nutrition and health for individuals residing in the U.S. Our study included participants in CHNS and NHANES who met the eligibility criteria.