Effects of seafood consumption and toenail mercury and selenium levels on cognitive function among American adults: 25 y of follow up

Xuanxia Mao, Cheng Chen, Pengcheng Xun, Martha Daviglus, Lyn M. Steffen, David R. Jacobs, Linda Van Horn, Stephen Sidney, Na Zhu, Ka He

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objectives: The aim of this study was to examine the longitudinal association between seafood and intake of long-chain ω-3 polyunsaturated fatty acids (LCω-3 PUFA) and cognitive function and to explore the possible effect modifications owing to mercury (Hg) and selenium (Se) levels. Methods: Participants (N = 3231) from the CARDIA (Coronary Artery Risk Development in Young Adults) study underwent baseline examination and were reexamined in eight follow-up visits. Diet was assessed at baseline and in exam years 7 and 20. Toenail Hg and Se were measured at exam year 2. Cognitive function was measured at exam year 25 using three tests: Rey Auditory Verbal Learning Test (RAVLT), Digit Symbol Substitution Test (DSST), and the Stroop test. The general linear regression model was used to examine cumulative average intakes of LCω-3 PUFA and seafood in relation to the cognitive test scores; and to explore the possible effect modifications caused by Hg and Se. Results: LCω-3 PUFA intake was significantly associated with better performance in the DSST test (quintile 5 versus quintile 1; mean difference = 1.74; 95% confidence interval, 0.19–3.29; P trend , 0.048]), but not in the RAVLT and Stroop tests. Similar results were observed for intakes of eicosapentaenoic acid, docosahexaenoic acid, and non-fried seafood. The observed associations were more pronounced in participants with body mass index ≥25 kg/m 2 , but not significantly modified by toenail Hg or Se. Conclusion: This longitudinal study supported the hypothesis that LCω-3 PUFA or non-fried seafood intake is associated with better cognitive performance in psychomotor speed among US adults, especially those who are overweight or obese.

Original languageEnglish (US)
Pages (from-to)77-83
Number of pages7
StatePublished - May 2019

Bibliographical note

Funding Information:
The CARDIA (Coronary Artery Risk Development in Young Adults) study was supported by grants from the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (HHSN268201300025 C and HHSN268201300026 C), Northwestern University (HHSN268201300027 C), University of Minnesota (HHSN268201300028 C), Kaiser Foundation Research Institute (HHSN268201300029 C), and Johns Hopkins University School of Medicine (HHSN268200900041 C). CARDIA is also partially supported by the Intramural Research Program of the National Institute on Aging (NIA) and an intra-agency agreement between NIA and NHLBI (grant AG0005). Representatives of the funding agency have been involved in the review of the manuscript but not directly involved in the collection, management, analysis, or interpretation of the data. XM and CC served as co-first authors. KH conceived of and designed the study. XM, CC, and PX analyzed and interpreted the data and drafted and revised the manuscript. MD, LS, DJ, LV, SS, and NZ revised the manuscript. All authors read and approved the final manuscript. The authors have no conflicts of interest to declare.

Publisher Copyright:
© 2018 Elsevier Inc.


  • Cognitive function
  • Hg
  • LCω-3 PUFA
  • Se
  • Seafood consumption


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