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Cited by 371Nutritional Studies and DietFatty Acid Research and HealthAcute Ischemic Stroke Management

Fish Consumption and Incidence of Stroke: A Meta-Analysis of Cohort Studies

He, Ka, Song, Yiqing, Daviglus, Martha L., Liu, Kiang, Van Horn, Linda, Dyer, Alan R., Goldbourt, Uri, Greenland, Philip·2004·Stroke
DOI 10.1161/01.str.0000130856.31468.47
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Abstract

Background and Purpose— Results from observational studies on fish consumption and risk of stroke are inconsistent. We quantitatively assessed the relationship between fish intake and incidence of stroke using a meta-analysis of cohort studies. Methods— We searched the Medline and Embase databases (1966 through October 2003) and identified 9 independent cohorts (from 8 studies) that provided a relative risk (RR) and corresponding 95% CI for total or any type of stroke in relation to fish consumption. Pooled RR and 95% CI of stroke were estimated by variance-based meta-analysis. Results— Compared with those who never consumed fish or ate fish less than once per month, the pooled RRs for total stroke were 0.91 (95% CI, 0.79 to 1.06) for individuals with fish intake 1 to 3 times per month, 0.87 (95% CI, 0.77 to 0.98) for once per week, 0.82 (95% CI, 0.72 to 0.94) for 2 to 4 times per week, and 0.69 (95% CI, 0.54 to 0.88) for ≥5 times per week ( P for trend=0.06). In stratified analyses of 3 large cohort studies with data on stroke subtypes, the pooled RRs across 5 categories of fish intake were 1.0, 0.69 (95% CI, 0.48 to 0.99), 0.68 (95% CI, 0.52 to 0.88), 0.66 (95% CI, 0.51 to 0.87), and 0.65 (95% CI, 0.46 to 0.93) for ischemic stroke ( P for trend=0.24); and 1.0, 1.47 (95% CI, 0.81 to 2.69), 1.21 (95% CI, 0.78 to 1.85), 0.89 (95% CI, 0.56 to 1.40), and 0.80 (95% CI, 0.44 to 1.47) for hemorrhagic stroke ( P for trend=0.31). Conclusions— These results suggest that intake of fish is inversely related to risk of stroke, particularly ischemic stroke. Fish consumption as seldom as 1 to 3 times per month may protect against the incidence of ischemic stroke.

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  • EPA and DHA do not affect serum cholesterol but reduce CHD mortality and, to a lesser extent, stroke mortality.

    “They do not have an impact on serum cholesterol levels, but have been shown to reduce CHD mortality and to a lesser extent stroke mortality.271,282”

    From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [282]

  • Another meta-analysis showed eating fish 2-4 times a week reduced stroke risk by 18% (RR 0.82, 95% CI 0.72-0.94) compared with eating fish less than once a month.

    “Another meta-analysis showed that eating fish 2-4 times a week reduced the risk of stroke by 18% (RR 0.82, 95% CI 0.72 -0.94) compared with eating fish less than once a month.282”

    From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [282]

  • A meta-analysis of 11 studies and 13 cohorts (n=222,364) found fish consumption inversely associated with CVD and possibly reduced CVD mortality.

    “A meta-analysis of 11 eligible studies and 13 cohorts (n = 222,364) found that fish consumption was inversely associated with CVD and may even reduce mortality due to CVD (50,51).”

    From Trimethylamine <i>N</i> -Oxide, the Microbiome, and Heart and Kidney Disease (2017) · cites this paper as [50]

  • Habitual fish consumption is associated with lower incidence of coronary heart disease and ischemic stroke, especially cardiac death, among generally healthy populations.

    “Consistent with these physiological benefits, habitual fish consumption is associated with lower incidence of CHD and ischemic stroke, especially risk of cardiac death (Figure 1), among generally healthy populations.39,47,48”

    From Components of a Cardioprotective Diet: New Insights (2011) · cites this paper as [47]

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  1. Willett WC, Sampson L, Stampfer MJ, Rosner B, Bain C, Witschi J, Hennekens CH, Speizer FE. Reproducibility and validity of a semiquan- titative food frequency questionnaire. Am J Epidemiol. 1985;122:51-65.

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Authors
He, K., Song, Y., Daviglus, M. L., Liu, K., Van Horn, L., Dyer, A. R., Goldbourt, U., & Greenland, P.
Affiliations
  • Northwestern University (US)
  • From the Department of Preventive Medicine (K.H., M.L.D., K.L., L.V.H., A.R.D., P.G.), Northwestern University Feinberg School of Medicine, Chicago, Ill; the Department of Nutrition (Y.S.), Harvard School of Public Health, Boston, Mass; and the Division of Epidemiology and Preventive Medicine (U.G.), Sackler Medical Faculty, Tel Aviv University, Tel Aviv, Israel.
ORCID
Venue
Stroke
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2004-07
Volume
35
Issue
7
Pages
1538-1542
ISSN
  • 0039-2499 (ISSN-L)
  • 1524-4628
DOI
10.1161/01.str.0000130856.31468.47
OpenAlex
W2060050759
Cited by
371
References
27
Citations by year
2026: 3 · 2025: 2 · 2024: 7 · 2023: 3 · 2022: 14 · 2021: 9 · 2020: 12 · 2019: 16 · 2018: 10 · 2017: 17 · 2016: 17 · 2015: 11 · 2014: 27 · 2013: 24 · 2012: 36
FWCI
17.05
Type
journal article
Language
en
Open access
closed
Locations
  • Stroke (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
  • Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
Keywords
fish consumption, stroke incidence, ischemic stroke, hemorrhagic stroke, stroke risk factors, omega-3 fatty acids, fish oil, dietary cholesterol, dietary fiber, dietary sodium, dietary calcium, dietary magnesium, potassium intake, dietary iron, dietary zinc, vitamin C intake, dietary vitamin E, dietary vitamin A, dietary carotenoids, dietary antioxidants
MeSH terms
Diet, Humans, Risk, Incidence, Seafood, Stroke

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