on May 20, 2004
Published online before print May 20, 2004, doi: 10.1161/01.STR.0000130856.31468.47
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Submitted on January 6, 2004
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. * To whom correspondence should be addressed. E-mail: kahe{at}northwestern.edu.
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 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.
Revised on March 25, 2004
Accepted on March 26, 2004
Fish Consumption and Incidence of Stroke. A Meta-Analysis of Cohort Studies
Ka He MD, ScD*;
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).
Key words: cerebrovascular accident • fishes • meta-analysis
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