Abstract 145: Dietary Fish and Omega-3 Intake and Risk of Ischemic Stroke: The REGARDS Study
Background: We previously reported that persons living in the Stroke Belt were more likely than non-Belt persons to consume ≥2 weekly servings of fried fish but less likely to meet the AHA recommendation of ≥2 weekly servings of nonfried fish. The objective of this report was to evaluate whether the differential consumption of fish contributes to the geographic and racial disparities in stroke.
Methods: REGARDS is a national cohort study that recruited 30,239 participants (2003-2007) ≥45 years with oversampling from the southeastern Stroke Belt and African Americans (AAs). Centralized phone interviewers obtained medical histories and in-home examiners obtained physical measures. Dietary data were collected using the self-administered Block98 Food Frequency Questionnaire (FFQ). After excluding the top and bottom 1% of total energy intake, individuals who did not answer 85% or more of the FFQ, and those with a history of stroke or TIA at baseline, the analysis cohort included 20,480 participants. Incident stroke was defined as first stroke occurrence over 5.0 years of follow-up.
Results: There were 549 incident strokes including 501 ischemic strokes. After excluding hemorrhagic strokes and stratifying by race, white participants eating ≥2 servings per week (vs <2/week) of fried fish were at a significantly increased risk of ischemic stroke after adjusting for demographic, SES, physical activity, BMI, caloric intake and Framingham stroke risk score factors (HR 2.80, 95% CI 1.12 to 6.96); there was no association found among AAs. Compared with participants in the lowest quartile of dietary n-3 intake (mean intake 0.74 g/day), participants in the highest quartile (mean intake 2.8 g/day) had a 29% reduction in ischemic stroke risk after adjusting for demographic factors and caloric intake (HR 0.71, 95% CI 0.52 to 0.97); when stratified by race, AAs in the highest quartile of n-3 intake had a 49% reduction in ischemic stroke risk compared with the lowest quartile after adjusting for demographic factors and caloric intake (HR 0.51, 95% CI 0.30 to 0.88).
Conclusions: Fried fish intake of ≥2 servings (vs <2) per week was associated with more than twice the risk of ischemic stroke among whites. High dietary n-3 intake may reduce the risk of ischemic stroke especially among AAs and warrants further study in primary stroke prevention. Differential consumption of fish may contribute to geographic and racial disparities in ischemic stroke.
- © 2012 by American Heart Association, Inc.