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Habitual fish consumption and risk of incident stroke: the European Prospective Investigation into Cancer (EPIC)–Norfolk prospective population study

Published online by Cambridge University Press:  02 January 2007

Phyo K Myint ,
Ailsa A Welch ,
Sheila A Bingham ,
Robert N Luben ,
Nicholas J Wareham ,
Nicholas E Day  and
Kay-Tee Khaw
Phyo K Myint*
Affiliation:
Department of Public Health and Primary Care, University of Cambridge, UK
Ailsa A Welch
Affiliation:
Department of Public Health and Primary Care, University of Cambridge, UK
Sheila A Bingham
Affiliation:
MRC Dunn Human Nutrition Unit, Cambridge, UK
Robert N Luben
Affiliation:
Department of Public Health and Primary Care, University of Cambridge, UK
Nicholas J Wareham
Affiliation:
MRC Epidemiology Unit, Elsie Widdowson Laboratories, Cambridge, UK
Nicholas E Day
Affiliation:
Department of Public Health and Primary Care, University of Cambridge, UK
Kay-Tee Khaw
Affiliation:
Department of Public Health and Primary Care, University of Cambridge, UK
*
*corresponding author: Email [email protected]
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Abstract

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Objectives

To examine the association between fish consumption and stroke risk.

Design

Prospective population cohort study.

Setting

Norfolk, UK cohort of the European Prospective Investigation into Cancer (EPIC–Norfolk).

Subjects

Subjects were 24 312 men and women aged 40–79 years who had no previous history of stroke at baseline.

Methods

Fish consumption was assessed using a food-frequency questionnaire at baseline in 1993–1997 and stroke incidence ascertained to 2004.

Results

A total of 421 incident strokes were identified (mean follow-up=8.5 years, total person-years=209 238). There were no significant relationships between total fish, shellfish or fish roe consumption and risk of stroke in men and women after adjusting for age, systolic blood pressure, body mass index, smoking, cholesterol, diabetes, physical activity, alcohol consumption, fish oil supplement use and total energy intake using Cox regression analyses. Oily fish consumption was significantly lower in women who subsequently had a stroke (odds ratio (OR) for consumers vs. non-consumers=0.69, 95% confidence interval (CI) 0.51–0.94, P=0.02). The trend in men was similar but not significant (OR for consumers vs. non-consumers=0.88, 95% CI 0.65–1.19, P=0.41).

Conclusions

There was no consistent relationship between fish consumption and stroke in this British population. Inconsistencies in the observed health effects of fish consumption in different populations may reflect different patterns and type of fish consumed and preparation methods.

Keywords

DietEpidemiologyFishStroke
Type
Research Article
Information
Public Health Nutrition , Volume 9 , Issue 7 , October 2006 , pp. 882 - 888
Copyright
Copyright © The Authors 2006

References

1Burr, ML, Fehily, AM, Gilbert, JF, Rogers, S, Holliday, RM, Sweetnam, PM, et al. Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: Diet and Reinfarction Trial (DART). Lancet 1989; 2: 757–61.Google Scholar
2Ness, AR, Hughes, J, Elwood, PC, Whitley, E, Smith, GD, Burr, ML. The long-term effect of dietary advice in men with coronary disease: follow-up of the Diet and Reinfarction trial (DART). European Journal of Clinical Nutrition 2002; 56: 512–8.CrossRefGoogle ScholarPubMed
3He, K, Rimm, EB, Merchant, A, Rosner, BA, Stampfer, MJ, Willett, WC, et al. Fish consumption and risk of stroke in men. Journal of the American Medical Association 2002; 288: 3130–6.CrossRefGoogle ScholarPubMed
4Yuan, JM, Ross, RK, Gao, YT, Yu, MC. Fish and shellfish consumption in relation to death from myocardial infarction among men in Shanghai, China. American Journal of Epidemiology 2001; 154: 809–16.Google Scholar
5Caicoya, M. Fish consumption and stroke: a community case–control study in Asturias, Spain. Neuroepidemiology 2002; 21: 107–14.CrossRefGoogle ScholarPubMed
6He, K, Song, Y, Daviglus, ML, Liu, K, Van Horn, L, Dyer, AR, et al. Fish consumption and incidence of stroke. A meta-analysis of cohort studies. Stroke 2004; 35: 1538–42.Google Scholar
7Day, N, Oakes, S, Luben, R, Khaw, KT, Bingham, S, Welch, A, et al. EPIC–Norfolk: study design and characteristics of the cohort. British Journal of Cancer 1999; 80: 95–103.Google Scholar
8Lohman, T, Roche, A, Martorell, R. Anthropometric Standardization Reference Manual. Champaign, IL: Human Kinetics Books, 1991.Google Scholar
9Friedewald, WT, Levy, RI, Fredrickson, DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clinical Chemistry 1972; 18: 499–502.Google Scholar
10Welch, AA, Luben, R, Khaw, KT, Bingham, SA. The CAFE computer program for nutritional analysis of the EPIC–Norfolk food frequency questionnaire and identification of extreme nutrient values. Journal of Human Nutrition and Dietetics 2005; 18: 99–116.Google Scholar
11Wareham, NJ, Jakes, RW, Rennie, KL, Schuit, J, Mitchell, J, Hennings, S, et al. Validity and repeatability of a simple index derived from the short physical activity questionnaire used in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Public Health Nutrition 2003; 6: 407–13.CrossRefGoogle ScholarPubMed
12Cox, DR. Regression models and life tables. Journal of the Royal Statistical Society Series B 1972; 34: 187–220.Google Scholar
13Skerrett, PJ, Hennekens, CH. Consumption of fish and fish oils and decreased risk of stroke. Preventive Cardiology 2003; 6: 38–41.Google Scholar
14Keli, SO, Feskens, EJ, Kromhout, D. Fish consumption and risk of stroke. The Zutphen Study. Stroke 1994; 25: 328–32.CrossRefGoogle ScholarPubMed
15Iso, H, Rexrode, KM, Stampfer, MJ, Manson, JE, Colditz, GA, Speizer, FE, et al. Intake of fish and omega-3 fatty acids and risk of stroke in women. Journal of the American Medical Association 2001; 285: 304–12.Google Scholar
16Morris, MC, Manson, JE, Rosner, B, Buring, JE, Willett, WC, Hennekens, CH. Fish consumption and cardiovascular disease in the Physicians' Health Study: a prospective study. American Journal of Epidemiology 1995; 142: 166–75.Google Scholar
17Gillum, RF, Mussolino, ME, Madans, JH. The relationship between fish consumption and stroke incidence. The NHANES I Epidemiologic Follow-up study (National Health and Nutrition Examination Survey). Archives of Internal Medicine 1996; 156: 537–42.Google Scholar
18Mozaffarian, D, Longstreth, WT, Lemaitre, RN, Manolio, TA, Kuller, LH, Burke, GL, et al. Fish consumption and stroke risk in elderly individuals. The Cardiovascular Health Study. Archives of Internal Medicine 2005; 165: 200–6.Google Scholar
19Welch, AA, Lund, E, Amiano, P, Dorronsoro, M, Brustad, M, Kumle, M. Variability of fish consumption within the 10 European countries participating in the European Investigation into Cancer and Nutrition (EPIC) study. Public Health Nutrition 2002; 5: 1273–85.CrossRefGoogle ScholarPubMed
20Orencia, AJ, Daviglus, ML, Dyer, AR, Shekelle, RB, Stamler, J. Fish consumption and stroke in men. 30-year findings of the Chicago Western Electric Study. Stroke 1996; 27: 204–9.Google Scholar
21Simopoulos, AP. Omega-3 fatty acids in inflammation and autoimmune diseases. Journal of the American College of Nutrition 2002; 21: 495–505.Google Scholar
22Christensen, JH. n-3 Fatty acids and the risk of sudden cardiac death. Emphasis on heart rate variability. Danish Medical Bulletin 2003; 50: 347–67.Google Scholar
23GISSI-Prevenzione Investigators. Dietary supplementation with n –3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico. Lancet 1999; 354: 447–55.Google Scholar