title: Fish consumption and incidence of stroke: a meta-analysis of cohort studies.
abstract: OBJECTIVE
  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 > or =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.
authors.affiliation: Department of Preventive Medicine, The Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Dr, Suite 1102, Chicago, IL 60611, USA. kahe@northwestern.edu
authors.forename: Ka
authors.initials: K
authors.lastname: He
authors.forename: Yiqing
authors.initials: Y
authors.lastname: Song
authors.forename: Martha L
authors.initials: ML
authors.lastname: Daviglus
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
authors.forename: Linda
authors.initials: L
authors.lastname: Van Horn
authors.forename: Alan R
authors.initials: AR
authors.lastname: Dyer
authors.forename: Uri
authors.initials: U
authors.lastname: Goldbourt
authors.forename: Philip
authors.initials: P
authors.lastname: Greenland
mesh_terms: D004032:Diet; D006801:Humans; D015994:Incidence; D012306:Risk; D017747:Seafood; D020521:Stroke / Q000453:epidemiology*