title: Gender-specific associations of marine n-3 fatty acids and fish consumption with 10-year incidence of stroke.
abstract: BACKGROUND
  There is some evidence that the association of fish and marine fatty acids with stroke risk differs between men and women. We investigated the gender-specific associations of habitual intake of the marine fatty acids eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) and fish on incident stroke in a population-based study in the Netherlands.
  
  
  METHODS
  We prospectively followed 20,069 men and women, aged 20-65 years, without cardiovascular diseases at baseline. Habitual diet was assessed with a validated 178-item food frequency questionnaire. Incidence of stroke was assessed through linkage with mortality and morbidity registers. Cox proportional hazards models were used to estimate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (95%CI).
  
  
  RESULTS
  During 8-13 years of follow-up, 221 strokes occurred. In women, an inverse dose-response relation (P-trend = 0.02) was observed between EPA-DHA intake and incident stroke, with an HR of 0.49 (95% CI: 0.27-0.91) in the top quartile of EPA-DHA (median 225 mg/d) as compared to the bottom quartile (median 36 mg/d). In men, the HR (95%CI) for the top quartile of EPA-DHA intake was 0.87 (0.51-1.48) (P-trend = 0.36). Similar results were observed for fish consumption and stroke incidence.
  
  
  CONCLUSIONS
  A higher EPA-DHA and fish intake is related to a lower stroke risk in women, while for men an inverse association could not be demonstrated.
authors.affiliation: Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
authors.forename: Janette
authors.initials: J
authors.lastname: de Goede
authors.forename: W M Monique
authors.initials: WM
authors.lastname: Verschuren
authors.forename: Jolanda M A
authors.initials: JM
authors.lastname: Boer
authors.forename: Daan
authors.initials: D
authors.lastname: Kromhout
authors.forename: Johanna M
authors.initials: JM
authors.lastname: Geleijnse
mesh_terms: D000328:Adult; D000818:Animals; D004281:Docosahexaenoic Acids / Q000008:administration & dosage*; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage*; D005260:Female; D005399:Fishes; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D017747:Seafood; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology* / Q000401:mortality* / Q000517:prevention & control; D055815:Young Adult
chemical_list: D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid