title: No association between fish consumption and risk of stroke in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain): a 13·8-year follow-up study.
abstract: OBJECTIVE
  To prospectively assess the associations between lean fish, fatty fish and total fish intakes and risk of stroke in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain).
  
  
  METHODS
  Fish intake was estimated from a validated dietary questionnaire. Cox proportional hazards regression models were used to assess the association between the intakes of lean fish, fatty fish and total fish and stroke risk. Models were run separately for men and women.
  
  
  METHODS
  Five Spanish regions (Asturias, San Sebastian, Navarra, Granada and Murcia).
  
  
  METHODS
  Individuals (n 41 020; 15 490 men and 25 530 women) aged 20-69 years, recruited from 1992 to 1996 and followed-up until December 2008 (December 2006 in the case of Asturias). Only participants with definite incident stroke were considered as cases.
  
  
  RESULTS
  During a mean follow-up of 13·8 years, 674 strokes were identified and subsequently validated by record linkage with hospital discharge databases, primary-care records and regional mortality registries, comprising 531 ischaemic, seventy-nine haemorrhagic, forty-two subarachnoid and twenty-two unspecific strokes. After multiple adjustments, no significant associations were observed between lean fish, fatty fish and total fish consumption and the risk of stroke in men or women. In men, results revealed a non-significant trend towards an inverse association between lean fish (hazard ratio=0·84; 95 % CI 0·55, 1·29, P trend=0·06) and total fish consumption (hazard ratio=0·77; 95 % CI 0·51, 1·16, P trend=0·06) and risk of total stroke.
  
  
  CONCLUSIONS
  In the EPIC-Spain cohort, no association was found between lean fish, fatty fish and total fish consumption and risk of stroke.
authors.affiliation: 1Public Health Department of Gipuzkoa,Government of the Basque Country,Avenida Navarra nº 4,20013 San Sebastian,Gipuzkoa,Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Amiano
authors.affiliation: 1Public Health Department of Gipuzkoa,Government of the Basque Country,Avenida Navarra nº 4,20013 San Sebastian,Gipuzkoa,Spain.
authors.forename: Saioa
authors.initials: S
authors.lastname: Chamosa
authors.affiliation: 1Public Health Department of Gipuzkoa,Government of the Basque Country,Avenida Navarra nº 4,20013 San Sebastian,Gipuzkoa,Spain.
authors.forename: Nerea
authors.initials: N
authors.lastname: Etxezarreta
authors.affiliation: 1Public Health Department of Gipuzkoa,Government of the Basque Country,Avenida Navarra nº 4,20013 San Sebastian,Gipuzkoa,Spain.
authors.forename: Larraitz
authors.initials: L
authors.lastname: Arriola
authors.affiliation: 4Navarre Public Health Institute,Pamplona,Spain.
authors.forename: Conchi
authors.initials: C
authors.lastname: Moreno-Iribas
authors.affiliation: 3Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP),Madrid,Spain.
authors.forename: José-María
authors.initials: JM
authors.lastname: Huerta
authors.affiliation: 2BioDonostia Research Institute,San Sebastian,Spain.
authors.forename: Nerea
authors.initials: N
authors.lastname: Egües
authors.affiliation: 3Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP),Madrid,Spain.
authors.forename: Marcela
authors.initials: M
authors.lastname: Guevara
authors.affiliation: 3Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP),Madrid,Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Navarro
authors.affiliation: 3Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP),Madrid,Spain.
authors.forename: María-Dolores
authors.initials: MD
authors.lastname: Chirlaque
authors.affiliation: 3Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP),Madrid,Spain.
authors.forename: María-José
authors.initials: MJ
authors.lastname: Sánchez
authors.affiliation: 3Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP),Madrid,Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Molina-Montes
authors.affiliation: 9Andalusian School of Public Health and Biosanitary Research Institute of Granada (Granada.ibs),Granada,Spain.
authors.forename: Mar
authors.initials: M
authors.lastname: Requena
authors.affiliation: 10Public Health and Health Planning Directorate,Oviedo,Spain.
authors.forename: Jose-Ramón
authors.initials: JR
authors.lastname: Quirós
authors.affiliation: 11Unit of Nutrition,Environment and Cancer,Cancer Epidemiology Research Program,Catalan Institute of Oncology (ICO-IDIBELL),Barcelona,Spain.
authors.forename: Mireia
authors.initials: M
authors.lastname: Obón-Santacana
authors.affiliation: 11Unit of Nutrition,Environment and Cancer,Cancer Epidemiology Research Program,Catalan Institute of Oncology (ICO-IDIBELL),Barcelona,Spain.
authors.forename: Paula
authors.initials: P
authors.lastname: Jakszyn
authors.affiliation: 11Unit of Nutrition,Environment and Cancer,Cancer Epidemiology Research Program,Catalan Institute of Oncology (ICO-IDIBELL),Barcelona,Spain.
authors.forename: Carlos-Alberto
authors.initials: CA
authors.lastname: González
authors.affiliation: 1Public Health Department of Gipuzkoa,Government of the Basque Country,Avenida Navarra nº 4,20013 San Sebastian,Gipuzkoa,Spain.
authors.forename: Miren
authors.initials: M
authors.lastname: Dorronsoro
mesh_terms: D000328:Adult; D000818:Animals; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D005399:Fishes; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D016016:Proportional Hazards Models; D011446:Prospective Studies; D017747:Seafood; D013030:Spain; D020521:Stroke / Q000517:prevention & control; D011795:Surveys and Questionnaires
keywords: Cohort studies; Fish consumption; Stroke