title: Fish consumption and risk of stroke: a second prospective case-control study from northern Sweden.
abstract: Fish consumption has been concluded to be associated with decreased risk of stroke in several reviews. However, among men, but not women, an increased risk of stroke was previously found at high fish consumption (>3 meals/week) in northern Sweden. This study investigates if previous results on elevated stroke risk with high fish consumption in men in northern Sweden can be confirmed in a larger study with new cases in the same population.
  
  
  
  A prospective nested case-control study was performed within the population-based Northern Sweden Health and Disease Study cohort. Information on fish consumption, other lifestyle and medical data was collected at baseline. Incident stroke cases (1987-2007, n = 735) were identified and 2698 controls matched for gender, age, year of baseline and geographical region.
  
  
  
  There were no associations between total fish or fatty fish consumption and stroke risk; thus the previous finding of increased risk of stroke with high fish consumption in men could not be repeated. High intake of lean fish (>twice/week compared to < once/month) was associated with increased stroke risk in men [OR 1.80 (95% CI 1.00, 3.21), but not in women [OR 0.50 (95% CI 0.24, 1.10)]. The association was driven by men living alone.
  
  
  
  The previous association between high total fish consumption and risk of stroke in men could not be repeated. The increased risk found in men with high intake of lean fish may be due to chance or confounding specific for this group.
authors.affiliation: Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, 901 87, Umeå, Sweden. maria.wennberg@umu.se.
authors.forename: Maria
authors.identifier: 0000-0002-1673-8494
authors.initials: M
authors.lastname: Wennberg
authors.affiliation: Department of Public Health and Clinical Medicine, Research Unit Skellefteå, Umeå University, Umeå, Sweden.
authors.forename: Jan-Håkan
authors.initials: JH
authors.lastname: Jansson
authors.affiliation: Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden.
authors.forename: Margareta
authors.initials: M
authors.lastname: Norberg
authors.affiliation: Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
authors.forename: Staffan
authors.initials: S
authors.lastname: Skerfving
authors.affiliation: Health Metrics Unit, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Strömberg
authors.affiliation: Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden.
authors.forename: Per-Gunnar
authors.initials: PG
authors.lastname: Wiklund
authors.affiliation: Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden.|Department of Biobank Research, Umeå University, Umeå, Sweden.
authors.forename: Ingvar A
authors.initials: IA
authors.lastname: Bergdahl
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D016022:Case-Control Studies; D004032:Diet; D005260:Female; D005399:Fishes; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D017747:Seafood; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
keywords: Confounding; Fish consumption; Hemorraghic stroke; Ischaemic stroke; Lifestyle