JAMA, Vol. 288 No. 24, December 25, 2002

http://jama.ama-assn.org/issues/v288n24/abs/joc21535.html

Ka He, MD, MPH; Eric B. Rimm, ScD; Anwar Merchant, DMD, ScD; Bernard A. Rosner, PhD; Meir J. Stampfer, MD, DrPH; Walter C. Willett, MD, DrPH; Alberto Ascherio, MD, DrPH

Context  
The effect of fish consumption or long-chain omega-3 polyunsaturated fatty acid (PUFA) intake on risk of stroke remains uncertain.

Objective  
To examine the relation of fish consumption and long-chain omega-3 PUFA intake and risk of stroke in men.

Design and Setting  
The Health Professional Follow-up Study, a US prospective cohort study with 12 years of follow-up.

Participants  
A total of 43 671 men aged 40 to 75 years who completed a detailed and validated semiquantitative food frequency questionnaire and who were free of cardiovascular disease at baseline in 1986.

Main Outcome Measure  
Relative risk (RR) of stroke by subtype based on cumulative average fish consumption or long-chain omega-3 PUFA intake, ascertained in 1986, 1990, and 1994.

Results  
We documented 608 strokes during the 12-year follow-up period, including 377 ischemic, 106 hemorrhagic, and 125 unclassified strokes. Compared with men who consumed fish less than once per month, the multivariate RR of ischemic stroke was significantly lower among those who ate fish 1 to 3 times per month (RR, 0.57; 95% confidence interval [CI], 0.35-0.95). However, a higher frequency of fish intake was not associated with further risk reduction; the RR was 0.54 (95% CI, 0.31-0.94) for men who consumed fish 5 or more times per week. This lack of linearity was confirmed by spline analyses. By dichotomized fish intake, the multivariate RR for men who consumed fish at least once per month compared with those who ate fish less than once per month was 0.56 (95% CI, 0.38-0.83) for ischemic stroke and 1.36 (95% CI, 0.48-3.82) for hemorrhagic stroke. The inverse association between fish intake and risk of ischemic stroke was not materially modified by use of aspirin. No significant associations were found between fish or long-chain omega-3 PUFA intake and risk of hemorrhagic stroke.

Conclusion  
Our findings suggest that eating fish once per month or more can reduce the risk of ischemic stroke in men.

JAMA. 2002;288:3130-3136

Fish Consumption and Risk of Stroke in Men
Ka He; Eric B. Rimm; Anwar Merchant; Bernard A. Rosner; Meir J. Stampfer; Walter C. Willett; Alberto Ascherio
JAMA. 2002;288:3130-3136
ABSTRACT  |   FULL TEXT  |   PDF

Eating fish fights heart ills
New studies bolster evidence of benefits of omega-3 fatty acid

Robert Bazzel's Healthbeat

By Robert Bazell
NBC NEWS CORRESPONDENT
Robert Bazell's HealthBeat

http://www.msnbc.com/news/736389.asp?cp1=1#BODY

April 9 —  New research out Tuesday provides the strongest evidence yet on the health benefits of eating fish — a simple dietary step that goes a long way in protecting against heart disease. NBC’s Robert Bazell reports.

MANY OF the lunchtime customers at Legal Seafoods in Boston have already heard of the health benefits of fish.

       “We love fish, and my husband’s had a heart attack and a bypass, and I have been told I have high cholesterol,” said Joan Romanish.

       The research out today leaves no doubt. A 16-year study of almost 85,000 women found that those who ate fish two to four times weekly cut their risk of heart disease by 30 percent, compared with women who rarely ate fish. Women who ate fish five or more times weekly reduced their risk 34 percent. Past studies showed similar benefits for men, but this was the first to look specifically at the effect in women, according to the new research published in Wednesday’s Journal of the American Medical Association.

Plus, a 17-year study of men with no history of heart disease — published in The New England Journal of Medicine — found that those with the highest blood levels of omega-3 fatty acids — the healthy fat found in fish — were more than 80 percent less likely to die suddenly from heart disease.

       “It’s a low-risk, very inexpensive way to lower the risk of heart disease,” said Dr. JoAnn Manson of Boston’s Brigham and Women’s Hospital, co-author of the men’s study.

The key to the heart benefits of fish is omega-3 fatty acid. Some kinds of fat are bad for you, but the fat in fish actually lowers cholesterol, helps prevent blood clots that form in heart attacks, and lessens the chances for the irregular heart beats that cause about 250,000 sudden deaths a year.

       The best sources of the healthy fatty acid are ocean fish such as salmon, tuna, mackerel and arctic char. But even if you can’t afford these tasty, sometimes expensive fish, canned tuna or sardines work just as well.

       Some people eat almost nothing else. “We eat fish at least eight times a week, maybe even more,” said Edel Cummings.

       There’s nothing wrong with that, but “you don’t have to be a seal — even eating fish twice a week can give almost all the benefits that there is to eating fish in general,” said Dr. Walter Willett of the Harvard School of Public Health.

And then there are fish oil supplements. A study in Tuesday’s issue of the journal Circulation suggests that fish oil supplements reduced sudden cardiac death by 42 percent in the three months after patients had a heart attack. Researchers stressed those findings must be confirmed, and the American Heart Association said it will not recommend supplements until there is more evidence.

       The best advice, expert say, is to eat fish — because the more science studies it, the more it seems to be a miracle food.

       Robert Bazell is the chief science correspondent for NBC News. The Associated Press contributed to this report.

Fish once a month reduces stroke risk

Occasional seafood meals just as beneficial as regular ones

ASSOCIATED PRESS

http://www.msnbc.com/news/851739.asp?0cv=HB10

Dec. 25 — Eating fish just once a month is enough to reduce the risk of strokes in men, according to a study of more than 43,000 health professionals. While numerous studies have touted the cardiovascular benefits of eating fish several times a week, the new research found a similar benefit from just occasional meals of seafood.

MEN WHO ate about 3 to 5 ounces of fish one to three times a month were 43 percent less likely to have a stroke during 12 years of follow-up. Men who ate fish more often did not reduce their risk any further, suggesting that a small amount works just as well as a larger one, said co-author Dr. Ka He of Harvard’s School of Public Health and colleagues.

       Their findings appear in Wednesday’s Journal of the American Medical Association.

       A study in JAMA last year found that women who ate about 4 ounces of fish two to four times a week cut their stroke risk by 48 percent. The study found lower risk reductions in women who ate fish once a week or less.

Whether the new results would apply to women was unknown because none were studied.

       The American Heart Association’s dietary recommendations include two servings of fish a week.

       The researchers in the Harvard study said the reasons for their findings were unclear.

       Omega-3 fatty acids, found in most fish, have been shown to lower levels of blood fats linked to cardiovascular disease and to help keep blood from clotting.

The study involved risk reductions for ischemic, or clot-related strokes, the most common kind. The researchers noted that native Alaskans eat a lot of fish and have a high incidence of hemorrhagic, or bleeding, strokes.

       That has raised concerns that while the anti-clotting effects of fish can decrease the risk of clot-related strokes, they can have the opposite effect on bleeding strokes.

       The Harvard study found no significant link between fish consumption and bleeding strokes, but only 106 of the 608 strokes that occurred were the bleeding type. The researchers said more study is needed.

       The study was funded by the National Institutes of Health.

Study in 43,000 men touts benefits of even a little fish

Posted 12/24/2002 4:00 PM

http://www.usatoday.com/news/health/2002-12-24-fish-strokes_x.htm

CHICAGO (AP) — Eating fish just once a month is enough to reduce the risk of strokes in men, according to a study of more than 43,000 health professionals.

While numerous studies have touted the cardiovascular benefits of eating fish several times a week, the new research found a similar benefit from just occasional meals of seafood.

Men who ate about 3 to 5 ounces of fish one to three times a month were 43% less likely to have a stroke during 12 years of follow-up. Men who ate fish more often did not reduce their risk any further, suggesting that a small amount works just as well as a larger one, said co-author Dr. Ka He of Harvard's School of Public Health and colleagues.

Their findings appear in Wednesday's Journal of the American Medical Association.

A study in JAMA last year found that women who ate about 4 ounces of fish two to four times a week cut their stroke risk by 48%. The study found lower risk reductions in women who ate fish once a week or less.

Whether the new results would apply to women was unknown because none were studied.

The American Heart Association's dietary recommendations include two servings of fish a week.

The researchers in the Harvard study said the reasons for their findings were unclear.

Omega-3 fatty acids, found in most fish, have been shown to lower levels of blood fats linked to cardiovascular disease and to help keep blood from clotting.

The study involved risk reductions for ischemic, or clot-related strokes, the most common kind. The researchers noted that native Alaskans eat a lot of fish and have a high incidence of hemorrhagic, or bleeding, strokes.

That has raised concerns that while the anti-clotting effects of fish can decrease the risk of clot-related strokes, they can have the opposite effect on bleeding strokes.

The Harvard study found no significant link between fish consumption and bleeding strokes, but only 106 of the 608 strokes that occurred were the bleeding type. The researchers said more study is needed.

The study was funded by the National Institutes of Health.

Eating Fish a Good Way to Prevent Stroke
One meal a month reduces a man's risk more than 40 percent

By Ed Edelson
HealthScoutNews Reporter

http://www.healthscoutnews.com/view.cfm?id=510983

THURSDAY, Dec. 26 (HealthScoutNews) -- Eating fish just once a month can reduce a man's risk of stroke by more than 40 percent, a study finds.

The omega-3 polyunsaturated fatty acids in fish prevent blood clots from forming and thus reduce the incidence of ischemic strokes, the kind that happen when a clot blocks an artery, says a report in the current Journal of the American Medical Association.

A number of studies have documented the beneficial effects of eating fish for prevention of heart disease, but this is one of just a few to look at the effect on stroke.

The information comes from the Health Professional Follow-Up Study, which has followed more than 43,000 men for 12 years, chronicling their dietary habits and illnesses. It finds a 43 percent reduction in strokes for men who ate one to three fish meals a month compared to those who ate no fish at all.

"The overall findings are not surprising," says Dr. Ka He, a researcher in the departments of nutrition and epidemiology at the Harvard School of Public Health. What is somewhat surprising is that there was no evidence of major risk reduction of stroke by consuming fish more often. The incidence of stroke was reduced just 46 percent for men who ate fish six times a month.

The reduction was entirely confined to ischemic strokes. There was no effect on hemorrhagic strokes, which happen when a blood vessel bursts. There is even a theoretical possibility that eating fish increases the risk of hemorrhagic stroke, He says, although there is no solid evidence of that from the study.

"We weren't surprised to find that adding fish to one's diet would prove beneficial," He adds. "But we were surprised to see how small amounts of fish and omega-3 fatty acids, eaten regularly, can significantly reduce the risk of ischemic stroke for men. The message is clear for men: incorporate fish, whether it's lobster, canned tuna or salmon, into your diet and reduce the risk for stroke."

But don't think that just eating fish once a month can justify ignoring other risky behaviors that can lead to heart disease and stroke, says Alice Lichtenstein, director of the cardiovascular nutrition research program at Tufts University and vice chairwoman of the American Heart Association's nutrition committee.

Looking at the study closely shows that men who ate fish also tended to: have lower blood levels of trans-fatty acids and saturated fats, eat more fruits and vegetables, engage more in physical activity and smoke less, Lichtenstein says.

"There is a constellation of factors, all taken together, that dramatically cut risk," she says. "Eating a tuna fish sandwich once a month will not do the trick."

The kind of fish that is eaten can be important. Light-meat fish, such as flounder or whiting, have lower levels of the omega-3 fatty acids compared to dark-meat fish such as salmon, mackerel, bluefish or sardines. And frozen fish dinners can be prepared with a lot of saturated fats and trans-fatty acids.

Still, Lichtenstein says, the study is "another example of how eating fish is associated with better health."

What To Do

You can learn more about healthy eating from the American Heart Association. And read this MSNBC story on fish and heart disease.

Study: Small Amount of Fish Benefits Heart

Tue Dec 24, 4:05 PM ET

http://story.news.yahoo.com/news=story2&cid/ap_on_he_me/fish_strokes

CHICAGO - Eating fish just once a month is enough to reduce the risk of strokes in men, according to a study of more than 43,000 health professionals.

While numerous studies have touted the cardiovascular benefits of eating fish several times a week, the new research found a similar benefit from just occasional meals of seafood.