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The NHANES I Epidemiologie Follow-up Study

Richard F. Gillum, MD; Michael E. Mussolino; Jennifer H. Madans, PhD

Arch Intern Med. 1996;156(5):537-542.

Abstract
Objective
To assess the level of fish consumption as a risk factor for stroke.

Methods
Participants were members of the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study, a longitudinal cohort study of a national sample. Included in this analysis were white and black women and men aged 45 to 74 years when examined in 1971 through 1975 who did not report a history of stroke at that time. Av-erage follow-up for survivors was 12 years (maximum, 16 years). The main outcome measure was incident stroke (fatal and nonfatal). Fish consumption at baseline was obtained from a 3-month food frequency questionnaire.

Results
White women aged 45 to 74 years who consumed fish more than once a week had an age-adjusted risk of stroke incidence only about half that of women who never consumed fish. This effect persisted after controlling for multiple stroke risk variables (relative risk, 0.55; 95% confidence interval [ CI], 0.32 to 0.93). Fish consumption more than once a week compared with never was not associated with age-adjusted stroke risk in white men aged 45 to 74 years (relative risk, 0.85; 95% CI, 0.49 to 1.46). In black women and men combined aged 45 to 74 years, any fish consumption compared with never was significantly associated with reduced adjusted stroke risk (relative risk, 0.51; 95% CI, 0.30 to 0.88).

Conclusions
White women who consumed fish more than once a week had significantly lower stroke incidence than those who never consumed fish. A similar protective effect was seen in black women and men combined. Further studies are needed to confirm these findings and to elucidate mechanisms for the effect of fish consumption on stroke incidence.

(Arch Intern Med. 1996;156:537-542)

Author Affiliations
From the Centers for Disease Control and Prevention, Hyattsville, Md.

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