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Nutrients 2018, 10(11), 1648; https://doi.org/10.3390/nu10111648

Substitution of Fish for Red Meat or Poultry and Risk of Ischemic Stroke

1
Department of Cardiology, Aalborg University Hospital, 9000 Aalborg, Denmark
2
Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark
3
National Food Institute, Division for Diet, Disease Prevention and Toxicology, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
4
Unit of Clinical Biostatistics, Aalborg University Hospital, 9000 Aalborg, Denmark
5
Atrial Fibrillation Study Group, Aalborg University Hospital, 9000 Aalborg, Denmark
6
Department of Neurology, Aarhus University Hospital, DK-8000 Aarhus C, Denmark
7
School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia
8
Danish Cancer Society Research Center, DK-2100 Copenhagen Ø, Denmark
9
Department of Public Health, University of Copenhagen, 2200 Copenhagen N, Denmark
10
Department of Public Health, Aarhus University, DK-8000 Aarhus C, Denmark
*
Author to whom correspondence should be addressed.
Received: 28 September 2018 / Revised: 29 October 2018 / Accepted: 30 October 2018 / Published: 3 November 2018
(This article belongs to the Special Issue Nutrition and Risk of Stroke)
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Abstract

We investigated the risk of ischemic stroke and its subtypes when red meat or poultry was substituted with fish. A total of 57,053 participants aged 50–65 years at baseline were included in the Danish Diet, Cancer and Health study. All participants filled in a food-frequency questionnaire at recruitment. Potential ischemic stroke cases were identified by linkage to the Danish National Patient Register, and all cases were validated and subclassified. Substitutions were investigated as 150 g/week of fish for 150 g/week of red meat or of poultry using multivariable Cox proportional hazard regression models. During 13.5 years of follow-up, 1879 participants developed an ischemic stroke. Replacing red meat or poultry with fish was not associated with the rate of total ischemic stroke, but there was a statistically significant lower rate of large artery atherosclerosis when fish replaced processed (hazard ratio (HR): 0.78; 95% confidence interval (CI): 0.67; 0.90) and unprocessed (HR: 0.87; 95% CI: 0.75; 0.99) red meat. A statistically significant higher rate of cardioembolism was found when poultry was replaced by total fish (HR: 1.42; 95% CI: 1.04; 1.93). When fatty fish replaced unprocessed red meat, a statistically significant lower rate of small-vessel occlusion was found (HR: 0.88; 95% CI: 0.77; 0.99). In conclusion, replacing red meat with fish was not associated with risk of total ischemic stroke but was associated with a lower risk of subtypes of ischemic stroke. View Full-Text
Keywords: ischemic stroke; TOAST classification; substitution models; cohort studies; diet; fish; meat; poultry ischemic stroke; TOAST classification; substitution models; cohort studies; diet; fish; meat; poultry
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Venø, S.K.; Bork, C.S.; Jakobsen, M.U.; Lundbye-Christensen, S.; Bach, F.W.; McLennan, P.L.; Tjønneland, A.; Schmidt, E.B.; Overvad, K. Substitution of Fish for Red Meat or Poultry and Risk of Ischemic Stroke. Nutrients 2018, 10, 1648.

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