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

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  • Stine K Venø, Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark., Kardiologisk Afdeling, Aalborg Sygehus, Denmark
  • Christian S Bork, Department of Cardiology, Aalborg University Hospital, 9000 Aalborg, Denmark., Denmark
  • Marianne U Jakobsen, National Food Institute, Division for Diet, Disease Prevention and Toxicology, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark.
  • ,
  • Søren Lundbye-Christensen
  • Flemming W Bach
  • Peter L McLennan, School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia., Australia
  • Anne Tjønneland, Department of Public Health, University of Copenhagen, 2200 Copenhagen N, Denmark. annet@CANCER.DK., Danish Cancer Society Research Center, Denmark
  • Erik B Schmidt
  • Kim Overvad

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.

Original languageEnglish
Article number1648
Pages (from-to)1648
Number of pages11
Publication statusPublished - 3 Nov 2018

    Research areas

  • ischemic stroke, TOAST classification, substitution models, cohort studies, diet, fish, meat, poultry, Poultry, Substitution models, Ischemic stroke, Meat, Diet, Cohort studies, Fish

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