Fishing for health: Neighborhood variation in fish intake, fish quality and association with stroke risk among older adults in the Cardiovascular Health Study

Fish consumption has been associated with better health outcomes. Dietary patterns may vary substantially by neighborhood of residence. However, it is unclear if the benefits of a healthy diet are equivalent in different communities. This study examines associations of fish consumption with stroke i...

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Bibliographic Details
Published in:Nutrition, metabolism, and cardiovascular diseases metabolism, and cardiovascular diseases, 2022-06, Vol.32 (6), p.1410-1417
Main Authors: Liang, Li-Jung, Casillas, Alejandra, Longstreth, W.T., PhanVo, Lynn, Vassar, Stefanie D., Brown, Arleen F.
Format: Article
Language:English
Subjects:
Aged
Animals
Diet
Fish preparation and intake
Humans
Neighborhood socioeconomic status
Older adults
Residence Characteristics
Risk Factors
Social Class
Stroke - diagnosis
Stroke - epidemiology
Stroke - prevention & control
Stroke and stroke risk factors
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Summary:Fish consumption has been associated with better health outcomes. Dietary patterns may vary substantially by neighborhood of residence. However, it is unclear if the benefits of a healthy diet are equivalent in different communities. This study examines associations of fish consumption with stroke incidence and stroke risk factors, and whether these differ by neighborhood socioeconomic status (NSES). We studied 4007 participants in the Cardiovascular Health Study who were 65 years or older and recruited between 1989 and 1990 from 4 US communities. Outcomes included fish consumption type (bakes/broiled vs. fried) and frequency, stroke incidence, and stroke risk factors. Multilevel regressions models were used to estimate fish consumption associations with clinical outcomes. Lower NSES was associated with higher consumption of fried fish (aOR = 1.47, 95% CI: 1.10–1.98) and lower consumption of non-fried fish (0.64, 0.47–0.86). Frequent fried fish (11.9 vs. 9.2 person-years for at least once weekly vs. less than once a month, respectively) and less frequent non-fried fish (17.7 vs. 9.6 person-years for less than once a month vs. at least once weekly, respectively) were independently associated with an increased risk of stroke (p-values < 0.05). However, among those with similar levels of healthy fish consumption, residents with low NSES had less benefit on stroke risk reduction, compared with high NSES. Fish consumption type and frequency both impact stroke risk. Benefits of healthy fish consumption differ by neighborhood socioeconomic status. •For stroke risk, how fish is prepared and how often it is consumed are both important.•Frequent fried fish is associated with an increased risk of stroke.•Frequent baked or broiled fish is associated with a reduced risk of stroke.•Benefits of healthy fish consumption differ by neighborhood socioeconomic status.
ISSN:0939-4753
1590-3729
DOI:10.1016/j.numecd.2022.03.005