Association between Fish Consumption and Stroke Incidence Across Different Predicted Risk Populations: A Prospective Cohort Study from China.

Hong Yue HU; Fang Chao LIU; Ke Yong HUANG; Chong SHEN; Jian LIAO; Jian Xin LI; Chen Xi YUAN; Ying LI; Xue Li YANG; Ji Chun CHEN; Jie CAO; Shu Feng CHEN; Dong Sheng HU; Jian Feng HUANG; Xiang Feng LU; Dong Feng GU

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Association between Fish Consumption and Stroke Incidence Across Different Predicted Risk Populations: A Prospective Cohort Study from China.

Author: Hong Yue HU ¹ ; Fang Chao LIU ² ; Ke Yong HUANG ² ; Chong SHEN ³ ; Jian LIAO ⁴ ; Jian Xin LI ² ; Chen Xi YUAN ¹ ; Ying LI ¹ ; Xue Li YANG ⁵ ; Ji Chun CHEN ² ; Jie CAO ² ; Shu Feng CHEN ² ; Dong Sheng HU ⁶ ; Jian Feng HUANG ² ; Xiang Feng LU ² ; Dong Feng GU ⁷
Author Information

1. Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, China;Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
2. Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China;Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China.
3. Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, China;Research Units of Cohort Study on Cardiovascular Diseases and Cancers, Chinese Academy of Medical Sciences, Beijing 100730, China.
4. School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, Guangdong, China.
5. Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China.
6. Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China;Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen 518071, Guangdong, China.
7. Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, China;Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China;Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China;School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, Guangdong, China.
Publication Type:Journal Article
Keywords: Cohort study; Fish consumption; Interaction; Predicted stroke risk; Stroke
MeSH: Humans; China/epidemiology*; Male; Female; Stroke/etiology*; Middle Aged; Prospective Studies; Incidence; Aged; Animals; Fishes; Risk Factors; Diet; Seafood; Adult; Cohort Studies
From: Biomedical and Environmental Sciences 2025;38(1):15-26
CountryChina
Language:English
Abstract: OBJECTIVE:The relationship between fish consumption and stroke is inconsistent, and it is uncertain whether this association varies across predicted stroke risks.
METHODS:A cohort study comprising 95,800 participants from the Prediction for Atherosclerotic Cardiovascular Disease Risk in China project was conducted. A standardized questionnaire was used to collect data on fish consumption. Participants were stratified into low- and moderate-to-high-risk categories based on their 10-year stroke risk prediction scores. Hazard ratios ( HRs) and 95% confidence intervals ( CIs) were estimated using Cox proportional hazard models and additive interaction by relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (SI).
RESULTS:During 703,869 person-years of follow-up, 2,773 incident stroke events were identified. Higher fish consumption was associated with a lower risk of stroke, particularly among moderate-to-high-risk individuals ( HR = 0.53, 95% CI: 0.47-0.60) than among low-risk individuals ( HR = 0.64, 95% CI: 0.49-0.85). A significant additive interaction between fish consumption and predicted stroke risk was observed (RERI = 4.08, 95% CI: 2.80-5.36; SI = 1.64, 95% CI: 1.42-1.89; AP = 0.36, 95% CI: 0.28-0.43).
CONCLUSION:Higher fish consumption was associated with a lower risk of stroke, and this beneficial association was more pronounced in individuals with moderate-to-high stroke risk.