Why eating fish might be better supplements for stroke risk

Kathleen Blanchard's picture
Two or more fish servings a day could lower stroke risk.

Adding just two servings of fish to the diet each week could be an important way to cut your risk of stroke, finds a new study. The newest research found fish oil supplements don’t seem to provide the same benefit.

Researchers recently discovered the long chain fatty acids found in fish oil supplements don’t seem to provide any extra heart protection as previously thought. But until now they weren’t sure if omega three fatty acids from oily fish like mackerel and sardines could lower the chances of having a stroke.

The newest finding comes from an international team of scientists. An analysis of studies, led by Dr. Rajiv Chowdhury at Cambridge University and Professor Oscar H. Franco at Erasmus MC Rotterdam, revealed every serving of fish a person needs per week lowers the risk of cerebral vascular events by 4%.

The risk reduction includes both ‘mini-strokes’ or TIA and stroke.

The researchers looked at 38 studies that included over 800,000 people in 15 countries. Included were people with established heart disease as well as low-risk individuals who were enrolled in prevention studies.

Questionnaires were used to assess fish oil supplement use and dietary intake of fatty fish to assess markers of omega three fatty acids in the blood.

People in the study who ate 2 to 4 servings of fish per week had a 6% lower chance of having a stroke compared to those who ate one or fewer servings.

Five or more servings of fish lowered the chances of having a stroke by 12%.

The researchers think the reason eating fish is better than taking supplements might be because fish contains other nutrients like vitamins, minerals and amino acids that interact with each other to lead to better cardiovascular health.

Another possible explanation is that if you’re eating more fish you’re eating less red meat. Saturated fat which is found in red meat is known to contribute to poor blood vessel health that can lead to coronary heart disease, heart attack and stroke.

The authors also note it may simply be that people who eat fish have higher socioeconomic status and practice healthier lifestyles both of which are linked to better vascular health.


Oily fish intake appeared to promote healthy blood vessels better than white fish, which is usually battered and fried.

In an accompanying editorial, authors from the Division of Human Nutrition at Wageningen University say nutritional guidance is a ‘reasonable’ approach for promoting healthy blood vessels. Supplements aren’t likely to do much for curbing heart disease or stroke.

What else can you do?

The finding is interesting because it supports multiple studies that show food is good medicine, especially when combined with a variety of other healthy foods.

Lycopene, found in fruits and vegetables and found in high levels in tomatoes is recently linked to lower chance of having a stroke.

Other dietary interventions include limiting portions of red meat, focusing on lean cuts, substituting vegetable oils for olive or canola oil and ensuring you get five (or more) servings of fruits and vegetables each day.

Adding good fats to the diet has an anti-inflammatory effect. Eating walnuts has been shown to improve cardiovascular health for diabetics, according to a 2010 study published in the journal Diabetes Care.

Keeping blood pressure less than 120/80 or less by limiting salt in the diet, engaging in daily exercise or activity also reduces the risk of having a mini stroke that can lead to a major stroke without lifestyle changes.

Foods that can help lower blood pressure include celery, beet juice, raw nuts, purple potatoes.

The finding also supports current dietary recommendations for consuming foods with healthy oils that are low in saturated fat.

Even though the reduction in stroke risk found from eating at least 2 servings of fish per week was modest the study authors say it is significant.

BMJ 2012;345:e6698

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