Intended for healthcare professionals


The role of fatty acids from fish in the prevention of stroke

BMJ 2012; 345 doi: (Published 30 October 2012) Cite this as: BMJ 2012;345:e7219
  1. Janette de Goede, postdoctoral researcher,
  2. Johanna M Geleijnse, associate professor
  1. 1Division of Human Nutrition, Wageningen University, 6700 EV Wageningen, Netherlands
  1. janette.degoede{at}

Fish oil supplements may not be protective in at risk patients who are optimally managed

Fish consumption once or twice a week is widely recommended for cardiovascular health. Fish is the main dietary source of the long chain omega 3 fatty acids eicosapentaenoic acid and docosahexaenoic acid. Low doses of these fatty acids (about 250 mg/day) have been suggested to protect against death from coronary heart disease (CHD).1 Fewer data are available on the part that fish intake plays in preventing stroke. In a linked systematic review and meta-analysis of prospective studies and randomised controlled trials (doi:10.1136/bmj.e6698), Chowdhury and colleagues evaluate the role of fish and omega 3 fatty acid intake in the primary and secondary prevention of stroke.2

Several meta-analyses on fish and incident stroke have been published previously.3 4 5 A 2004 meta-analysis of eight population based prospective cohort studies found that eating fish at least once a week was significantly associated with a 13-31% reduction in the risk of stroke when compared with eating fish less than once per month. The association was most pronounced for ischaemic stroke. A recently published update of this meta-analysis, which analysed 16 prospective cohort studies, came to a similar conclusion, although the effect sizes were smaller (9-14% lower risk).5 Another meta-analysis, published in 2011, which was based on 15 prospective cohort …

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