America's stroke belt partially fueled by fried fish

(Press-News.org) BIRMINGHAM, Ala. – Eating a Southern staple, fried fish, could be one reason people in Alabama and across the "stroke belt" states are more likely than other Americans to die of a stroke, according to a study published in the December 22, 2010, online issue of Neurology, the medical journal of the American Academy of Neurology (AAN).

In the stroke belt states – Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, South Carolina and Tennessee – the risk of dying from stroke is higher than in other parts of the country. In Alabama, the stroke death rate is 125 per every 100,000 people, against a national average of just 98 per 100,000.

The study was part of the long-running REGARDS (Reasons for Geographic And Racial Differences in Stroke) trial, led by George Howard, Dr. PH, at the University of Alabama at Birmingham. REGARDS enrolled 21,675 people over the age of 45 between January 2003 and October 2007, and continues to follow them for health events.

Studies have shown that the omega-3 fatty acids in fish, especially fatty fish, may reduce the risk of stroke, but other research has shown that frying fish leads to the loss of the natural fatty acids, the AAN said in a press release.

The American Heart Association recommends that people eat fish at least twice a week, with an emphasis on fatty fish. In the entire study, fewer than 1 in 4 participants consumed two or more servings of non-fried fish per week; people in the stroke buckle were 17 percent less likely to meet the recommendations than those in the rest of the country, the AAN said.

Moreover, the study showed that people in the stroke belt were 30 percent more likely to eat two or more servings of fried fish than those in the rest of the country.

"These differences in fish consumption may be one of the potential reasons for the racial and geographic differences in stroke incidence and mortality," Fadi Nahab, M.D., of Emory University, author of the current paper, said in an AAN press release.

"Our study showed that stroke belt residents, especially African-Americans, eat more fried fish than Caucasians and people living in the rest of the country," said Howard, professor and chair of the Department of Biostatistics in the School of Public Health at UAB.

The study found that blacks were more than three and a half times more likely to eat fried fish per week than whites, with an overall average of about one serving per week of fried fish for blacks compared to half of a serving for whites.

"One of the next steps in this research will be to determine if people who eat higher amounts of non-fried fish have less risk of stroke than people who don't eat a lot of fish or eat more fried fish," says Suzanne Judd, Ph.D., assistant professor of biostatistics at UAB and a study co-author.

### The study was supported by the National Institute of Neurological Disorders and Stroke, the National Institutes of Health, and the Department of Health and Human Services. Funding was provided by General Mills for coding of the food frequency questionnaire.

Other co-authors were Anh Le, MS, Department of Biostatistics and Virginia Howard, Ph.D., Department of Epidemiology, UAB School of Public Health.

About the School of Public Health at the University of Alabama at Birmingham (UAB)

More than 60 faculty members and 100 part-time and volunteer faculty lead the UAB School of Public Health. It is comprised of in Departments of Biostatistics, Environmental Health Sciences, Epidemiology, Health Behavior and Health Care Organization and Policy. Find more information at www.soph.uab.edu.