People in the “Stroke Belt” Eat More Fried Fish

Eight states in the southeast of the USA – North Carolina, South Carolina, Georgia, Alabama, Mississippi, Tennessee, Arkansas, and Louisiana - have an increased incidence of stroke in their populations; these states constitute what has become called the “Stroke Belt”.  Emory University researchers have studied this phenomenon and possible associated factors, and have published their findings online in the journal Neurology.

The subjects were recruited from a national study entitled Reasons for Geographic and Racial Differences in Stroke (REGARDS);  the 21,600-odd sample contained 44% living in non-stroke belt states, 34% living in the Stroke Belt, and 19% living in what they called the “Stroke Buckle” – the coastal plain region of North and South Carolina and Georgia.  The stroke buckle is the part of the stroke belt with the highest stroke mortality rates.  Food frequency questionnaires were used to assess the participants’ intake of oysters, shellfish, tuna, fried fish, and other non-fried.

The average age of the sample was 65.  Less than 1 in 4 of them ate at least 2 servings of non-fried fish a week; this is the minimum (especially fatty fish) recommended by the American Heart Association.

Total average servings of fish per week were lower in residents of the stroke belt and stroke buckle than residents of other areas of the USA, but the stroke belt and buckle residents ate less non-fried fish and more fried fish.  Stroke belt residents had a 30% higher likelihood of eating at least 2 servings of fried fish a week, while those in the stroke buckle had a 17% higher likelihood, compared to people elsewhere in the USA. 

Race also played a role.  Black participants ate a greater number of weekly servings of fish than white people overall, but this difference was driven by considerably greater consumption of fried fish by black subjects.  (Black people tend to have more strokes than white people.)  Omega-3 fatty acid intake was slightly lower in black participants.  (Frying, which is more often done with lean fish, such as cod and haddock, than with fatty fish –salmon, herring, or mackerel - is also associated with the loss of natural omega-3 fatty acids.)

This study doesn’t prove anything, but it raises concerns; firstly, people aren’t eating enough non-fried fish, and second, they may be eating too much fried fish for their health’s sake.  So, if you can afford it, choose salmon over cod, and skip the deep fry altogether.