Does Fish Intake Affect MRI Burden of Cerebrovascular Disease in Older Adults?

Increased consumption of fish is associated with a lower risk for cerebrovascular disease (CVD), according to results of a cross-sectional study published in Neurology.

Fish consumption is the primary source of long-chain omega-3 polyunsaturated fatty acids and may contribute to lower risk for age-related brain diseases. Yet, the mechanisms behind its potential impact on subclinical brain damage before the onset of these diseases is unknown. Previous research on fish intake and brain vascular health has also been mixed.

The objective of the current study was to examine the relationship between fish intake with global CVD burden based on brain magnetic resonance imaging (MRI) markers in a large population-based cohort of older adults.

To assess whether consuming fish associated with CVD burden, data were sourced from the Three City Dijon study. The participants consisted of a cohort of 1,623 community-dwellers aged 65 years or older in Dijon, France who were recruited between 1999 and 2001. Study participants were interviewed about demographics, medical and lifestyle information, responded to a brief food frequency questionnaire, and underwent MRI.

Participants were aged mean 72.3 (standard deviation [SD], 4.1) years, 63% were women, 44.6% had secondary education, 79.7% participated in moderate to vigorous physical activity, 76.6% had hypertension, 55.9% hypercholesterolemia, 21.3% cardiovascular disease, and 7.8% diabetes.

Participants were stratified by eating no fish (n=173), eating fish once (n=603), 2-3 times (n=756), or ³4 times (n=91) per week. Individuals who consumed more fish were more educated, had higher income, engaged more frequently in physical activity, had lower body mass index (BMI), and better cognitive performance.

The study population had an average white matter hyperintensities load of 2.2% (SD, 2.0%), 8.1% had covert brain infarcts, and 16.6% had degree 1, degree 2 (77.3%), and degree 3 (6.2%) perivascular space severity. Fish intake was associated with lower white matter hyperintensities (P <.001) and odds of covert brain infarct (P =.03) but was not associated with dilated perivascular spaces (P ³.18).

CVD burden was significantly associated with fish consumption (P <.001). Compared with no fish consumption, eating fish 2-3 (b, -0.19; 95% CI, -0.37 to -0.01 units) or ³4 (b, -0.30; 95% CI, -0.57 to -0.03 units) times per week was associated with decreased CVD burden scores.

The effect of fish consumption on CVD was modified by age (P =.04), in which the effect was stronger among those aged 65-69 years (P =.003) and 70-74 years (P =.006) than those ³75 years (P =.40).

Multivariate adjustments did not alter these observed trends and no other food groups were significantly associated with CVD.

This study was limited by its cross-sectional design, so no causal relationships could be assessed.

“To date, few protective factors against the development of subclinical cerebrovascular damage that lead to stroke or dementia have been identified. If confirmed in prospective studies or clinical trials, the beneficial role of fish intake for the preservation of cerebrovascular health in very early brain aging stages may lead to relatively simple and inexpensive preventive strategies,” the researchers concluded.


Thomas A, Crivello F, Mazoyer B, Debette S, Tzourio C, Samieri C. Fish Intake and MRI Burden of Cerebrovascular Disease in Older Adults. Neurology. Published online November 3, 2021. doi:10.1212/WNL.0000000000012916