Only 5,022 (23 percent) of the study participants consumed two or more servings of non-fried fish per week.
The study used a questionnaire to determine total omega-3 fat consumption among the 21,675 respondents who were originally recruited by phone. Of them, 34 percent were black, 66 percent were white, 74 percent were overweight and 56 percent lived in the stroke belt region. Men made up 44 percent of the participants.
Blacks, who have a four times greater risk of stroke, ate about the same amount of non-fried fish as whites, but whites had higher total intake of omega-3 fats, the study found. Omega-3 fats can also be found in other foods including canola oil, flaxseed oil, walnuts and soybeans, Nahab said.
"I grew up in California, and when I moved here [Atlanta] I became aware of noticeable dietary differences between there and the South," said Nahab.
In southern California, few people in their 30s or 40s suffered strokes, he said, adding that in those cases "we looked for rare genetic disorders or some other unusual cause that could account for this." Now, Nahab tells his students to always ask stroke patients about their diet.
In the stroke belt, people tend to fry more food than in the rest of the country, said Nahab, also an assistant professor of neurology at the school.
Stroke belt patients also report frequently eating breakfasts of grits with butter, bacon and eggs, and toast, also with butter. In southern California, breakfast more likely included cereal with milk and fruit, said Nahab.
Another expert said he was not surprised by the findings.
"It reinforces what we know about the 'stroke belt' and the less favorable dietary factors that might be one part of the explanation as to why they have higher stroke rates, as opposed to the rest of the country," said Howard Sesso, an associate epidemiologist at Brigham and Women's Hospital in Boston.
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