Is Eating Fish Good For You — Even If It’s Fried?

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Among the most familiar foods on the good-for-you list are fruits, vegetables and fish. But does fried fish count?

Umm, no, at least not according to the latest results of a study on fish consumption and stroke. The survey found that people who live in the so-called “stroke belt” of the United States, which stretches from the Carolinas to Arkansas and Louisiana and where stroke rates are among the highest in the country, are less likely to eat the recommended two servings of fish per week. And when residents in these states do eat fish, they are more likely to have it in fried form. (More on Time.com: Overeating: Is It an Addiction?)

That’s not a surprise, says the study’s lead author, Dr. Fadi Nahab, director of the stroke program at Emory University Hospital, given the popularity of fried foods in the South. But the results highlight one of the major contributors to the higher rates of stroke in the region, and that involves diet.

Strokes can result when blood vessels feeding the brain are blocked, starving nerve cells of much-needed oxygen. Many of the same risk factors that promote heart disease, such as high blood pressure and high cholesterol, can contribute to higher risk of stroke as well. “Our study is really the first study that looks at the dietary habits of people who live in and out of the stroke belt,” says Nahab. (More on Time.com: Want to Eat Less? Imagine Eating More)

In this part of the U.S., the odds of people eating the federally recommended two servings of fish a week in non-fried form are 17% lower than in other areas of the country. People in the stroke belt are also 32% more likely to be consuming two or more servings of fried fish each week than other Americans.

Nahab, a neurologist, had an interest in explaining why stroke-belt residents are 20% more likely to have a stroke than those living elsewhere in the U.S. Intrigued by government nutrition statistics showing that African Americans, who have the highest stroke rates in that region, were eating more than two servings of fish each week, he decided to tease apart exactly what people in that part of the country were eating.

It turns out that most of the fish being consumed was fried, which negated its potential stroke-preventing benefits on several levels. First, as studies by researchers in Spain have found, the act of frying fish can cause fatty fish such as salmon, which is rich in healthy omega-3 fatty acids, to lose its beneficial oils; those oils get replaced with the often unhealthier oil in which the fish is fried. In addition, the types of fish that are normally fried, such as cod and other white fish, tend to be less dense in omega-3 fats. (More on Time.com: Weight Watchers’ New Points: Zero for Most Fruits and Veggies)

“What we hope to highlight with our study is that it’s not just about having fish, but about how you prepare that fish,” says Nahab. “And it’s not about any kind of fish whatsoever, but having certain fish species that have more omega-3 fats, so if you’re going to have fish, it’s better to have fish like salmon, herring and mackerel that are much higher in omega-3 fats.”

Studies have already shown that consuming more omega-3 fats, whether from pelagic creatures or in supplement form, can lower the risk of heart attack, but the data is less conclusive when it comes to protecting against stroke. Nahab is planning to follow up this study by looking at stroke patients who take regular supplements of fish oil, to see if their risk of a recurrent stroke is any lower than among those who don’t add pills of omega-3 fats to their nutritional regimen.

Until then, the current study suggests that it’s not enough to simply eat fish, but to make sure that it’s cooked any way but fried. That may not be so easy to do in the South, but it could potentially shrink the girth of the stroke belt.

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