Background Stroke is a leading cause of disability and death worldwide. The best estimates of local, national, and global burden of stroke are derived from prospective population-based studies. We aimed to investigate the incidence, risk factors, long-term prognosis, care, and quality of life after stroke in the Ñuble region of Chile. MethodsWe did a prospective community-based study with use of multiple overlapping sources of hospitalised, ambulatory, and deceased cases. Standardised diagnostic criteria were used to identify and follow up all cases occurring in the resident population of the Ñuble region, Chile (in a low-income rural-urban population including predominantly people of Indigenous-European heritage), for 1 year. Participants were included if they had a clinical diagnosis of stroke confirmed according to the study criteria. All cases were adjudicated by vascular neurologists. Incidence rates of first-ever stroke were calculated from the population of Ñuble according to the 2017 national census. FindingsFrom April 1, 2015, to March 31, 2016, we ascertained 1103 stroke cases, of which 890 (80•7%) were first-ever incident cases. The mean age of patients with first-ever stroke was 70•3 years (SD 14•1) and 443 (49•8%) were women. A CT scan was obtained in 801 (90%) of 890 patients (mean time from symptom onset to scan of 13•4 h (SD 29•8). The incidence of first-ever stroke age-adjusted to the world population was 121•7 (95% CI 113•7-130•1) per 100 000. The age-adjusted incidence rates, per 100 000 inhabitants, by main pathological subtypes were as follows: ischaemic stroke (101•5 [95% CI 90•9-113•0]); intracerebral haemorrhage (17•9 [13•5-23•4]), and subarachnoid haemorrhage (4•2 [2•1-7•3]). The 30-day case-fatality rate was 24•6% (21•9-27•6). At 6 months after the stroke, 55•9% (432 of 773) of cases had died or were disabled, which increased to 61•0% (456 of 747) at 12 months. Health-related quality of life in survivors was low at 6 months, improving slightly at 12 months after the stroke.Interpretation The incidence of stroke in this low-resource population was higher than our previous finding in northern Chile and within the mid-range of most population-based stroke studies. This result was due mainly to a higher incidence of ischaemic stroke, probably associated with increasing age and a high prevalence of cardiometabolic risk factors in the population studied. Our findings suggest that more should be done for the prevention and care of stroke in communities like the Ñuble population.

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An association between dietary fish oil and decreased yolk weight and reduced sensory quality of eggs has been reported when eggs are enriched with n-3 FA from fish oil. Seaweeds are an important source of compounds that seem to increase egg weight when included in the laying hen diet. The objectives of this study were to determine the influence of the dietary seaweeds Macrocystis pyrifera, Sargassum sinicola and Enteromorpha sp. on the physical quality, lipid composition and consumer acceptability of n-3 FA enriched eggs. One-hundred and forty-four 35-weekold Leghorn hens were randomly distributed in four treatments that consisted of the inclusion of 2% of sardine oil (SO) and 10% of each marine alga (MA) in laying hens' diets; a control diet (C) was also prepared. The study lasted 8 weeks and egg physical quality, egg lipids and sensory attributes were evaluated. The results showed that incorporation of 10% M. pyrifera in the diets is an effective way of increasing the n-3 FA content, the albumen height and yolk color, but not the egg weight, when these are enriched with n-3 FA from fish oil. The egg flavor was also not affected.

BackgroundEpidemiological evidence suggests a cardioprotective role of α‐linolenic acid (ALA), a plant‐derived ω‐3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω‐3 fatty acids (long‐chain n‐3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all‐cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long‐chain n‐3 polyunsaturated fatty acids (≥500 mg/day).Methods and ResultsWe longitudinally evaluated 7202 participants in the PREvención con DIeta MEDiterránea (PREDIMED) trial. Multivariable‐adjusted Cox regression models were fitted to estimate hazard ratios. ALA intake correlated to walnut consumption (r=0.94). During a 5.9‐y follow‐up, 431 deaths occurred (104 cardiovascular disease, 55 coronary heart disease, 32 sudden cardiac death, 25 stroke). The hazard ratios for meeting ALA recommendation (n=1615, 22.4%) were 0.72 (95% CI 0.56–0.92) for all‐cause mortality and 0.95 (95% CI 0.58–1.57) for fatal cardiovascular disease. The hazard ratios for meeting the recommendation for long‐chain n‐3 polyunsaturated fatty acids (n=5452, 75.7%) were 0.84 (95% CI 0.67–1.05) for all‐cause mortality, 0.61 (95% CI 0.39–0.96) for fatal cardiovascular disease, 0.54 (95% CI 0.29–0.99) for fatal coronary heart disease, and 0.49 (95% CI 0.22–1.01) for sudden cardiac death. The highest reduction in all‐cause mortality occurred in participants meeting both recommendations (hazard ratio 0.63 [95% CI 0.45–0.87]).ConclusionsIn participants without prior cardiovascular disease and high fish consumption, dietary ALA, supplied mainly by walnuts and olive oil, relates inversely to all‐cause mortality, whereas protection from cardiac mortality is limited to fish‐derived long‐chain n‐3 polyunsaturated fatty acids.Clinical Trial Registration URL: http://www.Controlled-trials.com/. Unique identifier: ISRCTN35739639.