In “Fish intake and MRI burden of cerebrovascular disease in older adults,” Thomas et al. reported that higher fish intake was associated with lower burden of cerebrovascular disease, particularly in subjects aged <75 years. Brenner commented that these findings might be attributed to lower consumption of red meat and dairy products, which contain glycolyneuraminic acid (Neu5Gc), a sialic acid that can cause chronic inflammation leading to atherosclerosis. Thomas and Samieri agreed that red meat and dairy products can lead to cerebrovascular disease, but noted that they adjusted for these and other confounders such as intake of fruit, vegetables, legumes, and olive oil. As such, they believe that their findings are directly attributed to higher fish intake, rather than lower intake of red meat and dairy. They reported that this may be due to the main beneficial effects of long-chain omega-3 polyunsaturated fatty acids.