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The associations of major foods and fibre with risks of ischaemic and haemorrhagic stroke : A prospective study of 418 329 participants in the EPIC cohort across nine European countries

Tong, Tammy Y.N. ; Appleby, Paul N. ; Key, Timothy J. ; Dahm, Christina C. ; Overvad, Kim ; Olsen, Anja ; Tjønneland, Anne ; Katzke, Verena ; Kühn, Tilman and Boeing, Heiner , et al. (2020) In European Heart Journal 41(28). p.2632-2640
Abstract

Aim: To investigate the associations between major foods and dietary fibre with subtypes of stroke in a large prospective cohort. Methods and results: We analysed data on 418 329 men and women from nine European countries, with an average of 12.7 years of follow-up. Diet was assessed using validated country-specific questionnaires which asked about habitual intake over the past year, calibrated using 24-h recalls. Multivariable-adjusted Cox regressions were used to estimate hazard ratios (HRs) for ischaemic and haemorrhagic stroke associated with consumption of red and processed meat, poultry, fish, dairy foods, eggs, cereals, fruit and vegetables, legumes, nuts and seeds, and dietary fibre. For ischaemic stroke (4281 cases), lower... (More)

Aim: To investigate the associations between major foods and dietary fibre with subtypes of stroke in a large prospective cohort. Methods and results: We analysed data on 418 329 men and women from nine European countries, with an average of 12.7 years of follow-up. Diet was assessed using validated country-specific questionnaires which asked about habitual intake over the past year, calibrated using 24-h recalls. Multivariable-adjusted Cox regressions were used to estimate hazard ratios (HRs) for ischaemic and haemorrhagic stroke associated with consumption of red and processed meat, poultry, fish, dairy foods, eggs, cereals, fruit and vegetables, legumes, nuts and seeds, and dietary fibre. For ischaemic stroke (4281 cases), lower risks were observed with higher consumption of fruit and vegetables combined (HR; 95% CI per 200 g/day higher intake, 0.87; 0.82-0.93, P-trend < 0.001), dietary fibre (per 10 g/day, 0.77; 0.69-0.86, P-trend < 0.001), milk (per 200 g/day, 0.95; 0.91-0.99, P-trend = 0.02), yogurt (per 100 g/day, 0.91; 0.85-0.97, P-trend = 0.004), and cheese (per 30 g/day, 0.88; 0.81-0.97, P-trend = 0.008), while higher risk was observed with higher red meat consumption which attenuated when adjusted for the other statistically significant foods (per 50 g/day, 1.07; 0.96-1.20, P-trend = 0.20). For haemorrhagic stroke (1430 cases), higher risk was associated with higher egg consumption (per 20 g/day, 1.25; 1.09-1.43, P-trend = 0.002). Conclusion: Risk of ischaemic stroke was inversely associated with consumption of fruit and vegetables, dietary fibre, and dairy foods, while risk of haemorrhagic stroke was positively associated with egg consumption. The apparent differences in the associations highlight the importance of examining ischaemic and haemorrhagic stroke subtypes separately.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Diet, Fibre, Fruit, Haemorrhagic stroke, Ischaemic stroke, Vegetables
in
European Heart Journal
volume
41
issue
28
pages
9 pages
publisher
Oxford University Press
external identifiers
  • pmid:32090257
  • scopus:85084352935
ISSN
0195-668X
DOI
10.1093/eurheartj/ehaa007
language
English
LU publication?
yes
id
5213bcdd-f1f5-4904-999a-b481747eec06
date added to LUP
2020-12-18 13:52:35
date last changed
2021-06-16 04:23:17
@article{5213bcdd-f1f5-4904-999a-b481747eec06,
  abstract     = {<p>Aim: To investigate the associations between major foods and dietary fibre with subtypes of stroke in a large prospective cohort. Methods and results: We analysed data on 418 329 men and women from nine European countries, with an average of 12.7 years of follow-up. Diet was assessed using validated country-specific questionnaires which asked about habitual intake over the past year, calibrated using 24-h recalls. Multivariable-adjusted Cox regressions were used to estimate hazard ratios (HRs) for ischaemic and haemorrhagic stroke associated with consumption of red and processed meat, poultry, fish, dairy foods, eggs, cereals, fruit and vegetables, legumes, nuts and seeds, and dietary fibre. For ischaemic stroke (4281 cases), lower risks were observed with higher consumption of fruit and vegetables combined (HR; 95% CI per 200 g/day higher intake, 0.87; 0.82-0.93, P-trend &lt; 0.001), dietary fibre (per 10 g/day, 0.77; 0.69-0.86, P-trend &lt; 0.001), milk (per 200 g/day, 0.95; 0.91-0.99, P-trend = 0.02), yogurt (per 100 g/day, 0.91; 0.85-0.97, P-trend = 0.004), and cheese (per 30 g/day, 0.88; 0.81-0.97, P-trend = 0.008), while higher risk was observed with higher red meat consumption which attenuated when adjusted for the other statistically significant foods (per 50 g/day, 1.07; 0.96-1.20, P-trend = 0.20). For haemorrhagic stroke (1430 cases), higher risk was associated with higher egg consumption (per 20 g/day, 1.25; 1.09-1.43, P-trend = 0.002). Conclusion: Risk of ischaemic stroke was inversely associated with consumption of fruit and vegetables, dietary fibre, and dairy foods, while risk of haemorrhagic stroke was positively associated with egg consumption. The apparent differences in the associations highlight the importance of examining ischaemic and haemorrhagic stroke subtypes separately. </p>},
  author       = {Tong, Tammy Y.N. and Appleby, Paul N. and Key, Timothy J. and Dahm, Christina C. and Overvad, Kim and Olsen, Anja and Tjønneland, Anne and Katzke, Verena and Kühn, Tilman and Boeing, Heiner and Karakatsani, Anna and Peppa, Eleni and Trichopoulou, Antonia and Weiderpass, Elisabete and Masala, Giovanna and Grioni, Sara and Panico, Salvatore and Tumino, Rosario and Boer, Jolanda M.A. and Verschuren, W. M.Monique and Quirós, J. Ramón and Agudo, Antonio and Rodríguez-Barranco, Miguel and Imaz, Liher and Chirlaque, Mariá Dolores and Moreno-Iribas, Conchi and Engström, Gunnar and Sonestedt, Emily and Lind, Marcus and Otten, Julia and Khaw, Kay Tee and Aune, Dagfinn and Riboli, Elio and Wareham, Nicholas J. and Imamura, Fumiaki and Forouhi, Nita G. and Di Angelantonio, Emanuele and Wood, Angela M. and Butterworth, Adam S. and Perez-Cornago, Aurora},
  issn         = {0195-668X},
  language     = {eng},
  number       = {28},
  pages        = {2632--2640},
  publisher    = {Oxford University Press},
  series       = {European Heart Journal},
  title        = {The associations of major foods and fibre with risks of ischaemic and haemorrhagic stroke : A prospective study of 418 329 participants in the EPIC cohort across nine European countries},
  url          = {http://dx.doi.org/10.1093/eurheartj/ehaa007},
  doi          = {10.1093/eurheartj/ehaa007},
  volume       = {41},
  year         = {2020},
}