Dietary amino acids and risk of stroke subtypes : a prospective analysis of 356,000 participants in seven European countries
(2023) In European Journal of Nutrition- Abstract
Purpose: Previously reported associations of protein-rich foods with stroke subtypes have prompted interest in the assessment of individual amino acids. We examined the associations of dietary amino acids with risks of ischaemic and haemorrhagic stroke in the EPIC study. Methods: We analysed data from 356,142 participants from seven European countries. Dietary intakes of 19 individual amino acids were assessed using validated country-specific dietary questionnaires, calibrated using additional 24-h dietary recalls. Multivariable-adjusted Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of ischaemic and haemorrhagic stroke in relation to the intake of each amino acid. The role of blood... (More)
Purpose: Previously reported associations of protein-rich foods with stroke subtypes have prompted interest in the assessment of individual amino acids. We examined the associations of dietary amino acids with risks of ischaemic and haemorrhagic stroke in the EPIC study. Methods: We analysed data from 356,142 participants from seven European countries. Dietary intakes of 19 individual amino acids were assessed using validated country-specific dietary questionnaires, calibrated using additional 24-h dietary recalls. Multivariable-adjusted Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of ischaemic and haemorrhagic stroke in relation to the intake of each amino acid. The role of blood pressure as a potential mechanism was assessed in 267,642 (75%) participants. Results: After a median follow-up of 12.9 years, 4295 participants had an ischaemic stroke and 1375 participants had a haemorrhagic stroke. After correction for multiple testing, a higher intake of proline (as a percent of total protein) was associated with a 12% lower risk of ischaemic stroke (HR per 1 SD higher intake 0.88; 95% CI 0.82, 0.94). The association persisted after mutual adjustment for all other amino acids, systolic and diastolic blood pressure. The inverse associations of isoleucine, leucine, valine, phenylalanine, threonine, tryptophan, glutamic acid, serine and tyrosine with ischaemic stroke were each attenuated with adjustment for proline intake. For haemorrhagic stroke, no statistically significant associations were observed in the continuous analyses after correcting for multiple testing. Conclusion: Higher proline intake may be associated with a lower risk of ischaemic stroke, independent of other dietary amino acids and blood pressure.
(Less)
- author
- Tong, Tammy Y.N.
; Clarke, Robert
; Schmidt, Julie A.
; Huybrechts, Inge
; Noor, Urwah
; Forouhi, Nita G.
; Imamura, Fumiaki
; Travis, Ruth C.
; Weiderpass, Elisabete
; Aleksandrova, Krasimira
; Dahm, Christina C.
; van der Schouw, Yvonne T.
; Overvad, Kim
; Kyrø, Cecilie
; Tjønneland, Anne
; Kaaks, Rudolf
; Katzke, Verena
; Schiborn, Catarina
; Schulze, Matthias B.
; Mayen-Chacon, Ana Lucia
; Masala, Giovanna
; Sieri, Sabina
; de Magistris, Maria Santucci
; Tumino, Rosario
; Sacerdote, Carlotta
; Boer, Jolanda M.A.
; Verschuren, W. M.Monique
; Brustad, Magritt
; Nøst, Therese Haugdahl
; Crous-Bou, Marta
; Petrova, Dafina
; Amiano, Pilar
; Huerta, José María
; Moreno-Iribas, Conchi
; Engström, Gunnar
LU
; Melander, Olle
LU
; Johansson, Kristina
; Lindvall, Kristina
; Aglago, Elom K.
; Heath, Alicia K.
; Butterworth, Adam S.
; Danesh, John
and Key, Timothy J.
(Less) - organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- epub
- subject
- keywords
- Amino acids, Dietary protein, Haemorrhagic stroke, Ischaemic stroke, Nutritional epidemiology, Prospective cohort
- in
- European Journal of Nutrition
- publisher
- Springer
- external identifiers
-
- pmid:37804448
- scopus:85173723528
- ISSN
- 1436-6207
- DOI
- 10.1007/s00394-023-03251-4
- language
- English
- LU publication?
- yes
- id
- 7f588e82-4889-4248-b643-a4e000643601
- date added to LUP
- 2024-01-11 14:29:38
- date last changed
- 2024-04-12 08:19:45
@article{7f588e82-4889-4248-b643-a4e000643601,
abstract = {{<p>Purpose: Previously reported associations of protein-rich foods with stroke subtypes have prompted interest in the assessment of individual amino acids. We examined the associations of dietary amino acids with risks of ischaemic and haemorrhagic stroke in the EPIC study. Methods: We analysed data from 356,142 participants from seven European countries. Dietary intakes of 19 individual amino acids were assessed using validated country-specific dietary questionnaires, calibrated using additional 24-h dietary recalls. Multivariable-adjusted Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of ischaemic and haemorrhagic stroke in relation to the intake of each amino acid. The role of blood pressure as a potential mechanism was assessed in 267,642 (75%) participants. Results: After a median follow-up of 12.9 years, 4295 participants had an ischaemic stroke and 1375 participants had a haemorrhagic stroke. After correction for multiple testing, a higher intake of proline (as a percent of total protein) was associated with a 12% lower risk of ischaemic stroke (HR per 1 SD higher intake 0.88; 95% CI 0.82, 0.94). The association persisted after mutual adjustment for all other amino acids, systolic and diastolic blood pressure. The inverse associations of isoleucine, leucine, valine, phenylalanine, threonine, tryptophan, glutamic acid, serine and tyrosine with ischaemic stroke were each attenuated with adjustment for proline intake. For haemorrhagic stroke, no statistically significant associations were observed in the continuous analyses after correcting for multiple testing. Conclusion: Higher proline intake may be associated with a lower risk of ischaemic stroke, independent of other dietary amino acids and blood pressure.</p>}},
author = {{Tong, Tammy Y.N. and Clarke, Robert and Schmidt, Julie A. and Huybrechts, Inge and Noor, Urwah and Forouhi, Nita G. and Imamura, Fumiaki and Travis, Ruth C. and Weiderpass, Elisabete and Aleksandrova, Krasimira and Dahm, Christina C. and van der Schouw, Yvonne T. and Overvad, Kim and Kyrø, Cecilie and Tjønneland, Anne and Kaaks, Rudolf and Katzke, Verena and Schiborn, Catarina and Schulze, Matthias B. and Mayen-Chacon, Ana Lucia and Masala, Giovanna and Sieri, Sabina and de Magistris, Maria Santucci and Tumino, Rosario and Sacerdote, Carlotta and Boer, Jolanda M.A. and Verschuren, W. M.Monique and Brustad, Magritt and Nøst, Therese Haugdahl and Crous-Bou, Marta and Petrova, Dafina and Amiano, Pilar and Huerta, José María and Moreno-Iribas, Conchi and Engström, Gunnar and Melander, Olle and Johansson, Kristina and Lindvall, Kristina and Aglago, Elom K. and Heath, Alicia K. and Butterworth, Adam S. and Danesh, John and Key, Timothy J.}},
issn = {{1436-6207}},
keywords = {{Amino acids; Dietary protein; Haemorrhagic stroke; Ischaemic stroke; Nutritional epidemiology; Prospective cohort}},
language = {{eng}},
publisher = {{Springer}},
series = {{European Journal of Nutrition}},
title = {{Dietary amino acids and risk of stroke subtypes : a prospective analysis of 356,000 participants in seven European countries}},
url = {{http://dx.doi.org/10.1007/s00394-023-03251-4}},
doi = {{10.1007/s00394-023-03251-4}},
year = {{2023}},
}