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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

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
Authors: Tong, TYN
Appleby, PN
Key, TJ
Dahm, CC
Overvad, K
Olsen, A
Tjønneland, A
Katzke, V
Kühn, T
Boeing, H
Karakatsani, A
Peppa, E
Trichopoulou, A
Weiderpass, E
Masala, G
Grioni, S
Panico, S
Tumino, R
Boer, JMA
Verschuren, WMM
Quirós, JR
Agudo, A
Rodríguez-Barranco, M
Imaz, L
Chirlaque, M-D
Moreno-Iribas, C
Engström, G
Sonestedt, E
Lind, M
Otten, J
Khaw, K-T
Aune, D
Riboli, E
Wareham, NJ
Imamura, F
Forouhi, NG
Di Angelantonio, E
Wood, AM
Butterworth, AS
Perez-Cornago, A
Item Type: Journal Article
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 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.
Issue Date: 21-Jul-2020
Date of Acceptance: 10-Jan-2020
URI: http://hdl.handle.net/10044/1/76996
DOI: 10.1093/eurheartj/ehaa007
ISSN: 0195-668X
Publisher: Oxford University Press (OUP)
Start Page: 2632
End Page: 2640
Journal / Book Title: European Heart Journal
Volume: 41
Issue: 28
Copyright Statement: © The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Diet
Haemorrhagic stroke
Ischaemic stroke
Haemorrhagic stroke
Ischaemic stroke
1102 Cardiorespiratory Medicine and Haematology
1103 Clinical Sciences
Cardiovascular System & Hematology
Publication Status: Published
Conference Place: England
Online Publication Date: 2020-02-24
Appears in Collections:Faculty of Medicine
School of Public Health

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