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.
View / Open Files
Authors
Tong, Tammy YN
Appleby, Paul N
Key, Timothy J
Dahm, Christina C
Overvad, Kim
Olsen, Anja
Tjønneland, Anne
Katzke, Verena
Kühn, Tilman
Boeing, Heiner
Karakatsani, Anna
Peppa, Eleni
Trichopoulou, Antonia
Weiderpass, Elisabete
Masala, Giovanna
Grioni, Sara
Panico, Salvatore
Tumino, Rosario
Boer, Jolanda MA
Verschuren, WM Monique
Quirós, J Ramón
Agudo, Antonio
Rodríguez-Barranco, Miguel
Imaz, Liher
Chirlaque, María-Dolores
Moreno-Iribas, Conchi
Engström, Gunnar
Sonestedt, Emily
Lind, Marcus
Otten, Julia
Khaw, Kay-Tee
Aune, Dagfinn
Riboli, Elio
Perez-Cornago, Aurora
Publication Date
2020-07-21Journal Title
Eur Heart J
ISSN
0195-668X
Publisher
Oxford University Press (OUP)
Volume
41
Issue
28
Pages
2632-2640
Language
eng
Type
Article
This Version
AM
Physical Medium
Print
Metadata
Show full item recordCitation
Tong, T. Y., Appleby, P. N., Key, T. J., Dahm, C. C., Overvad, K., Olsen, A., Tjønneland, A., et al. (2020). 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.. Eur Heart J, 41 (28), 2632-2640. https://doi.org/10.1093/eurheartj/ehaa007
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.
Keywords
Animals, Humans, Brain Ischemia, Diet, Risk Factors, Prospective Studies, Dietary Fiber, Europe, Female, Male, Stroke, Hemorrhagic Stroke
Sponsorship
Analyses were supported by the UK Medical Research Council (MR/M012190/1), Cancer Research UK (C8221/A19170 and 570/A16491), and the Wellcome Trust (Our Planet Our Health, Livestock Environment and People 205212/Z/16/Z). EPIC-CVD has been supported by the European Union Framework 7 (HEALTH-F2-2012-279233), the European Research Council (268834), the UK Medical Research Council (G0800270 and MR/L003120/1), the British Heart Foundation (SP/09/002 and RG/08/014 and RG13/13/30194), and the UK National Institute of Health Research. The establishment of the study subcohort was supported by the EU Sixth Framework Programme (FP6) (grant LSHM_CT_2006_037197 to the InterAct project) and the Medical Research Council Epidemiology Unit (grants MC_UU_12015/1 and MC_UU_12015/5).
Funder references
Medical Research Council (MC_UU_12015/5)
Medical Research Council (MC_UU_12015/1)
Department of Health (via National Institute for Health Research (NIHR)) (NF-SI-0617-10149)
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
Medical Research Council (G0401527)
Medical Research Council (MR/N003284/1)
Medical Research Council (G1000143)
Medical Research Council (G0800270)
European Research Council (268834)
Medical Research Council (MR/L003120/1)
British Heart Foundation (None)
Medical Research Council (G0700463)
MRC (MC_UU_00006/1)
MRC (MC_UU_00006/3)
Embargo Lift Date
2023-01-13
Identifiers
External DOI: https://doi.org/10.1093/eurheartj/ehaa007
This record's URL: https://www.repository.cam.ac.uk/handle/1810/300851
Rights
All rights reserved
Licence:
http://www.rioxx.net/licenses/all-rights-reserved
Statistics
Total file downloads (since January 2020). For more information on metrics see the
IRUS guide.