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.


Journal

European heart journal
ISSN: 1522-9645
Titre abrégé: Eur Heart J
Pays: England
ID NLM: 8006263

Informations de publication

Date de publication:
21 07 2020
Historique:
received: 24 06 2019
revised: 20 09 2019
accepted: 10 01 2020
pubmed: 25 2 2020
medline: 15 5 2021
entrez: 25 2 2020
Statut: ppublish

Résumé

To investigate the associations between major foods and dietary fibre with subtypes of stroke in a large prospective cohort. 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). 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.

Identifiants

pubmed: 32090257
pii: 5748325
doi: 10.1093/eurheartj/ehaa007
pmc: PMC7377582
doi:

Substances chimiques

Dietary Fiber 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2632-2640

Subventions

Organisme : British Heart Foundation
ID : RG/13/13/30194
Pays : United Kingdom
Organisme : Cancer Research UK
ID : 570/A16491
Pays : United Kingdom
Organisme : European Research Council
ID : 268834
Pays : International
Organisme : Medical Research Council
ID : G0401527
Pays : United Kingdom
Organisme : Medical Research Council
ID : G1000143
Pays : United Kingdom
Organisme : Cancer Research UK
ID : 14136
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/M012190/1
Pays : United Kingdom
Organisme : British Heart Foundation
ID : RG13/13/30194
Pays : United Kingdom
Organisme : Cancer Research UK
ID : C8221/A19170
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_00006/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/L003120/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : G0700463
Pays : United Kingdom
Organisme : Medical Research Council
ID : G0800270
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_12015/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/N003284/1
Pays : United Kingdom
Organisme : British Heart Foundation
ID : SP/09/002
Pays : United Kingdom
Organisme : British Heart Foundation
ID : RG/08/014
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_12015/5
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_00006/3
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 205212/Z/16/Z
Pays : United Kingdom

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.

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Auteurs

Tammy Y N Tong (TYN)

Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK.

Paul N Appleby (PN)

Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK.

Timothy J Key (TJ)

Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK.

Christina C Dahm (CC)

Department of Public Health, Aarhus University, Nordre Ringgade 1, 8000 Aarhus, Demark.

Kim Overvad (K)

Department of Public Health, Aarhus University, Nordre Ringgade 1, 8000 Aarhus, Demark.
Department of Cardiology, Aalborg University Hospital, Reberbansgade 15, 9000 Aalborg, Denmark.

Anja Olsen (A)

Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark.

Anne Tjønneland (A)

Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark.
Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Strandboulevarden 49, 2100 Copenhagen, Denmark.

Verena Katzke (V)

Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120 Heidelberg Germany.

Tilman Kühn (T)

Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120 Heidelberg Germany.

Heiner Boeing (H)

Department of Epidemiology, German Institute of Human Nutrition (DIfE) Postdam-Rehbrücke, Arthur-Scheunert-Allee 114, 14558 Nuthetal, Germany.

Anna Karakatsani (A)

Hellenic Health Foundation, Kaisareias 13 & Alexandroupoleos, 11527 Athens, Greece.
2nd Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, 1, Rimini Str, Haidari, 12462 Athens, Greece.

Eleni Peppa (E)

Hellenic Health Foundation, Kaisareias 13 & Alexandroupoleos, 11527 Athens, Greece.

Antonia Trichopoulou (A)

Hellenic Health Foundation, Kaisareias 13 & Alexandroupoleos, 11527 Athens, Greece.

Elisabete Weiderpass (E)

International Agency for Research on Cancer (IARC), World Health Organization (WHO), 150 Cours Albert Thomas, 69372, Lyon CEDEX 08, France.

Giovanna Masala (G)

Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Via Cosimo Il Vecchio.

Sara Grioni (S)

Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Giacomo Venezian, 1, 20133 Milan, Italy.

Salvatore Panico (S)

Dipartimento Di Medicina Clinica E Chirurgia Federico II University, Corso Umberto I, 40, 80138 Naples, Italy.

Rosario Tumino (R)

Cancer Registry and Histopathology Department, "M.P.Arezzo" Hospital, ASP Contrada Rito, 97100 Ragusa, Italy.

Jolanda M A Boer (JMA)

National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, the Netherlands.

W M Monique Verschuren (WMM)

National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, the Netherlands.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 Utrecht, the Netherlands.

J Ramón Quirós (JR)

Public Health Directorate, General Elorza 32, 33001 Oviedo, Asturias, Spain.

Antonio Agudo (A)

Unit of Nutrition and Cancer. Cancer Epidemiology Research Program. Catalan Institute of Oncology-IDIBELL. Avinguda de la Gran Via de l'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain.

Miguel Rodríguez-Barranco (M)

Andalusian School of Public Health. Biomedical Research Institute ibs.GRANADA, University of Granada, Cuesta del Observatorio, 4, 18011 Granada, Spain.
CIBER of Epidemiology and Public Health. Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain.

Liher Imaz (L)

Ministry of Health of the Basque Government, Public Health Division of Gipuzkoa, Andia 13, 20004 Donostia-San Sebastian, Spain.
Biodonostia Health Research Institute, Paseo Doctor Begiristain, s/n, 20014 Donostia-San Sebastian, Spain.

María-Dolores Chirlaque (MD)

CIBER of Epidemiology and Public Health. Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain.
Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, Ronda de Levante, 11, 30008 Murcia, Spain.

Conchi Moreno-Iribas (C)

Instituto de Salud Pública de Navarra, IdiSNA, Navarre Institute for Health Research, Calle de Irunlarrea 3, 31008 Pamplona, Spain.
Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Recinto Hospitalario de Navarra, Calle de Irunlarrea s/n, 31621 Pamplona, Spain.

Gunnar Engström (G)

Department of Clinical Science in Malmö, Lund University, Bergsgatan 31 B, 21445 Malmö, Sweden.

Emily Sonestedt (E)

Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, CRC, hus 60 plan 13 205 02 Malmö, Sweden.

Marcus Lind (M)

Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden.

Julia Otten (J)

Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden.

Kay-Tee Khaw (KT)

Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge CB1 8RN, UK.

Dagfinn Aune (D)

Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, South Kensington Campus, London SW7 2AZ, UK.
Department of Nutrition, Bjørknes University College, Lovisenberggata 13, N- 0456 Oslo, Norway.
Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital Ullevål, OUS HF Aker sykehus, Postboks 4959 Nydalen, 0424 Oslo, Norway.

Elio Riboli (E)

Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, South Kensington Campus, London SW7 2AZ, UK.

Nicholas J Wareham (NJ)

MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK.

Fumiaki Imamura (F)

MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK.

Nita G Forouhi (NG)

MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK.

Emanuele di Angelantonio (E)

MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Wort's Causeway, Cambridge CB1 8RN, UK.

Angela M Wood (AM)

MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Wort's Causeway, Cambridge CB1 8RN, UK.

Adam S Butterworth (AS)

MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Wort's Causeway, Cambridge CB1 8RN, UK.

Aurora Perez-Cornago (A)

Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK.

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