Components of a healthy diet and different types of physical activity and risk of atherothrombotic ischemic stroke: A prospective cohort study

Abstract

BackgroundDiet and physical activity (PA) are modifiable risk factors thought to influence the risk of ischemic stroke (IS). However, few studies have examined their effect on different subtypes of IS.AimTo examine components of overall diet quality and different types of PA in relation to the risk of atherothrombotic IS (aIS).Materials and methodsThe study population included 23,797 participants (mean age 58 years; 63% women) from the Malmö Diet and Cancer Study cohort. Participants were enrolled between 1991 and 1996 and followed until end of 2016 (median follow-up 21.5 years). Incident aIS events were identified using national registries (total cases 1,937). Measures of PA (total, leisure-time, occupational, and domestic) were assessed using a baseline questionnaire and dietary intakes were estimated using a modified diet history method. Overall diet quality was assessed using a diet quality index. Intake of key food groups and beverages associated with overall diet quality were investigated separately. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using multivariable Cox regression models adjusting for confounders.ResultsA high diet quality with high intake of fruit and vegetables, fish and shellfish and low intake of sugar-sweetened beverages and red and processed meat compared to a low diet quality was associated with lower risk of aIS (HR = 0.82, 95% CI = 0.69–0.97; p = 0.015). Leisure-time PA was associated with reduced risk of aIS (HR = 0.95 per SD increase in MET-hours/week, 95% CI = 0.91–0.99; p = 0.028) with null associations observed for total, occupational and domestic PA level. We observed no significant interaction between diet and PA on the risk of aIS. The standardized 20-year risk of aIS among subjects with low leisure-time PA and low diet quality was 8.1% compared to 6.1% among those with high leisure-time PA and high diet quality.ConclusionSeveral components of a healthy diet and being physically active may reduce the risk of aIS, however, the absolute risk reduction observed was modest. A high diet quality seemed to have a risk reducing effect regardless of level of PA suggesting that individuals with a sedentary lifestyle may still gain some positive health benefits through a healthy diet.

Prevalence and factors associated with multimorbidity in adults in Brazil, according to sex: a population-based cross-sectional survey

“…We found an inverse association between recommended fruit and vegetable consumption and multimorbidity, regardless of sex. Evidence suggests that high consumption of fruits and vegetables is a protective factor for several NCDs, such as obesity ( 89 ), ischemic stroke ( 90 ), and diabetes ( 91 ), contrary to our findings. This can be explained by the following factors: (i) information on the recommended fruit and vegetable consumption is self-reported in the NHS.…”

Impact of dietary intervention on eating behavior after ischemic stroke

“…Although the importance of the dietary risk factor, including SFA, in the occurrence of ischemic stroke was discussed according to the etiology of stroke (39), adherence to the Mediterranean diet rich in nuts, olive oil, fruits and vegetables, low SFA, dairy products, and red meat is associated with a decreased risk in stroke (26).…”

“…The link between SFA and stroke is the most debated ( 40 ). Previous studies have demonstrated an association between SFA and stroke ( 41 ) but also the opposite ( 42 , 43 ).…”

Consumption of sugar sweetened beverages, artificially sweetened beverages and fruit juices and risk of type 2 diabetes, hypertension, cardiovascular disease, and mortality: A meta-analysis

“…Twenty-seven studies were included in the analyses of beverage consumption and CVD risk. A total of 207,460 cases of hypertension (n = 10), 23,757 cases of CHD (n = 8), and 15,830 cases due to stroke (n = 9) in 1,395,468 participants were included in the present study (32,33,(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68). Compared with participants in the bottom category of SSBs, those in the top category had a 12% higher risk of hypertension (RR: 1.12; 95% CI: 1.08, 1.17; P heterogeneity = 0.05; I 2 = 50.3%; n = 8; Figure 2; Supplementary Figure 4).…”