Dietary patterns associated with stroke among West Africans: A case–control study

Abstract

Background: The relationship of diet with stroke risk among Africans is not well understood. Aim: To investigate the association between dietary patterns and stroke risk among West Africans. Methods: In this multi-centre case-control study, 3684 stroke patients matched (for age and sex) with 3684 healthy controls were recruited from Nigeria and Ghana. Food consumption was assessed using a food frequency questionnaire, and dietary patterns were summarized using principal component analysis. Stroke was defined using predefined criteria primarily on clinical evaluation following standard guidelines. Conditional logistic regression was applied to compute odds ratio (OR) and 95% confidence interval (CI) for stroke risk by tertiles of dietary patterns. Results: Overall, mean age was 59.0±13.9 years, and 3992(54.2%) were males. Seven dietary patterns were identified. Multivariable-adjusted OR (95%CI) for risk of stroke by second and third tertiles (using the lowest (first) tertile as reference) of dietary patterns were; 1.65 (1.43, 1.90) and 1.74 (1.51, 2.02) respectively for ‘poultry product and organ meat’; 1.69 (1.47, 1.96 and, 1.51 (1.31, 1.75) for ‘red meat’; 1.07 (0.92, 1.23) and 1.21 (1.04, 1.40) for ‘fried foods and sweetened drinks’; 0.69 (0.60, 0.80) and 0.45 (0.39, 0.53) for ‘vegetables’; 0.84 (0.72, 0.97) and 0.81 (0.70, 0.93) for ‘whole-grain and fruit drinks’; and 0.97 (0.84, 1.12) and 0.85 (0.73, 0.98) for ‘fruits’ (P<0.05). Conclusions: These data suggest that plant-based diets are associated with a lower risk of stroke and might be a beneficial dietary recommendation for the primary prevention of stroke among Africans.

Stroke in Africa: A systematic review and meta-analysis of the incidence and case-fatality rates

“…43 In addition, there is a significant deficit of well-coordinated and holistic stroke care program(s), including the lack of public awareness, primary prevention, acute management, and post-stroke management, in many African countries. 44–46…”

“…Some notable studies on stroke epidemiology among Africans 47–49 were omitted in this systematic review primarily due to missing details, uncertainties in reporting and other methodological issues previously identified in stroke incidence studies in Africa. 42 We intentionally and prospectively limited our review to studies whose design is close to an ideal stroke incidence study in design and rigor.…”

“…43 In addition, there is a significant deficit of well-coordinated and holistic stroke care program(s), including the lack of public awareness, primary prevention, acute management, and post-stroke management, in many African countries. [44][45][46] Some notable studies on stroke epidemiology among Africans [47][48][49] were omitted in this systematic review primarily due to missing details, uncertainties in reporting and other methodological issues previously identified in stroke incidence studies in Africa. 42 We intentionally and prospectively limited our review to studies whose design is close to an ideal stroke incidence study in design and rigor.…”

The diversity of global stroke research in the IJS

“…16 A further important paper from the SIREN group is published in this issue, and investigates the association between dietary patterns and stroke. 17 Poultry products, organ meat, red meat, fried foods, and sweetened drinks were all associated with increased stroke risk, while vegetables, whole-grain, fruit drinks, and fruits with lower risk. The authors conclude that plant-based diets are associated with a lower risk of stroke and might be a beneficial dietary recommendation for the primary prevention of stroke in Africa.…”

Stroke mortality attributable to high red meat intake in China and South Korea: An age–period–cohort and joinpoint analysis

“…Published studies have suggested that dietary factors have a positive association with the increase in stroke risk (8). Consuming diets high in salt (9) and lacking vegetables or fruit (10), drinking alcohol (11), low whole grain intake (12), and high red or processed meat intake (13) were all found to be positively associated with high stroke risk. A recent study found that high consumption of red meat might result in an increased risk of stroke (14), and a previous study also revealed that high consumption of red meat was associated with all-cause mortality (15).…”