Protective Effect of Fruits and Vegetables on Development of Stroke in Men

Mw, Gillman; Cupples, L. Adrienne; Gagnon, David; Bm, Posner; Rc, Ellison; Wp, Castelli; Pa, Wolf

doi:10.1001/jama.1995.03520380049034

Cited by 398 publications

(166 citation statements)

References 42 publications

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“…Sixteen prospective studies were included in the meta-analysis for consumption of whole grains (16 reports) (Del Gobbo et al 2015;Djousse and Gaziano 2007;Hansen et al 2017;Helnaes et al 2016;Jensen et al 2004;Liu et al 2000b;Liu et al 1999;Mizrahi et al 2009;Muraki et al 2015;Neelakantan et al 2016;Nettleton et al 2008;Rautiainen et al 2012;Sonestedt et al 2015;Steffen et al 2003;Tektonidis et al 2015Tektonidis et al , 2016 (Supplemental Table 2), 9 studies for refined grains (8 reports) (Djousse and Gaziano 2007;Eshak et al 2014;Liu et al 2000b;Mizrahi et al 2009;Muraki et al 2015;Sonestedt et al 2015;Steffen et al 2003;Yu et al 2013) (Supplemental Table 3), 35 for vegetables (32 reports) (Belin et al 2011a;Bendinelli et al 2011;Bhupathiraju et al 2013;Buckland et al 2009;Dauchet et al 2004;Del Gobbo et al 2015;Dilis et al 2012;Gillman et al 1995;Hansen et al 2017;Hansen et al 2010;Hirvonen et al 2001;Johnsen et al 2003;Joshipura et al 1999;Keli et al 1996;…”

Section: Resultsmentioning

confidence: 99%

Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies

Bechthold¹,

Boeing

Schwedhelm

et al. 2017

Critical Reviews in Food Science and Nutrition

506

492

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(2017): Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies, Critical Reviews in Food Science and Nutrition, DOI: 10.1080DOI: 10. /10408398.2017 Background: Despite growing evidence for food-based dietary patterns' potential to reduce cardiovascular disease risk, knowledge about the amounts of food associated with the greatest change in risk of specific cardiovascular outcomes and about the quality of meta-evidence is limited. Therefore, the aim of this metaanalysis was to synthesize the knowledge about the relation between intake of 12 major food groups (whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugarsweetened beverages [SSB]) and the risk of coronary heart disease (CHD), stroke and heart failure (HF).Methods: We conducted a systematic search in PubMed and Embase up to March 2017 for prospective studies. Summary risk ratios (RRs) and 95% confidence intervals (95% CI) were estimated using a random effects model for highest versus lowest intake categories, as well as for linear and non-linear relationships.Results: Overall, 123 reports were included in the meta-analyses. An inverse association was present for whole grains ( (1.02-1.34), RR HF : 1.12 (1.05-1.19)), and SSB consumption (RR CHD : 1.17 (1.11-1.23), RR stroke : 1.07 (1.02-1.12), RR HF : 1.08 (1.05-1.12)) in the linear dose-response meta-analysis. There were clear indications for nonlinear dose-response relationships between whole grains, fruits, nuts, dairy, and red meat and CHD.Conclusion: An optimal intake of whole grains, vegetables, fruits, nuts, legumes, dairy, fish, red and processed meat, eggs and SSB showed an important lower risk of CHD, stroke, and HF.

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Section: Resultsmentioning

confidence: 99%

Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies

Bechthold¹,

Boeing

Schwedhelm

et al. 2017

Critical Reviews in Food Science and Nutrition

506

492

View full text Add to dashboard Cite

show abstract

“…In comparison, relatively few prospective cohort studies have examined this relationship, and those that have report less consistent findings. A 1997 review identified only five prospective studies [30][31][32][33][34] that have directly examined fruit and vegetable intake rather than nutrients in relation to CVD [35], and three of these studies showed significant inverse associations, whereas the remainder showed no significant association [30,31]. Small sample sizes and low event rates may partially explain the inconsistent findings from these studies.…”

Section: Fruit and Vegetable Intake And Risk Of Cardiovascular Diseasementioning

confidence: 99%

Dietary intake of fruits and vegetables and risk of cardiovascular disease

Bazzano

Serdula

Liu

2003

Curr Atheroscler Rep

368

209

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Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in the United States and worldwide. In this review, we examine the scientific evidence in support of current dietary recommendations to increase fruit and vegetable intake for CVD prevention. Available evidence indicates that persons who consume more fruits and vegetables often have lower prevalence of important risk factors for CVD, including hypertension, obesity, and type 2 diabetes mellitus. Recent large, prospective studies also show a direct inverse association between fruit and vegetable intake and the development of CVD incidents such as coronary heart disease and stroke. However, the biologic mechanisms whereby fruits and vegetables may exert their effects are not entirely clear and are likely to be multiple. Many nutrients and phytochemicals in fruits and vegetables, including fiber, potassium, and folate, could be independently or jointly responsible for the apparent reduction in CVD risk. Functional aspects of fruits and vegetables, such as their low dietary glycemic load and energy density, may also play a significant role. Although it is important to continue our quest for mechanistic insights, given the great potential for benefits already known, greater efforts and resources are needed to support dietary changes that encourage increased fruit and vegetable intake.

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“…Diets that are rich in magnesium and cereal fiber are also associated with a reduced risk of stroke, especially among men with hypertension [33]. Consuming fruits and vegetables may reduce stroke risk [34]. Higher consumption of fish and omega-3-fatty acids has been associated with a reduced risk of ischemic stroke [35], although consumption of meat more than four times per week seems to increase that risk [36].…”

Section: Diet and Lifestyle Factorsmentioning

confidence: 99%

Atherosclerotic risk factors in patients with ischemic cerebrovascular disease

Cucchiara¹,

Kasner²

2002

Curr Treat Options Neurol

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Aggressive treatment of atherosclerotic risk factors can substantially reduce stroke risk in patients with a history of stroke or transient ischemic attack. Data from several recent large clinical trials provide convincing evidence of benefit for a number of specific therapies directed at this population. The authors recommend treatment with ramipril alone or perindopril plus indapamide regardless of blood pressure, provided there is no contraindication. For patients already taking a different angiotensin- converting enzyme (ACE) inhibitor, the authors do not routinely switch agents. The authors recommend use of simvastatin 40 mg per day in patients with a total cholesterol level of 135 mg/dL or greater, provided no contraindication exists. The authors also recommend consideration of gemfibrozil in patients with isolated low high- density lipoprotein levels. In patients with diabetes mellitus, tight glycemic control has not been shown to reduce macrovascular complications such as stroke, but does reduce microvascular complications. However, diabetics should receive especially aggressive treatment of other vascular risk factors. There is no role for post-menopausal hormone replacement therapy in prevention of stroke. Weight loss for overweight patients, regular exercise, and a diet rich in fruits, vegetables, cereals, and fish, as well as low in fat and cholesterol, should be a standard recommendation for this group of patients. Treatment with folic acid, B(6), and B(12) for patients with elevated homocysteine appears rational, though this is unproven. However, there is no benefit to vitamin E, vitamin C, or beta-carotene supplementation. Smokers should stop. For every 43 smokers who quit, one stroke is prevented. Moderate consumption of alcohol (one to two drinks a day) may be beneficial, but heavy alcohol use (more than five drinks a day) increases stroke risk.

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Protective Effect of Fruits and Vegetables on Development of Stroke in Men

Abstract: Intake of fruits and vegetables may protect against development of stroke in men.

Cited by 398 publications

References 42 publications

Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies

Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies

Dietary intake of fruits and vegetables and risk of cardiovascular disease

Atherosclerotic risk factors in patients with ischemic cerebrovascular disease

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