on July 1, 2004
Published online before print July 1, 2004, doi: 10.1161/01.STR.0000135762.89154.92
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on March 15, 2004
From the Department of Nutrition (T.T.F.), Simmons College; the Departments of Nutrition (T.T.F., M.J.S., W.C.W., F.B.H.) and Epidemiology (M.J.S., J.E.M., W.C.W., F.B.H.), Harvard School of Public Health; and the Channing Laboratory, Department of Medicine (M.J.S., J.E.M., K.M.R., W.C.W., F.B.H.). * To whom correspondence should be addressed. E-mail: fung{at}simmons.edu.
Background and Purpose--Many foods have been suggested to influence the risk of stroke. However, no previous studies have examined the relationship between overall dietary patterns and risk of stroke. Methods--Using dietary information collected in 1984 from 71 768 women aged 38 to 63 years without a history of cardiovascular disease or diabetes in 1984, we conducted factor analysis and identified 2 major dietary patterns: "prudent" and "Western." We calculated scores for each participant for each pattern and prospectively examined their associations with stroke risk using a proportional hazard model, adjusting for other stroke risk factors. Results--The prudent pattern was characterized by higher intakes of fruits, vegetables, legumes, fish, and whole grains, whereas the Western pattern by higher intakes of red and processed meats, refined grains, and sweets and desserts. During 14 years of follow-up, we identified 791 incidents of stroke, with 476 ischemic and 189 hemorrhagic strokes. After adjusting for potential confounders, we observed a relative risk (RR) of 1.58 (95% CI, 1.15 to 2.15; P=0.0002 for trend) for total strokes and 1.56 (95% CI, 1.05 to 2.33; P=0.02 for trend) for ischemic stroke when comparing the highest with lowest quintiles of the Western pattern. For the prudent pattern, the RRs comparing extreme quintiles were 0.78 (95% CI, 0.61 to 1.01) for total stroke and 0.74 (95% CI, 0.54 to 1.02) for ischemic stroke. Conclusions--These data suggest that a dietary pattern typified by higher intakes of red and processed meats, refined grains, and sweets and desserts may increase stroke risk, whereas a diet higher in fruits and vegetables, fish, and whole grains may protect against stroke.
Revised on May 18, 2004
Accepted on May 19, 2004
Prospective Study of Major Dietary Patterns and Stroke Risk in Women
Teresa T. Fung ScD*;
Key words: epidemiology • risk factors • diet
This article has been cited by other articles:
 |
|
 |
|
  C. Heidemann, M. B. Schulze, O. H. Franco, R. M. van Dam, C. S. Mantzoros, and F. B. Hu Dietary Patterns and Risk of Mortality From Cardiovascular Disease, Cancer, and All Causes in a Prospective Cohort of Women Circulation, July 15, 2008; 118(3): 230 - 237. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. S. Bassuk and J. E. Manson Lifestyle and Risk of Cardiovascular Disease and Type 2 Diabetes in Women: A Review of the Epidemiologic Evidence American Journal of Lifestyle Medicine, June 1, 2008; 2(3): 191 - 213. [Abstract] [PDF]
|
|
|
|
 |
|
 T. T. Fung, S. E. Chiuve, M. L. McCullough, K. M. Rexrode, G. Logroscino, and F. B. Hu Adherence to a DASH-Style Diet and Risk of Coronary Heart Disease and Stroke in Women Arch Intern Med, April 14, 2008; 168(7): 713 - 720. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Dubowitz, S. A. Smith-Warner, D. Acevedo-Garcia, S.V. Subramanian, and K. E. Peterson Nativity and Duration of Time in the United States: Differences in Fruit and Vegetable Intake Among Low-Income Postpartum Women Am J Public Health, October 1, 2007; 97(10): 1787 - 1790. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. R Harriss, D. R English, J. Powles, G. G Giles, A. M Tonkin, A. M Hodge, L. Brazionis, and K. O'Dea Dietary patterns and cardiovascular mortality in the Melbourne Collaborative Cohort Study Am. J. Clinical Nutrition, July 1, 2007; 86(1): 221 - 229. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Dauchet, E. Kesse-Guyot, S. Czernichow, S. Bertrais, C. Estaquio, S. Peneau, A.-C. Vergnaud, S. Chat-Yung, K. Castetbon, V. Deschamps, et al. Dietary patterns and blood pressure change over 5-y follow-up in the SU.VI.MAX cohort Am. J. Clinical Nutrition, June 1, 2007; 85(6): 1650 - 1656. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Shimazu, S. Kuriyama, A. Hozawa, K. Ohmori, Y. Sato, N. Nakaya, Y. Nishino, Y. Tsubono, and I. Tsuji Dietary patterns and cardiovascular disease mortality in Japan: a prospective cohort study Int. J. Epidemiol., June 1, 2007; 36(3): 600 - 609. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Chen, P. Factor-Litvak, G. R Howe, F. Parvez, and H. Ahsan Nutritional influence on risk of high blood pressure in Bangladesh: a population-based cross-sectional study. Am. J. Clinical Nutrition, November 1, 2006; 84(5): 1224 - 1232. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Kurth, S. C. Moore, J. M. Gaziano, C. S. Kase, M. J. Stampfer, K. Berger, and J. E. Buring Healthy lifestyle and the risk of stroke in women. Arch Intern Med, July 10, 2006; 166(13): 1403 - 1409. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A Nettleton, L. M Steffen, E. J Mayer-Davis, N. S Jenny, R. Jiang, D. M Herrington, and D. R Jacobs Jr Dietary patterns are associated with biochemical markers of inflammation and endothelial activation in the Multi-Ethnic Study of Atherosclerosis (MESA) Am. J. Clinical Nutrition, June 1, 2006; 83(6): 1369 - 1379. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. A. Bischoff, H. B. Staehelin, and W. C. Willett The effect of undernutrition in the development of frailty in older persons. J. Gerontol. A Biol. Sci. Med. Sci., June 1, 2006; 61(6): 585 - 589. [Full Text] [PDF]
|
|
|
|
|
|
P. M. Waijers, M. C Ocke, C. T. van Rossum, P. H. Peeters, C. Bamia, Y. Chloptsios, Y. T van der Schouw, N. Slimani, and H B. Bueno-de-Mesquita Dietary patterns and survival in older Dutch women Am. J. Clinical Nutrition, May 1, 2006; 83(5): 1170 - 1176. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. V. Howard, L. Van Horn, J. Hsia, J. E. Manson, M. L. Stefanick, S. Wassertheil-Smoller, L. H. Kuller, A. Z. LaCroix, R. D. Langer, N. L. Lasser, et al. Low-Fat Dietary Pattern and Risk of Cardiovascular Disease: The Women's Health Initiative Randomized Controlled Dietary Modification Trial JAMA, February 8, 2006; 295(6): 655 - 666. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. H. Kroenke, T. T. Fung, F. B. Hu, and M. D. Holmes Dietary Patterns and Survival After Breast Cancer Diagnosis J. Clin. Oncol., December 20, 2005; 23(36): 9295 - 9303. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. O. Cheng Influence of Dietary Patterns on Stroke Risk in China Stroke, February 1, 2005; 36(2): 228 - 228. [Full Text] [PDF]
|
|
|
|
 |
|
 Western Dietary Pattern Increases Stroke Risk Journal Watch Women's Health, November 23, 2004; 2004(1123): 6 - 6. [Full Text]
|
|