Abstract 144: Southern Diet Pattern Increases Risk Of Stroke While Plant-based Pattern Decreases Risk Of Stroke in the REGARDS Study
Background: Diet is one of many potential factors proposed to explain racial and regional differences in stroke. We examined prospectively the association of diet patterns with risk of stroke in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study.
Methods: Between 2003-2007, REGARDS enrolled black and white Americans aged 45 years or older. A two-stage analytic approach was employed. First, principle components analysis was used to assess underlying diet patterns using 56 food groups for 20,480 participants who completed the Block98 food frequency questionnaire. Second, participant scores (divided into quartiles) on these patterns were then considered as predictors of incident stroke using Cox regression. The factor analysis identified five dietary patterns: “Convenience” (Chinese and Mexican foods, pasta, pizza), “Plant-based” (fruits, vegetables, legumes), and “Southern” (fried foods, organ meats, sweetened beverages), “Sweets/Fats” (desserts, added sugars, sweet snacks) and “Alcohol/Salads” (alcohol, fats, vegetables).
Results: Participants with a higher adherence to the Southern dietary pattern were more likely to reside in the Southeast (comparing Q4 to Q1: 64% vs 48%) and experienced a 41% increased risk of stroke (comparing Q4 to Q1: HR=1.41; 95% CI = 1.07, 1.85). In contrast, higher adherence to the Plant-based pattern was association with a 29% reduction in stroke risk (comparing Q4 to Q1: HR=0.71; 95% CI = 0.55, 0.91). The trend across quartiles was <0.001 indicating a dose response for adherence to each pattern. Adding socio-economic status, smoking, physical activity and total energy (calories) intake to the models attenuated the association but the direction remained the same and persisted in sub-group analysis examining only ischemic strokes. The Convenience, Sweets, and Alcohol patterns were not associated with stroke risk.
Discussion: The present study suggests that foods common to Southern cuisine such as fried foods and sweetened beverages may increase the risk of stroke while diets rich in legumes, fruits, vegetables, and fish may reduce stroke risk. Interventions focusing on increasing plant-based foods and fish while reducing fried foods and sweetened beverages are needed.
- © 2012 by American Heart Association, Inc.