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. 2013 Dec;44(12):3305-11.
doi: 10.1161/STROKEAHA.113.002636. Epub 2013 Oct 24.

Dietary patterns are associated with incident stroke and contribute to excess risk of stroke in black Americans

Suzanne E Judd  1 , Orlando M Gutiérrez, P K Newby, George Howard, Virginia J Howard, Julie L Locher, Brett M Kissela, James M Shikany
Affiliations

Dietary patterns are associated with incident stroke and contribute to excess risk of stroke in black Americans

Suzanne E Judd et al. Stroke. 2013 Dec.

Abstract

Background and purpose: Black Americans and residents of the Southeastern United States are at increased risk of stroke. Diet is one of many potential factors proposed that might explain these racial and regional disparities.

Methods: Between 2003 and 2007, the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study enrolled 30 239 black and white Americans aged≥45 years. Dietary patterns were derived using factor analysis and foods from food frequency data. Incident strokes were adjudicated using medical records by a team of physicians. Cox-proportional hazards models were used to examine risk of stroke.

Results: During 5.7 years, 490 incident strokes were observed. In a multivariable-adjusted analysis, greater adherence to the plant-based pattern was associated with lower stroke risk (hazard ratio, 0.71; 95% confidence interval, 0.56-0.91; Ptrend=0.005). This association was attenuated after addition of income, education, total energy intake, smoking, and sedentary behavior. Participants with a higher adherence to the Southern pattern experienced a 39% increased risk of stroke (hazard ratio, 1.39; 95% confidence interval, 1.05, 1.84), with a significant (P=0.009) trend across quartiles. Including Southern pattern in the model mediated the black-white risk of stroke by 63%.

Conclusions: These data suggest that adherence to a Southern style diet may increase the risk of stroke, whereas adherence to a more plant-based diet may reduce stroke risk. Given the consistency of finding a dietary effect on stroke risk across studies, discussing nutrition patterns during risk screening may be an important step in reducing stroke.

Keywords: continental population groups; dietary habits; epidemiology; ethnicity; stroke.

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References

    1. Casper ML, Wing S, Anda RF, Knowles M, Pollard RA. The shifting stroke belt. Changes in the geographic pattern of stroke mortality in the united states, 1962 to 1988. Stroke. 1995;26:755–760. - PubMed
    1. Lanska DJ, Kuller LH. The geography of stroke mortality in the united states and the concept of a stroke belt. Stroke. 1995;26:1145–1149. - PubMed
    1. Liao Y, Greenlund KJ, Croft JB, Keenan NL, Giles WH. Factors explaining excess stroke prevalence in the us stroke belt. Stroke. 2009;40:3336–3341. - PubMed
    1. Glymour MM, Avendano M, Berkman LF. Is the ‘stroke belt’ worn from childhood?: Risk of first stroke and state of residence in childhood and adulthood. Stroke. 2007;38:2415–2421. - PubMed
    1. Howard G. Why do we have a stroke belt in the southeastern united states? A review of unlikely and uninvestigated potential causes. The American journal of the medical sciences. 1999;317:160–167. - PubMed

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