http://stroke.ahajournals.org/content/48/11/3168?etoc=
An Update of the Evidence
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Since last reviewed,1
several epidemiological studies have reported the substantial role of
suboptimal nutrition in the risk and burden of stroke and illustrated
the potential for dietary modification to reduce the global burden of
stroke.
Search Strategy
I
searched the Cochrane Library, PubMed, and MEDLINE using the search
term stroke in combinations with the terms nutrition, diet, nutrients,
foods, dietary patterns, risk, burden, epidemiology, randomised trial,
systematic review, and meta-analysis for articles published between
January 1, 2012, and June 1, 2017. I also searched the reference lists
of articles identified by the search. I selected mainly articles
published in the past 5 years but included older key publications.
The Role of Nutrition in the Risk of Stroke
Case–Control Studies
Diet
quality was 1 of 10 potentially modifiable risk factors for stroke in
the prospective INTERSTROKE study of 13 447 cases of acute first stroke
and 13 472 age- and sex-matched controls with no history of stroke in 32
countries.2 Diet quality was
derived from the modified Alternative Healthy Eating Index, which was
based on daily servings of fruits, vegetables, nuts and soy protein,
fish, meat, eggs, whole grain, and fried foods. Higher modified
Alternative Healthy Eating Index scores have been associated with lower
risk of cardiovascular disease in previous studies.3
In INTERSTROKE, individuals in the highest tertile for the modified
Alternative Healthy Eating Index had a 40% lower odds of stroke (odds
ratio, 0.60; 99% confidence interval [CI], 0.53–0.67), and individuals
in the second tertile had a 23% lower odds of stroke (odds ratio, 0.77;
99% CI, 0.69–0.86), compared with those in the lowest tertile.2
Individuals in the lowest 2 tertiles contributed substantially to the
population attributable risk of stroke (population attributable risk,
23.2%; CI, 18.2–28.9) compared with the highest tertile of modified
Alternative Healthy Eating Index.2
Diet had a stronger association with stroke in individuals older than 55 years …
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