Gesundheitswesen 2017; 79(08/09): 656-804
DOI: 10.1055/s-0037-1605857
Vorträge
Georg Thieme Verlag KG Stuttgart · New York

Low Diet Quality and the Risk of Stroke Mortality: The Multiethnic Cohort Study

A Aigner
1   Institut für Medizinische Biometrie und Epidemiologie, Epidemiologie, Hamburg
,
H Becher
1   Institut für Medizinische Biometrie und Epidemiologie, Epidemiologie, Hamburg
,
S Jacobs
2   University of Heidelberg, Institute of Public Health, Heidelberg
,
LR Wilkens
3   University of Hawaii Cancer Center, Cancer Epidemiology, Honolulu
,
CJ Boushey
3   University of Hawaii Cancer Center, Cancer Epidemiology, Honolulu
,
L Le Marchand
3   University of Hawaii Cancer Center, Cancer Epidemiology, Honolulu
,
CA Haiman
4   Norris Cancer Center, University of Southern California, Department of Preventive Medicine, Los Angeles
,
G Maskarinec
3   University of Hawaii Cancer Center, Cancer Epidemiology, Honolulu
› Author Affiliations
Further Information

Publication History

Publication Date:
01 September 2017 (online)

Also available at
 

Objectives:

Several diets, e.g. those low in fruits/vegetables, high in sodium and red/processed meat, have been related to a higher stroke risk. We investigated stroke mortality associated with a priori dietary patterns in the Multiethnic Cohort study.

Methods:

Based on 172 043 observations including 3 548 stroke deaths, we investigated the Healthy Eating Index-2010 (HEI-2010), the Alternative HEI-2010, the alternate Mediterranean diet score, and the Dietary Approaches to Stop Hypertension index in relation to stroke mortality. Using Cox regression, we estimated adjusted population attributable risks (PAR) and hazard ratios (HR) for tertiles of the indices while adjusting for relevant confounders.

Results:

The associations between all diet-quality indices and stroke mortality were consistent in direction; a low-quality diet was associated with a greater risk of stroke death but the HEI-2010 was the strongest predictor. The PAR for stroke death associated with individuals in the lowest and middle tertiles for HEI-2010 modifying their food pattern to the highest tertile was 7.9% (95%-CI: 3.7 – 12.2%). The lowest as compared to the highest tertile of the HEI-2010 was associated with a 1.23-fold (95%-CI: 1.13 – 1.34) risk. The PARs for low and medium adherence to the indices were similar by sex and follow-up time, but varied by ethnicity with the highest PAR in Whites (15.4%) and the lowest in Latinos (-3.9%).

Conclusions:

Findings for four diet-quality indices, in particular the HEI-2010, indicated that diet quality acts as an independent risk factor for stroke mortality. Promotion of a high diet quality could have a substantial impact on the prevention of stroke deaths.