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Impact of diet on mortality from stroke: results from the U.S. multiethnic cohort study.

Abstract

OBJECTIVES

Stroke is the fourth leading cause of death in the United States and stroke mortality rates vary by ethnicity. The purpose of this study was to examine the associations between food group consumption and risk of death from stroke among 5 ethnic groups in the United States.

METHODS

The Multiethnic Cohort includes >215,000 participants, the majority of whom are African American, Native Hawaiian, Japanese American, Latino, and Caucasian men and women recruited by mail survey in Hawaii and Los Angeles in 1993-1996. Deaths from stroke were identified by linkage to the state death files and the U.S. National Death Index. Diet was assessed using a validated food frequency questionnaire. Associations were examined using multivariable Cox proportional hazards models, stratified by ethnicity and gender.

RESULTS

A total of 860 deaths from stroke were identified among the cohort participants. Vegetable intake was associated with a significant reduction in risk for fatal stroke among African American women (relative risk [RR]=0.60; 95% CI: 0.36-0.99). Among Japanese American women only, high fruit intake was significantly associated with a risk reduction for stroke mortality (RR=0.43; 95% confidence interval [CI]: 0.22-0.85), whereas meat intake increased risk (RR=2.36; 95% CI: 1.31-4.26). Among men, a significant reduction in stroke mortality was observed among Native Hawaiians (RR=0.26; 95% CI: 0.07-0.95). After pooling the data for the ethnic groups, the findings support an elevated risk for high meat intake among women overall (RR=1.56; 95% CI: 1.12-2.16); no significant effects of dietary intake on risk for fatal stroke were observed among men.

CONCLUSIONS

Although some variations were observed for the associations between diet and stroke mortality among ethnic groups, the findings suggest that these differences are not substantial and may be due to dietary intake of specific food subgroups. Additional investigations including dietary subgroups and nutrients sources are needed to clarify these findings.

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  • Authors+Show Affiliations

    ,

    Epidemiology Program, Cancer Research Center of Hawaii, University of Hawaii, Honolulu, Hawaii, USA. gita.sharma@ualberta.ca

    , , , ,

    Source

    MeSH

    African Americans
    Aged
    Asian Americans
    Cohort Studies
    Diet
    Ethnic Groups
    European Continental Ancestry Group
    Feeding Behavior
    Female
    Follow-Up Studies
    Hawaii
    Hispanic Americans
    Humans
    Los Angeles
    Male
    Middle Aged
    Nutrition Assessment
    Nutrition Surveys
    Proportional Hazards Models
    Risk Factors
    Stroke
    Surveys and Questionnaires
    Vegetables

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.

    Language

    eng

    PubMed ID

    23885988

    Citation

    Sharma, Sangita, et al. "Impact of Diet On Mortality From Stroke: Results From the U.S. Multiethnic Cohort Study." Journal of the American College of Nutrition, vol. 32, no. 3, 2013, pp. 151-9.
    Sharma S, Cruickshank JK, Green DM, et al. Impact of diet on mortality from stroke: results from the U.S. multiethnic cohort study. J Am Coll Nutr. 2013;32(3):151-9.
    Sharma, S., Cruickshank, J. K., Green, D. M., Vik, S., Tome, A., & Kolonel, L. N. (2013). Impact of diet on mortality from stroke: results from the U.S. multiethnic cohort study. Journal of the American College of Nutrition, 32(3), pp. 151-9. doi:10.1080/07315724.2013.791798.
    Sharma S, et al. Impact of Diet On Mortality From Stroke: Results From the U.S. Multiethnic Cohort Study. J Am Coll Nutr. 2013;32(3):151-9. PubMed PMID: 23885988.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Impact of diet on mortality from stroke: results from the U.S. multiethnic cohort study. AU - Sharma,Sangita, AU - Cruickshank,J Kennedy, AU - Green,Deborah M, AU - Vik,Shelly, AU - Tome,Anne, AU - Kolonel,Laurence N, PY - 2013/7/27/entrez PY - 2013/7/28/pubmed PY - 2014/2/25/medline SP - 151 EP - 9 JF - Journal of the American College of Nutrition JO - J Am Coll Nutr VL - 32 IS - 3 N2 - OBJECTIVES: Stroke is the fourth leading cause of death in the United States and stroke mortality rates vary by ethnicity. The purpose of this study was to examine the associations between food group consumption and risk of death from stroke among 5 ethnic groups in the United States. METHODS: The Multiethnic Cohort includes >215,000 participants, the majority of whom are African American, Native Hawaiian, Japanese American, Latino, and Caucasian men and women recruited by mail survey in Hawaii and Los Angeles in 1993-1996. Deaths from stroke were identified by linkage to the state death files and the U.S. National Death Index. Diet was assessed using a validated food frequency questionnaire. Associations were examined using multivariable Cox proportional hazards models, stratified by ethnicity and gender. RESULTS: A total of 860 deaths from stroke were identified among the cohort participants. Vegetable intake was associated with a significant reduction in risk for fatal stroke among African American women (relative risk [RR]=0.60; 95% CI: 0.36-0.99). Among Japanese American women only, high fruit intake was significantly associated with a risk reduction for stroke mortality (RR=0.43; 95% confidence interval [CI]: 0.22-0.85), whereas meat intake increased risk (RR=2.36; 95% CI: 1.31-4.26). Among men, a significant reduction in stroke mortality was observed among Native Hawaiians (RR=0.26; 95% CI: 0.07-0.95). After pooling the data for the ethnic groups, the findings support an elevated risk for high meat intake among women overall (RR=1.56; 95% CI: 1.12-2.16); no significant effects of dietary intake on risk for fatal stroke were observed among men. CONCLUSIONS: Although some variations were observed for the associations between diet and stroke mortality among ethnic groups, the findings suggest that these differences are not substantial and may be due to dietary intake of specific food subgroups. Additional investigations including dietary subgroups and nutrients sources are needed to clarify these findings. SN - 1541-1087 UR - https://www.unboundmedicine.com/medline/citation/23885988/Impact_of_diet_on_mortality_from_stroke:_results_from_the_U_S__multiethnic_cohort_study_ L2 - http://www.tandfonline.com/doi/full/10.1080/07315724.2013.791798 DB - PRIME DP - Unbound Medicine ER -