Whether intakes of dietary fat and cholesterol are associated with risk of stroke remain unclear. We examined the associations between intakes of total fat, specific types of fat, and cholesterol and risk of stroke in a prospective cohort of women.
The study population consisted of 34,670 women, aged 49-83 years, in the Swedish Mammography Cohort who were free of cardiovascular disease and completed a food-frequency questionnaire in 1997. Cox proportional hazard regression models were used to estimate relative risks (RR) with 95% confidence intervals (CI).
During a mean follow-up of 10.4 years, we ascertained 1680 stroke events, including 1310 cerebral infarctions, 233 hemorrhagic strokes, and 137 unspecified strokes. After adjustment for other stroke risk factors, intake of long-chain omega-3 polyunsaturated fatty acids (PUFA) was inversely associated with risk of total stroke. The multivariable RR of total stroke for the highest compared with the lowest quintile of long-chain omega-3 PUFA intake was 0.84 (95% CI, 0.72-0.99; P for trend=0.04). Dietary cholesterol was positively associated with risk of total stroke (highest versus lowest quintile: RR=1.20; 95% CI, 1.00-1.44; P for trend=0.01) and cerebral infarction (corresponding RR=1.29; 95% CI, 1.05-1.58; P for trend=0.004). Total fat, saturated fat, monounsaturated fat, polyunsaturated fat, α-linolenic acid, and omega-6 PUFA intakes were not associated with stroke.
These findings suggest that intake of long-chain omega-3 PUFAs is inversely associated with risk of stroke, whereas dietary cholesterol is positively associated with risk.