Renaud S C
INSERM, Unit 330, University Bordeaux 2, 146 Rue Léo Saigant, 33076 Bordeaux Cedex, France.
J Nutr Health Aging. 2001;5(3):167-72.
In industrialized countries, stroke is the most frequent life-threatening neurological disorder. The mortality trend for stroke appears to be similar to that of coronary heart disease (CHD) in different countries. Thus the dietary changes that protect from CHD, may also protect from stroke. The purpose of the present paper is not to review exhaustively the associations between foodstuffs and stroke. It is rather to emphasize a few important relationships that may be conducive to efficient recommendations in Public Health. The intake of saturated fat, considered as the main environmental factor for CHD, does not appear to be also closely related to stroke. It has even been observed in the Framingham prospective study, that saturated fats were associated with a protective effect on stroke. The multivariate analysis of the ecological study reported in the present paper suggests that the villain for stroke could be the high intake of linoleic acid, the main polyunsaturated fatty acid prescribed through the world, to most of the CHD patients. Observation and intervention studies suggest that the fatty acid with the most efficient protective effect on stroke is alpha-linolenic acid (ALA) as for CHD clinical manifestations. Also similarly to CHD, fruit, vegetables and folic acid, may have important protective effect on stroke. Finally, at very moderate intake, alcohol may be related to a similar lowering on the risk of stroke as on that of CHD. Nevertheless alcohol, at high intake for intoxication (binge drinking) has been associated with up to a 10 fold increased in the risk of stroke. Finally, the diet recommendations suggested by the present analysis are similar to those used in the Lyon Diet Heart Study and in Finland, in the last 20 years. In both of these intervention studies mortality from CHD, cancer and stroke have been markedly reduced by more than 50 %.
在工业化国家，中风是最常见的危及生命的神经系统疾病。不同国家中风的死亡率趋势似乎与冠心病（CHD）相似。因此，有助于预防冠心病的饮食变化，可能也有助于预防中风。本文的目的并非详尽回顾食物与中风之间的关联。而是强调一些重要关系，这些关系可能有助于在公共卫生领域提出有效的建议。饱和脂肪的摄入被认为是冠心病的主要环境因素，但似乎与中风并无密切关联。甚至在弗雷明汉前瞻性研究中观察到，饱和脂肪对中风具有保护作用。本文所报告的生态研究的多变量分析表明，中风的罪魁祸首可能是亚油酸的高摄入量，亚油酸是全球大多数冠心病患者所摄入的主要多不饱和脂肪酸。观察性和干预性研究表明，对中风具有最有效保护作用的脂肪酸是α-亚麻酸（ALA），这与冠心病的临床表现情况相同。同样与冠心病类似，水果、蔬菜和叶酸可能对中风具有重要的保护作用。最后，适量饮酒可能会使中风风险降低程度与冠心病风险降低程度相似。然而，大量饮酒（暴饮）会使中风风险增加多达10倍。最后，本分析所建议的饮食建议与过去20年里里昂饮食心脏研究和芬兰所采用的建议相似。在这两项干预性研究中，冠心病、癌症和中风导致的死亡率均显著降低了50%以上。
