Dearborn Jennifer L, Urrutia Victor C, Kernan Walter N
Department of Neurology, Yale University School of Medicine , New Haven, CT , USA.
Department of Neurology, Johns Hopkins University School of Medicine , Baltimore, MD , USA.
Front Neurol. 2015 Feb 2;6:1. doi: 10.3389/fneur.2015.00001. eCollection 2015.
Diet is strongly associated with risk for first stroke. In particular, observational and experimental research suggests that a Mediterranean-type diet may reduce risk for first ischemic stroke with an effect size comparable to statin therapy. These data for first ischemic stroke suggest that diet may also be associated with risk for recurrent stroke and that diet modification might represent an effective intervention for secondary prevention. However, research on dietary pattern after stroke is limited and direct experimental evidence for a therapeutic effect in secondary prevention does not exist. The uncertain state of science in this area is reflected in recent guidelines on secondary stroke prevention from the American Heart Association, in which the Mediterranean-type diet is listed with only a class IIa recommendation (level of evidence C). To change guidelines and practice, research is needed, starting with efforts to better define current nutritional practices of stroke patients. Food frequency questionnaires and mobile applications for real-time recording of intake are available for this purpose. Dietary strategies for secondary stroke prevention are low risk, high potential, and warrant further evaluation.
饮食与首次中风风险密切相关。特别是，观察性和实验性研究表明，地中海式饮食可能会降低首次缺血性中风的风险，其效应大小与他汀类药物治疗相当。这些关于首次缺血性中风的数据表明，饮食也可能与复发性中风风险相关，并且饮食调整可能是二级预防的有效干预措施。然而，关于中风后饮食模式的研究有限，且不存在二级预防治疗效果的直接实验证据。该领域科学的不确定状态反映在美国心脏协会最近的二级中风预防指南中，其中地中海式饮食仅被列为IIa类推荐（证据水平C）。为了改变指南和实践，需要开展研究，首先要努力更好地界定中风患者当前的营养习惯。为此可使用食物频率问卷和用于实时记录摄入量的移动应用程序。二级中风预防的饮食策略风险低、潜力大，值得进一步评估。
