Juan Juan, Liu Gang, Willett Walter C, Hu Frank B, Rexrode Kathryn M, Sun Qi
From the Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China (J.J.); Departments of Nutrition (J.J., G.L., W.C.W., F.B.H., Q.S.) and Epidemiology (W.C.W., F.B.H.), Harvard T.H. Chan School of Public Health, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (W.C.W., F.B.H., Q.S.); and Divisions of Women's Health (K.M.R.) and Preventive Medicine (K.M.R.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Stroke. 2017 Dec;48(12):3203-3209. doi: 10.1161/STROKEAHA.117.018979. Epub 2017 Nov 10.
Higher intake of whole grains may exert cardiometabolic benefits, although findings on stroke risk are inconclusive. The potentially differential effects of individual whole grain foods on ischemic stroke have not been examined.
We analyzed whole grain consumption in relation to ischemic stroke among 71 750 women from the Nurses' Health Study and 42 823 men from the Health Professionals Follow-up Study who were free of cardiovascular disease, diabetes mellitus, and cancer at baseline (1984 and 1986, respectively) through 2010 using a Cox proportional hazards model. Validated semiquantitative food frequency questionnaires were used to assess consumption of whole grain intake, including whole grain cold breakfast cereal, dark bread, oatmeal, brown rice, popcorn, bran, and germ. Self-reported incident cases of ischemic stroke were confirmed through medical record review.
During 2 820 128 person-years of follow-up in the 2 cohorts, 2458 cases of ischemic stroke were identified and confirmed. Intake of total whole grains was not associated with risk of ischemic stroke after adjustment for covariates: the pooled hazard ratio (95% confidence interval) comparing extreme intake levels was 1.04 (0.91-1.19). However, intake of whole grain cold breakfast cereal and total bran was inversely associated with ischemic stroke after multivariate adjustment: the pooled hazard ratios (95% confidence intervals) were 0.88 (0.80-0.96; =0.008) and 0.89 (0.79-1.00; =0.004), respectively. Other whole grain foods were not associated with a lower risk of ischemic stroke.
Although overall consumption of whole grains was not associated with lower risk of ischemic stroke, greater consumption of whole grain cold breakfast cereal and bran was significantly associated with a lower risk of ischemic stroke. More studies are needed to replicate these associations between individual whole grain foods and risk of ischemic stroke among other populations.
尽管全谷物摄入量对中风风险的影响尚无定论，但较高的全谷物摄入量可能对心脏代谢有益。尚未研究个别全谷物食品对缺血性中风的潜在差异影响。
我们使用Cox比例风险模型分析了护士健康研究中的71750名女性和健康专业人员随访研究中的42823名男性的全谷物摄入量与缺血性中风之间的关系，这些人在基线时（分别为1984年和1986年）至2010年期间无心血管疾病、糖尿病和癌症。使用经过验证的半定量食物频率问卷来评估全谷物摄入量，包括全谷物冷早餐麦片、黑面包、燕麦片、糙米、爆米花、麸皮和胚芽。通过病历审查确认自我报告的缺血性中风病例。
在这两个队列的2820128人年的随访期间，共确定并确认了2458例缺血性中风病例。在调整协变量后，总全谷物摄入量与缺血性中风风险无关：比较极端摄入量水平的合并风险比（95%置信区间）为1.04（0.91 - 1.19）。然而，在多变量调整后，全谷物冷早餐麦片和总麸皮的摄入量与缺血性中风呈负相关：合并风险比（95%置信区间）分别为0.88（0.80 - 0.96；P = 0.008）和0.89（0.79 - 1.00；P = 0.004）。其他全谷物食品与较低的缺血性中风风险无关。
尽管全谷物的总体摄入量与较低的缺血性中风风险无关，但更多地食用全谷物冷早餐麦片和麸皮与较低的缺血性中风风险显著相关。需要更多研究来在其他人群中重复这些个别全谷物食品与缺血性中风风险之间的关联。
