Department of Public Health, Aarhus University, Aarhus, Denmark.
Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
PLoS One. 2018 Oct 24;13(10):e0206242. doi: 10.1371/journal.pone.0206242. eCollection 2018.
National dietary guidelines are intended to promote primary prevention of lifestyle-related diseases, but little is known about their effectiveness in prevention of stroke.
We used the Danish cohort Diet, Cancer and Health (n = 57 053) to investigate whether adherence to the Danish food-based dietary guidelines was associated with risk of stroke. Adherence was assessed by the Danish Dietary Guidelines Index, score 0 [no adherence] to 6 [complete adherence]. Cox proportional hazards models were used to estimate adjusted hazard ratios and 95% confidence intervals for stroke and subtypes of stroke in men and women separately.
Incident stroke was determined in 1357 men and 900 women during follow-up (median 12.5 years and 13.0 years, respectively). A higher Danish Dietary Guidelines Index score was inversely associated with total stroke in men but not in women. In men, a high Index score (≥4) was also inversely associated with total ischemic stroke (hazard ratio 0.75, 95% confidence interval 0.65-0.86), large-artery atherosclerosis (hazard ratio 0.63, 95% confidence interval 0.44-0.92) and small artery occlusion (hazard ratio 0.68, 95% confidence interval 0.54-0.84) compared to a low Index score (<4). In women, inverse associations were found for total ischemic stroke (hazard ratio 0.84, 95% confidence interval 0.72-0.98) and intracerebral hemorrhage (hazard ratio 0.64, 95% confidence interval 0.43-0.96).
Our findings suggest that adherence to the Danish Dietary Guidelines is associated with a lower rate of stroke, and thus may be useful in primary prevention of disease.
国家饮食指南旨在促进与生活方式相关疾病的一级预防，但对于其在预防中风方面的效果知之甚少。
我们使用丹麦队列 Diet, Cancer and Health（n=57053）研究了遵循丹麦基于食物的饮食指南与中风风险之间的关系。通过丹麦饮食指南指数评估依从性，得分 0（无依从）至 6（完全依从）。使用 Cox 比例风险模型分别估计男性和女性中风和中风亚型的调整风险比和 95%置信区间。
在随访期间（男性中位数 12.5 年，女性中位数 13.0 年），男性 1357 例和女性 900 例发生了中风事件。较高的丹麦饮食指南指数与男性的总中风呈负相关，但与女性无关。在男性中，高指数得分（≥4）也与总缺血性中风（风险比 0.75，95%置信区间 0.65-0.86）、大动脉粥样硬化（风险比 0.63，95%置信区间 0.44-0.92）和小动脉闭塞（风险比 0.68，95%置信区间 0.54-0.84）呈负相关，与低指数得分（<4）相比。在女性中，总缺血性中风（风险比 0.84，95%置信区间 0.72-0.98）和脑出血（风险比 0.64，95%置信区间 0.43-0.96）也存在负相关。
我们的研究结果表明，遵循丹麦饮食指南与较低的中风发生率相关，因此可能对疾病的一级预防有用。
