植物性饮食质量与全因、缺血性和出血性卒中风险。
Quality of Plant-Based Diet and Risk of Total, Ischemic, and Hemorrhagic Stroke.
机构信息
From the Department of Nutrition (M.Y.B., Z.S., F.W., Y.L., E.B.R., W.C.W., F.B.H.), Department of Epidemiology (J.E.M., E.B.R., W.C.W., F.B.H.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Metabolic Medicine (M.Y.B.), Osaka University Graduate School of Medicine, Japan; Channing Division of Network Medicine (J.E.M., W.C.W., F.B.H.), Department of Medicine, Division of Preventive Medicine (J.E.M.), Department of Medicine, and Division of Women's Health (K.M.R.), Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA.
出版信息
Neurology. 2021 Apr 13;96(15):e1940-e1953. doi: 10.1212/WNL.0000000000011713. Epub 2021 Mar 10.
OBJECTIVE
To determine whether a healthful plant-based diet is related to lower stroke risk, we examined the associations of plant-based diet quality with risk of total, ischemic, and hemorrhagic stroke.
METHODS
The participants were 73,890 women in Nurses' Health Study (NHS; 1984-2016), 92,352 women in NHSII (1991-2017), and 43,266 men in Health Professionals Follow-Up Study (1986-2012) without cardiovascular disease and cancer at baseline. Plant-based diet quality was evaluated by the overall plant-based diet index (PDI), the healthful PDI (hPDI), and the unhealthful PDI (uPDI). Participants who reported that their meat and/or fish intakes were 0 or <1 serving per month were categorized as vegetarians, and others were classified as nonvegetarians. Strokes with available medical records were subtyped as ischemic or hemorrhagic.
RESULTS
During the follow-up, 6,241 total stroke cases (including 3,015 ischemic and 853 hemorrhagic strokes) were documented. Compared to participants with the lowest PDIs, among participants with the highest PDIs, the hazard ratios (HRs) for total stroke were 0.94 (95% confidence interval 0.86-1.03) for PDI, 0.90 (0.83-0.98) for hPDI, and 1.05 (0.96-1.15) for uPDI. Participants in the highest hPDI showed marginally lower HR for ischemic stroke (0.92 [0.82-1.04]) and no consistent associations for hemorrhagic stroke. We observed no association between a vegetarian diet and total stroke (1.00 [0.76-1.32]), although the number of cases was small.
CONCLUSION
Lower risk of total stroke was observed by those who adhered to a healthful plant-based diet.
目的
为了确定健康的植物性饮食是否与较低的中风风险有关，我们研究了植物性饮食质量与总中风、缺血性中风和出血性中风风险之间的关联。
方法
研究对象为参加护士健康研究（NHS；1984-2016 年）的 73890 名女性、参加护士健康研究 II（NHSII；1991-2017 年）的 92352 名女性和参加健康专业人员随访研究（1986-2012 年）的 43266 名男性，这些人在基线时均无心血管疾病和癌症。植物性饮食质量通过总体植物性饮食指数（PDI）、健康 PDI（hPDI）和不健康 PDI（uPDI）进行评估。报告每月肉类和/或鱼类摄入量为 0 或 <1 份的参与者被归类为素食者，其余的则被归类为非素食者。有可获取病历的中风被分为缺血性或出血性。
结果
在随访期间，记录到 6241 例总中风病例（包括 3015 例缺血性中风和 853 例出血性中风）。与 PDI 最低的参与者相比，PDI 最高的参与者中，总中风的风险比（HR）分别为 PDI（0.94 [0.86-1.03]）、hPDI（0.90 [0.83-0.98]）和 uPDI（1.05 [0.96-1.15]）。hPDI 最高的参与者中，缺血性中风的 HR 略有降低（0.92 [0.82-1.04]），但与出血性中风无一致关联。我们没有观察到素食与总中风之间的关联（1.00 [0.76-1.32]），尽管病例数量较少。
结论
坚持健康的植物性饮食与较低的总中风风险有关。
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