School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, Australia.
Department of Cardiology, Herlev & Gentofte University Hospital, Copenhagen, Denmark.
Am J Clin Nutr. 2021 Jul 1;114(1):348-357. doi: 10.1093/ajcn/nqab138.
Flavonoid-rich foods have antiinflammatory, antiatherogenic, and antithrombotic properties that may contribute to a lower risk of ischemic stroke.
We aimed to investigate the relationship between habitual flavonoid consumption and incidence of ischemic stroke in participants from the Danish Diet, Cancer and Health Study.
In this prospective cohort study, 55,169 Danish residents without a prior ischemic stroke [median (IQR) age at enrolment of 56 y (52-60)], were followed for 21 y (20-22). We used Phenol-Explorer to estimate flavonoid intake from food frequency questionnaires obtained at study entry. Incident cases of ischemic stroke were identified from Danish nationwide registries and restricted cubic splines in Cox proportional hazards models were used to investigate relationships with flavonoid intake.
During follow-up, 4237 individuals experienced an ischemic stroke. Compared with participants in Q1 and after multivariable adjustment for demographics and lifestyle factors, those in Q5-for intake of total flavonoids, flavonols, and flavanol oligo + polymers-had a 12% [HR (95% CI): 0.88 (0.81, 0.96)], 10% [0.90 (0.82, 0.98)], and 18% [0.82 (0.75, 0.89)] lower risk of ischemic stroke incidence, respectively. Multivariable (demographic and lifestyle) adjusted associations for anthocyanins and flavones with risk of ischemic stroke were not linear, with moderate but not higher intakes associated with lower risk [anthocyanins Q3 vs. Q1 HR (95% CI): 0.85 (0.79, 0.93); flavones: 0.90 (0.84, 0.97)]. Following additional adjustment for dietary confounders, similar point estimates were observed; however, significance was only retained for anthocyanins and flavanol oligo + polymers [anthocyanins Q3 vs. Q1 HR (95% CI): 0.86 (0.79, 0.94); flavanol oligo + polymers Q5 vs. Q1 0.86 (0.78, 0.94)].
These findings suggest that moderate habitual consumption of healthy flavonoid-rich foods is associated with a lower risk of ischemic stroke and further investigation is therefore warranted.
富含类黄酮的食物具有抗炎、抗动脉粥样硬化和抗血栓形成的特性，这可能降低缺血性中风的风险。
我们旨在研究丹麦饮食、癌症和健康研究参与者中习惯性黄酮类化合物摄入与缺血性中风发病之间的关系。
在这项前瞻性队列研究中，我们随访了 55169 名没有既往缺血性中风（入组时中位（IQR）年龄为 56 岁（52-60））的丹麦居民 21 年（20-22 年）。我们使用 Phenol-Explorer 从研究开始时的食物频率问卷中估计类黄酮的摄入量。从丹麦全国登记处确定缺血性中风的发病病例，并使用 Cox 比例风险模型中的限制三次样条调查类黄酮摄入量与缺血性中风的关系。
在随访期间，有 4237 人发生缺血性中风。与 Q1 组和多变量调整后的人口统计学和生活方式因素相比，Q5 组（总黄酮、黄酮醇和黄烷醇寡聚体+聚合物）的摄入分别与缺血性中风发病风险降低 12%[风险比（95%置信区间）：0.88（0.81, 0.96）]、10%[0.90（0.82, 0.98）]和 18%[0.82（0.75, 0.89）]。多变量（人口统计学和生活方式）调整后的花青素和黄酮类化合物与缺血性中风风险的关联不是线性的，中等但不高的摄入量与较低的风险相关[花青素 Q3 与 Q1 的 HR（95%CI）：0.85（0.79, 0.93）；黄酮类化合物：0.90（0.84, 0.97）]。在进一步调整饮食混杂因素后，观察到相似的点估计值；然而，仅保留了花青素和黄烷醇寡聚体+聚合物的显著性[花青素 Q3 与 Q1 的 HR（95%CI）：0.86（0.79, 0.94）；黄烷醇寡聚体+聚合物 Q5 与 Q1 的 HR（95%CI）：0.86（0.78, 0.94）]。
这些发现表明，习惯性摄入适量富含类黄酮的健康食物与较低的缺血性中风风险相关，因此需要进一步研究。
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