Ge Rongguang, You Shoujiang, Zheng Danni, Zhang Zengli, Cao Yongjun, Chang Jie
Department of Neurology and Clinical Research Center of Neurological Disease, Soochow Medical College, The Second Affiliated Hospital of Soochow University, Suzhou, China.
The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
Int J Stroke. 2024 Jul;19(6):665-675. doi: 10.1177/17474930241237932. Epub 2024 Mar 16.
Stroke is the second leading cause of death and the third leading cause of disability in the general population worldwide. However, the changing trend of ischemic stroke burden attributable to various dietary risk factors has not been fully revealed and may contribute to a better understanding of stroke epidemiology.
Our article aimed to evaluate the temporal trend of diet-related ischemic stroke burden to inform future research and policy-making.
This analysis was based on the data from the Global Burden of Disease (GBD) Study 2019 (spanning years 1990 to 2019), and we used the joinpoint regression to model temporal trends in diet-related ischemic stroke burden across countries and regions of the world during the study period. Six specific dietary factors known to influence stroke risk, including sodium, red meat, fiber, vegetables, whole grains, and fruits, were evaluated in the GBD study to determine their individual and joint impact on ischemic stroke. The changing trend was primarily measured by the average annual percent change (AAPC). Age-standardized rates (ASRs) of mortality and years lived with disability (YLD) per 100,000 population were used to evaluate disease burden. Finally, the socioeconomic background, which was quantified as sociodemographic index (SDI), and its association with diet-related ischemic stroke burden were also explored with the Pearson correlation coefficient.
During the study period, the ischemic stroke ASR of mortality attributable to overall dietary risk decreased by an average of 1.6% per year, while the ASR of YLD decreased by an average of 0.2% per year. High sodium diet was still a key driver of diet-related ischemic stroke, accounting for 8.4% and 11.0% of deaths and disabilities, respectively, in 2019. In addition, we found a negative association between temporal evolution of stroke burden and socioeconomic background ( = -0.6603 for mortality and = -0.4224 for disability, < 0.001), which suggested that the developing countries with weak social and economic foundation faced greater challenges from the ongoing burden of diet-related strokes compared with developed countries.
Our study found declining trends and revealed the current status of diet-related ischemic stroke mortality and disability. Interdisciplinary countermeasures involving the development of effective food policies, evidence-based guidelines, and public education are needed in the future to combat this global epidemic.
The data used for analysis were open-access and can be obtained from https://vizhub.healthdata.org/gbd-results/.
中风是全球普通人群中第二大致死原因和第三大致残原因。然而，各种饮食风险因素导致的缺血性中风负担的变化趋势尚未完全揭示，这可能有助于更好地理解中风流行病学。
我们的文章旨在评估饮食相关缺血性中风负担的时间趋势，为未来的研究和政策制定提供参考。
本分析基于《2019年全球疾病负担研究》（涵盖1990年至2019年）的数据，我们使用连接点回归对研究期间全球各国和各地区饮食相关缺血性中风负担的时间趋势进行建模。在全球疾病负担研究中评估了六种已知会影响中风风险的特定饮食因素，包括钠、红肉、纤维、蔬菜、全谷物和水果，以确定它们对缺血性中风的单独和联合影响。变化趋势主要通过年均变化百分比（AAPC）来衡量。使用每10万人口的年龄标准化死亡率（ASR）和伤残调整生命年（YLD）来评估疾病负担。最后，还使用皮尔逊相关系数探讨了量化为社会人口指数（SDI）的社会经济背景及其与饮食相关缺血性中风负担的关联。
在研究期间，总体饮食风险导致的缺血性中风年龄标准化死亡率平均每年下降1.6%，而伤残调整生命年的年龄标准化率平均每年下降0.2%。高钠饮食仍然是饮食相关缺血性中风的关键驱动因素，在2019年分别占死亡和残疾的8.4%和ll.0%。此外，我们发现中风负担的时间演变与社会经济背景之间存在负相关（死亡率r=-0.6603，残疾率r=-0.4224，P<0.0（）1），这表明与发达国家相比，社会经济基础薄弱的发展中国家面临着饮食相关中风持续负担带来的更大挑战。
我们的研究发现了下降趋势，并揭示了饮食相关缺血性中风死亡率和残疾率的现状。未来需要采取跨学科对策，制定有效的食品政策、循证指南并开展公众教育，以应对这一全球流行病。
用于分析的数据是开放获取的，可从https://vizhub.healthdata.org/gbd-results/获取。
