NHC Key Laboratory of Human Disease Comparative Medicine, Beijing Key Laboratory for Animal Models of Emerging and Remerging Infectious Diseases, Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100730, China.
Changping Laboratory, Beijing 102206, China.
Nutrients. 2024 Oct 19;16(20):3548. doi: 10.3390/nu16203548.
Understanding the causal relations between dietary habits and stroke is crucial for prioritizing public health interventions and developing effective health strategies. This study utilized Mendelian randomization (MR) analysis to examine the causal associations between 20 dietary habits and various stroke subtypes, aiming to identify potential mediators and evaluate the proportions of mediation.
A two-sample MR analysis was conducted to examine the causal relationships between dietary habits and stroke incidence. Mediation analysis, two-step MR (TSMR), and multivariable MR (MVMR) were employed to identify potential mediators. Genetic data pertaining to dietary habits and stroke were obtained from extensive genome-wide association study (GWAS) consortia. The inverse variance-weighted (IVW) method served as the primary analytical approach, with the additional scrutiny of significant correlations conducted through the Egger regression, MR-Pleiotropy Residual Sum and Outlier (MR-PRESSO), and weighted median techniques.
Our analyses indicated that genetically predicted intakes of dried fruits, cheese, cereal, oily fish, and hot drink temperatures were protective against stroke, whereas higher intakes of lamb/mutton, poultry, and added salt significantly elevated stroke risk. Specifically, dried fruit consumption demonstrated a protective effect against total stroke (β = -0.009, = 0.013), ischemic stroke (β = -0.475, = 0.003), and small-vessel ischemic stroke (β = -0.682, = 0.033) through reductions in BMI levels, accounting for mediated proportions of 3.2%, 17.1%, and 8.5%, respectively. Furthermore, cheese intake provided a protective effect against ischemic stroke (β = -0.275, = 0.003) by decreasing BMI and increasing HDL-C levels, with mediated proportions of 30.5% and 6.5%. Together, BMI and HDL-C accounted for 34.9% of the beneficial effect of cheese intake on reducing the risk of ischemic stroke. In contrast, an increased salt intake exhibited a positive association with large-artery ischemic stroke (β = 0.432, = 0.033) through BMI elevation, with a mediated proportion of 10.9%.
Our findings provide compelling evidence supporting causal relationships between dietary habits and stroke subtypes, while identifying mediators and evaluating the proportions of mediation. Adhering to a low-calorie, nutrient-dense diet enriched with dried fruits, cheese, and cereal, along with reduced salt and poultry consumption, could potentially mitigate stroke risk.
了解饮食习惯与中风之间的因果关系对于优先考虑公共卫生干预措施和制定有效的健康策略至关重要。本研究利用孟德尔随机化（MR）分析来检验 20 种饮食习惯与各种中风亚型之间的因果关联，旨在确定潜在的中介因素并评估中介作用的比例。
进行了两样本 MR 分析，以检验饮食习惯与中风发病之间的因果关系。采用中介分析、两步 MR（TSMR）和多变量 MR（MVMR）来识别潜在的中介因素。饮食习惯和中风的遗传数据来自广泛的全基因组关联研究（GWAS）联盟。反向方差加权（IVW）方法是主要分析方法，通过 Egger 回归、MR-Pleiotropy Residual Sum and Outlier（MR-PRESSO）和加权中位数技术对显著相关性进行了额外的检查。
我们的分析表明，遗传预测的干果、奶酪、谷物、油性鱼类和热饮温度的摄入量可预防中风，而较高的羊肉/羊肉、家禽和加盐摄入量会显著增加中风风险。具体来说，干果摄入量通过降低 BMI 水平对总中风（β=−0.009， =0.013）、缺血性中风（β=−0.475， =0.003）和小血管缺血性中风（β=−0.682， =0.033）具有保护作用，分别占介导比例的 3.2%、17.1%和 8.5%。此外，奶酪摄入量通过降低 BMI 和增加 HDL-C 水平对缺血性中风（β=−0.275， =0.003）具有保护作用，介导比例分别为 30.5%和 6.5%。总的来说，BMI 和 HDL-C 占奶酪摄入降低缺血性中风风险的有益作用的 34.9%。相比之下，盐摄入量的增加与 BMI 升高呈正相关，与大动脉缺血性中风（β=0.432， =0.033）相关，介导比例为 10.9%。
我们的研究结果提供了强有力的证据，支持饮食习惯与中风亚型之间存在因果关系，同时确定了中介因素并评估了中介作用的比例。遵循低热量、富含干果、奶酪和谷物的营养密集型饮食，并减少盐和家禽的摄入，可能有助于降低中风风险。
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