Ailsa A. Welch
Adherence to a Mediterranean-style diet may help to reduce stroke risk in adults at high risk for CVD, especially women older than 40 years, according to a study published in Stroke.
“We found that following a Mediterranean-style diet may reduce stroke risk by 22% in women over 40 years of age,” Ailsa A. Welch, PhD, professor of nutritional epidemiology in the department of public health and primary care at Norwich Medical School at the University of East Anglia, Norwich, U.K., told Cardiology Today. “In men and women at high risk of cardiovascular disease, the Mediterranean-style diet also reduced risk of stroke. This means that following a healthy balanced diet is important for everyone both young and old.”
To examine the effects of the Mediterranean diet on stroke risk, researchers conducted an observational, prospective, population-based cohort study of 23,232 white men and women aged 40 to 77 years (54.5% women; mean BP in men, 137 mm Hg systolic/84.3 mm Hg diastolic; mean BP in women, 134 mm Hg systolic/80.8 mm Hg diastolic). All were participants in the EPIC-Norfolk study between 1993 and 1997.
At baseline, participants completed a 7-day diet diary consisting of all food and drinks they consumed. Researchers assessed adherence to the Mediterranean diet by calculating Mediterranean diet scores. Here, one point was given for intakes of each protective item (for instance, fruit and nuts, vegetables, legumes, bread, potatoes, fish and a higher unsaturated to saturated fat ratio) and zero points were given for dairy, meat and eggs. The range of possible scores was 0 to 9. The mean scores were 4.4 in men and 4.2 in women. Participants were stratified into quartiles by Mediterranean diet score.
Using multivariable Cox regression, researchers calculated risk for incident stroke in the whole population and then stratified by sex and 10-year CVD risk profile, which was determined with the Framingham Risk Score. Participants were divided into low CVD risk (score below the median) or high risk (score above the median).
Follow-up was until March 31, 2015 (mean, 17 years).
There were 2,009 incident strokes (961 in men; 1,048 in women) during follow-up.
Researchers found that there was reduced risk for stroke with greater adherence to the Mediterranean diet in the whole population (HR for highest quartile of diet score vs. lowest = 0.83; 95% CI, 0.74-0.94) and, when stratified by sex, in women (HR for highest quartile of diet score vs. lowest = 0.78; 95% CI, 0.65-0.83) but not in men (HR for highest quartile of diet score vs. lowest = 0.94; 95% CI, 0.79-1.12). Women with a moderate Mediterranean diet score had a trend toward reduced stroke risk vs. women with a low diet score (HR = 0.8; 95% CI, 0.67-1.02).
Furthermore, higher adherence to the Mediterranean diet was associated with reduced stroke risk in participants at high CVD risk (HR for highest quartile of diet score vs. lowest = 0.87; 95% CI; 0.76-0.99), but this was driven by the associations in women (HR for highest quartile of diet score vs. lowest = 0.8; 95% CI, 0.65-0.97), according to the researchers.
It is still necessary to understand why the effects of the Mediterranean diet differ between men and women, according to Welch. More studies are required to investigate these differences, she said.
“Our study shows that following a Mediterranean-style diet is important for preventing stroke in people at both high and low risk,” Welch said. “As prevention is important, clinicians can encourage their patients to follow a healthy eating pattern starting at any age.” – by Melissa J. Webb
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Ailsa A. Welch, PhD, can be reached at email@example.com.
Disclosures: The authors report no relevant financial disclosures.