Study of 418,000 Europeans finds different foods linked to different types of stroke
February 24, 2020
Science Daily/European Society of Cardiology
Different types of food are linked to risks of different types of stroke, according to the largest study to investigate this, published in the European Heart Journal today (Monday).
Until now, most studies have looked at the association between food and total stroke (all types of stroke combined), or focused on ischaemic stroke only. However, the current study of more than 418,000 people in nine European countries investigated ischaemic stroke and haemorrhagic stroke separately.
The study found that while higher intakes of fruit, vegetables, fibre, milk, cheese or yoghurt were each linked to a lower risk of ischaemic stroke, there was no significant association with a lower risk of haemorrhagic stroke. However, greater consumption of eggs was associated with a higher risk of haemorrhagic stroke, but not with ischaemic stroke.
Ischaemic stroke occurs when a blood clot blocks an artery supplying blood to the brain or forms somewhere else in the body and travels to the brain where it blocks blood flow. Haemorrhagic stroke occurs when there is bleeding in the brain that damages nearby cells. About 85% of strokes are ischaemic and 15% are haemorrhagic. Stroke is the second leading cause of deaths worldwide.
Dr Tammy Tong, the first author of the paper and a nutritional epidemiologist at the Nuffield Department of Population Health, University of Oxford (UK), said: "The most important finding is that higher consumption of both dietary fibre and fruit and vegetables was strongly associated with lower risks of ischaemic stroke, which supports current European guidelines. The general public should be recommended to increase their fibre and fruit and vegetable consumption, if they are not already meeting these guidelines.
"Our study also highlights the importance of examining stroke subtypes separately, as the dietary associations differ for ischaemic and haemorrhagic stroke, and is consistent with other evidence, which shows that other risk factors, such as cholesterol levels or obesity, also influence the two stroke subtypes differently."
The total amount of fibre (including fibre from fruit, vegetables, cereal, legumes, nuts and seeds) that people ate was associated with the greatest potential reduction in the risk of ischaemic stroke. Every 10g more intake of fibre a day was associated with a 23% lower risk, which is equivalent to around two fewer cases per 1000 of the population over ten years.
Fruit and vegetables alone were associated with a 13% lower risk for every 200g eaten a day, which is equivalent to one less case per 1000 of the population over ten years. No foods were linked to a statistically significant higher risk of ischaemic stroke.
Based on UK estimates, two thick slices of wholemeal toast provide 6.6g of fibre, a portion of broccoli (around eight florets) provides about 3g, and a medium raw, unpeeled apple provides about 1.2g of fibre. The European Society of Cardiology (ESC) and the World Health Organization Regional Office for Europe recommend consuming at least 400g of fruit and vegetables a day; the ESC also suggests people should consume 30-45g of fibre a day.
The researchers found that for every extra 20g of eggs consumed a day there was a 25% higher risk of haemorrhagic stroke, equivalent to 0.66 extra cases per 1000 (or around two cases per 3000) of the population over ten years. An average large-sized egg weighs approximately 60g. Egg consumption in the EPIC study was low overall, with an average of less than 20g eaten a day.
The researchers say the associations they found between different foods and ischaemic and haemorrhagic stroke might be explained partly by the effects on blood pressure and cholesterol.
Dr Tong and her colleagues analysed data from 418,329 men and women in nine countries (Denmark, Germany, Greece, Italy, The Netherlands, Norway, Spain, Sweden and the United Kingdom) who were recruited to the European Prospective Investigation into Cancer and Nutrition (EPIC) study between 1992 and 2000. The participants completed questionnaires asking about diet, lifestyle, medical history and socio-demographic factors, and were followed up for an average of 12.7 years. During this time, there were 4281 cases of ischaemic stroke and 1430 cases of haemorrhagic stroke.
Food groups studied included meat and meat products (red meat, processed meat and poultry), fish and fish products (white fish and fatty fish), dairy products (including milk, yogurt, cheese), eggs, cereals and cereal products, fruit and vegetables (combined and separately), legumes, nuts and seeds, and dietary fibre (total fibre and cereal, fruit and vegetable fibre).
Major strengths of the study include the large numbers of people studied in several different countries and long follow-up period. Most types of food were included in the study, although information on diet was collected at only one point in time, when the participants joined the study. As the study is observational it cannot show that the foods studied cause an increase or decrease in risk of ischaemic or haemorrhagic stroke, only that they are associated with different risks. Information on medication use (including statins) was not available.
https://www.sciencedaily.com/releases/2020/02/200224102024.htm
Moderate egg consumption not associated with higher cardiovascular disease risk
March 5, 2020
Science Daily/Harvard T.H. Chan School of Public Health
Consuming up to one egg per day does not appear to be associated with cardiovascular disease (CVD) risk, according to a new study and meta-analysis led by researchers at Harvard T.H. Chan School of Public Health.
"Recent studies reignited the debate on this controversial topic, but our study provides compelling evidence supporting the lack of an appreciable association between moderate egg consumption and cardiovascular disease," said first author Jean-Philippe Drouin-Chartier, visiting scientist in the Department of Nutrition and assistant professor at Laval University in Québec, Canada. The study will be published online March 4, 2020 in the BMJ.
The relationship between egg consumption and CVD risk has been a topic of intense debate in the scientific community in recent decades. Just in the past 12 months, three published studies have reported conflicting results.
The new findings update a 1999 study -- the first major analysis of eggs and cardiovascular disease -- that found no association between eggs and CVD risk. That study was led by Frank Hu, Fredrick J. Stare Professor of Nutrition and Epidemiology, chair of the Department of Nutrition, and a co-author of the current study.
For this study, researchers analyzed health data from 173,563 women and 90,214 men participating in the Nurses' Health Study (NHS) I and II, and the Health Professionals Follow-Up Study (HPFS) who were free of CVD, type 2 diabetes, and cancer at baseline. They used repeated measures of diet during up to 32 years of follow-up to gain a detailed picture of potentially confounding lifestyle factors such as high body mass index and red meat consumption. The researchers also conducted the largest meta-analysis of this topic, including 28 prospective cohort studies with up to 1.7 million participants.
The analysis of NHS and HPFS participants found no association between moderate egg consumption and risk of CVD. Results from the meta-analysis supported this finding in U.S. and European populations; however, some evidence suggested that moderate egg consumption may be associated with lower CVD risk in Asian populations although this may be confounded by the overall dietary pattern.
Study co-author Shilpa Bhupathiraju, research scientist in the Harvard Chan School Department of Nutrition and associate epidemiologist at Brigham and Women's Hospital, said that while moderate egg consumption can be part of a healthy eating pattern, it is not essential. "There is a range of other foods that can be included in a healthy breakfast, such as whole grain toasts, plain yogurt, and fruits."
https://www.sciencedaily.com/releases/2020/03/200305002842.htm
An egg a day not tied to risk of heart disease
January 27, 2020
Science Daily/McMaster University
The controversy about whether eggs are good or bad for your heart health may be solved, and about one a day is fine. A team of researchers found the answer by analyzing data from three large, long-term multinational studies.
A team of researchers from the Population Health Research Institute (PHRI) of McMaster University and Hamilton Health Sciences found the answer by analyzing data from three large, long-term multinational studies.
The results suggest there is no harm from consuming eggs. Given that the majority of individuals in the study consumed one or fewer eggs per day, it would be safe to consume this level, says Mahshid Dehghan, first author and a PHRI investigator.
"Moderate egg intake, which is about one egg per day in most people, does not increase the risk of cardiovascular disease or mortality even if people have a history of cardiovascular disease or diabetes," she said.
"Also, no association was found between egg intake and blood cholesterol, its components or other risk factors. These results are robust and widely applicable to both healthy individuals and those with vascular disease."
The details are published in The American Journal of Clinical Nutrition.
Although eggs are an inexpensive source of essential nutrients, some guidelines have recommended limiting consumption to fewer than three eggs a week due to concerns they increase the risk of cardiovascular disease.
Previous studies on egg consumption and diseases have been contradictory, said Salim Yusuf, principal investigator of the study and director of PHRI.
"This is because most of these studies were relatively small or moderate in size and did not include individuals from a large number of countries," he said.
The researchers analyzed three international studies conducted by the PHRI. Egg consumption of 146,011 individuals from 21 countries was recorded in the PURE study and in 31,544 patients with vascular disease from the ONTARGET and the TRANSEND studies.
The data from these three studies involved populations from 50 countries spanning six continents at different income levels, so the results are widely applicable, said Yusuf.
https://www.sciencedaily.com/releases/2020/01/200127134727.htm