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Dietary Interventions to Lower the Risk of Stroke

  • Bernadette Boden-Albala
  • Lauren Southwick
  • Heather Carman
Stroke (HP Adams, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Stroke

Abstract

Stroke is a major cause of death and permanent disability in the USA; primary prevention and risk reduction are a critical health concern. A wealth of research investigated stroke risk factors, including primary hypertension, diabetes, and atrial fibrillation. Research has expanded to examine lifestyle factors, such as diet/dietary patterns, physical activity, cigarette smoking, and obesity distribution, as critical modifiable risk factors. Emerging evidence suggests diet/dietary patterns may lead to heightened risk of stroke. Despite a growing literature, research has yet to implement dietary interventions to explore this relationship within a US sample. This review discusses available clinical research findings reporting on the relationship among diet/dietary patterns, cardiovascular disease, and risk of stroke. We will assess challenges, limitations, and controversies, and address future research directions.

Keywords

Cardiovascular disease (CVD) Stroke Diet/dietary patterns Clinical trial intervention Health disparities 

Notes

Acknowledgment

Dr. Boden-Abala has multiple NIH/NINDS grants to conduct stroke clinical research to investigate demographic and behavioral risk factors and to improve recruitment and retention of racial-ethnic minorities in neurological clinical trials (P50NS049060, U10NS086531, U01U54NS057405, and U24MD006961).

Compliance with Ethics Guidelines

Conflict of Interest

Bernadette Boden-Albala, Lauren Southwick, and Heather Carman declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.••
    Legislature, N.C.o.S. Heart disease and stroke: an overview of our nation’s leading killers. 2014. Available from: http://www.ncsl.org/research/health/heart-disease-and-stroke-an-overview.aspx. Vital stroke statistics.
  2. 2.
    Heidenreich PA et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation. 2011;123(8):933–44.CrossRefPubMedGoogle Scholar
  3. 3.
    Furie KL et al. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42(1):227–76.CrossRefPubMedGoogle Scholar
  4. 4.
    Sacco RL et al. American Heart Association Prevention Conference. IV. Prevention and rehabilitation of stroke. Risk factors. Stroke. 1997;28(7):1507–17.CrossRefPubMedGoogle Scholar
  5. 5.••
    Association, T.A.H. The American Heart Association’s Diet and Lifestyle Recommendations. 2014. Available from: http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/The-American-Heart-Associations-Diet-and-Lifestyle-Recommendations_UCM_305855_Article.jsp. The American Heart Association’s Diet and Lifestyle Recommendations provides an comprehensive overview of current and future research.
  6. 6.
    Spence JD. Nutrition and stroke prevention. Stroke. 2006;37(9):2430–5.CrossRefPubMedGoogle Scholar
  7. 7.
    Chiuve SE et al. Primary prevention of stroke by healthy lifestyle. Circulation. 2008;118(9):947–54.CrossRefPubMedCentralPubMedGoogle Scholar
  8. 8.
    Jacobs Jr DR, Steffen LM. Nutrients, foods, and dietary patterns as exposures in research: a framework for food synergy. Am J Clin Nutr. 2003;78(3 Suppl):508S–13.PubMedGoogle Scholar
  9. 9.
    Hu FB. Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol. 2002;13(1):3–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Kontogianni MD, Panagiotakos DB. Dietary patterns and stroke: a systematic review and re-meta-analysis. Maturitas. 2014;79(1):41–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Ding EL, Mozaffarian D. Optimal dietary habits for the prevention of stroke. Semin Neurol. 2006;26(1):11–23.CrossRefPubMedGoogle Scholar
  12. 12.
    Fung TT et al. Adherence to a DASH-style diet and risk of coronary heart disease and stroke in women. Arch Intern Med. 2008;168(7):713–20.CrossRefPubMedGoogle Scholar
  13. 13.
    Sherzai A et al. Stroke, food groups, and dietary patterns: a systematic review. Nutr Rev. 2012;70(8):423–35.CrossRefPubMedGoogle Scholar
  14. 14.
    Boden-Albala B et al. Dietary total fat intake and ischemic stroke risk: the Northern Manhattan Study. Neuroepidemiology. 2009;32(4):296–301.CrossRefPubMedCentralPubMedGoogle Scholar
  15. 15.
    Gardener H et al. Diet soft drink consumption is associated with an increased risk of vascular events in the Northern Manhattan Study. J Gen Intern Med. 2012;27(9):1120–6.CrossRefPubMedCentralPubMedGoogle Scholar
  16. 16.
    Gardener H et al. Coffee and tea consumption are inversely associated with mortality in a multiethnic urban population. J Nutr. 2013;143(8):1299–308.CrossRefPubMedCentralPubMedGoogle Scholar
  17. 17.
    Hruby A, et al. Magnesium intake is inversely associated with coronary artery calcification: the Framingham heart study. JACC Cardiovasc Imaging. 2013.Google Scholar
  18. 18.
    Gillman MW et al. Protective effect of fruits and vegetables on development of stroke in men. JAMA. 1995;273(14):1113–7.CrossRefPubMedGoogle Scholar
  19. 19.
    Colditz GA, Manson JE, Hankinson SE. The Nurses’ Health Study: 20-year contribution to the understanding of health among women. J Womens Health. 1997;6(1):49–62.CrossRefPubMedGoogle Scholar
  20. 20.
    Fung TT et al. Prospective study of major dietary patterns and stroke risk in women. Stroke. 2004;35(9):2014–9.CrossRefPubMedGoogle Scholar
  21. 21.
    Block G et al. A data-based approach to diet questionnaire design and testing. Am J Epidemiol. 1986;124(3):453–69.PubMedGoogle Scholar
  22. 22.
    Gardener H et al. Dietary sodium and risk of stroke in the Northern Manhattan study. Stroke. 2012;43(5):1200–5.CrossRefPubMedCentralPubMedGoogle Scholar
  23. 23.
    Whelton PK et al. Sodium, blood pressure, and cardiovascular disease: further evidence supporting the American Heart Association sodium reduction recommendations. Circulation. 2012;126(24):2880–9.CrossRefPubMedGoogle Scholar
  24. 24.
    Thornton SN. Salt in health and disease—a delicate balance. N Engl J Med. 2013;368(26):2531.CrossRefPubMedGoogle Scholar
  25. 25.
    Debette S, Markus HS. The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ. 2010;341:c3666.CrossRefPubMedCentralPubMedGoogle Scholar
  26. 26.
    Gardener H et al. Mediterranean-style diet and risk of ischemic stroke, myocardial infarction, and vascular death: the Northern Manhattan Study. Am J Clin Nutr. 2011;94(6):1458–64.CrossRefPubMedCentralPubMedGoogle Scholar
  27. 27.
    Gardener H et al. Mediterranean diet and white matter hyperintensity volume in the Northern Manhattan Study. Arch Neurol. 2012;69(2):251–6.CrossRefPubMedCentralPubMedGoogle Scholar
  28. 28.
    Howard VJ et al. The reasons for geographic and racial differences in stroke study: objectives and design. Neuroepidemiology. 2005;25(3):135–43.CrossRefPubMedGoogle Scholar
  29. 29.•
    Howard VJ et al. Disparities in stroke incidence contributing to disparities in stroke mortality. Ann Neurol. 2011;69(4):619–27. REGARDS’ key findings. Google Scholar
  30. 30.
    Howard G. Why do we have a stroke belt in the southeastern United States? A review of unlikely and uninvestigated potential causes. Am J Med Sci. 1999;317(3):160–7.CrossRefPubMedGoogle Scholar
  31. 31.••
    Judd SE et al. Dietary patterns are associated with incident stroke and contribute to excess risk of stroke in black Americans. Stroke. 2013;44(12):3305–11. REGARDS’ key findings Google Scholar
  32. 32.
    Kulshreshtha A et al. Life’s Simple 7 and risk of incident stroke: the reasons for geographic and racial differences in stroke study. Stroke. 2013;44(7):1909–14.CrossRefPubMedGoogle Scholar
  33. 33.
    Tsivgoulis G et al. Adherence to a Mediterranean diet and risk of incident cognitive impairment. Neurology. 2013;80(18):1684–92.CrossRefPubMedCentralPubMedGoogle Scholar
  34. 34.
    Smith MA et al. Designing multi-ethnic stroke studies: the Brain Attack Surveillance in Corpus Christi (BASIC) project. Ethn Dis. 2004;14(4):520–6.PubMedGoogle Scholar
  35. 35.
    Morgenstern LB et al. Fast food and neighborhood stroke risk. Ann Neurol. 2009;66(2):165–70.CrossRefPubMedCentralPubMedGoogle Scholar
  36. 36.
    Wang MC et al. Changes in neighbourhood food store environment, food behaviour and body mass index, 1981–1990. Public Health Nutr. 2008;11(9):963–70.CrossRefPubMedGoogle Scholar
  37. 37.
    Martinez-Gonzalez MA et al. Cohort profile: design and methods of the PREDIMED study. Int J Epidemiol. 2012;41(2):377–85.CrossRefPubMedGoogle Scholar
  38. 38.
    Estruch R et al. Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial. Ann Intern Med. 2006;145(1):1–11.CrossRefPubMedGoogle Scholar
  39. 39.••
    Estruch R et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279–90. PREDIMED’s key findings. Google Scholar
  40. 40.••
    Berciano S, Ordovas JM. Nutrition and cardiovascular health. Rev Esp Cardiol (Engl Ed). 2014;67(9):738–47. PREDIMED’s key findings. Google Scholar
  41. 41.
    Bureau, U.S.C. State and County QuickFacts - USA. Available at http://quickfacts.census.gov/qfd/states/00000.html. Accessed 28 Jan 2014. (In: U.S. Census Bureau: State and County QuickFacts. Data derived from Population Estimates, American Community Survey, Census of Population and Housing, State and County Housing Unit Estimates, County Business Patterns, Nonemployer Statistics, Economic Census, Survey of Business Owners, Building Permits [online].).
  42. 42.••
    Lloyd-Jones DM et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic Impact Goal through 2020 and beyond. Circulation. 2010;121(4):586–613. AHA’s “Strategic Impact Goals” for 2020. Google Scholar
  43. 43.
    Brown DL et al. Stroke Health and Risk Education (SHARE): design, methods, and theoretical basis. Contemp Clin Trials. 2012;33(4):721–9.CrossRefPubMedCentralPubMedGoogle Scholar
  44. 44.
    Zahuranec DB et al. Stroke health and risk education (SHARE) pilot project: feasibility and need for church-based stroke health promotion in a bi-ethnic community. Stroke. 2008;39(5):1583–5.CrossRefPubMedGoogle Scholar
  45. 45.
    Kristal AR, Peters U, Potter JD. Is it time to abandon the food frequency questionnaire? Cancer Epidemiol Biomarkers Prev. 2005;14(12):2826–8.CrossRefPubMedGoogle Scholar
  46. 46.
    Kristal AR, Potter JD. Not the time to abandon the food frequency questionnaire: counterpoint. Cancer Epidemiol Biomarkers Prev. 2006;15(10):1759–60.CrossRefPubMedGoogle Scholar
  47. 47.
    Willett WC, Hu FB. Not the time to abandon the food frequency questionnaire: point. Cancer Epidemiol Biomarkers Prev. 2006;15(10):1757–8.CrossRefPubMedGoogle Scholar
  48. 48.
    Kipnis V et al. Structure of dietary measurement error: results of the OPEN biomarker study. Am J Epidemiol. 2003;158(1):14–21. discussion 22-6.CrossRefPubMedGoogle Scholar
  49. 49.
    Stricker MD et al. Dietary patterns derived from principal component- and k-means cluster analysis: long-term association with coronary heart disease and stroke. Nutr Metab Cardiovasc Dis. 2013;23(3):250–6.CrossRefPubMedGoogle Scholar
  50. 50.•
    Illner AK et al. Review and evaluation of innovative technologies for measuring diet in nutritional epidemiology. Int J Epidemiol. 2012;41(4):1187–203. Revie and evaulation of current methodologies used in diet research. Google Scholar
  51. 51.
    O’Brien DM et al. A stable isotope biomarker of marine food intake captures associations between n-3 fatty acid intake and chronic disease risk in a Yup’ik study population, and detects new associations with blood pressure and adiponectin. J Nutr. 2014;144(5):706–13.CrossRefPubMedGoogle Scholar
  52. 52.
    Toole JF et al. Lowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myocardial infarction, and death: the Vitamin Intervention for Stroke Prevention (VISP) randomized controlled trial. JAMA. 2004;291(5):565–75.CrossRefPubMedGoogle Scholar
  53. 53.
    Guallar E et al. Enough is enough: stop wasting money on vitamin and mineral supplements. Ann Intern Med. 2013;159(12):850–1.CrossRefPubMedGoogle Scholar
  54. 54.
    Grodstein F et al. Long-term multivitamin supplementation and cognitive function in men: a randomized trial. Ann Intern Med. 2013;159(12):806–14.CrossRefPubMedCentralPubMedGoogle Scholar
  55. 55.••
    Meschia JF, et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014. AHA/ASA guidelines discussing primary prevention of stroke. Google Scholar
  56. 56.
    Sacks FM et al. Rationale and design of the Dietary Approaches to Stop Hypertension trial (DASH). A multicenter controlled-feeding study of dietary patterns to lower blood pressure. Ann Epidemiol. 1995;5(2):108–18.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Bernadette Boden-Albala
    • 1
    • 2
    • 3
  • Lauren Southwick
    • 1
  • Heather Carman
    • 1
  1. 1.Division of Social Epidemiology, Global Institute of Public HealthNew York UniversityNew YorkUSA
  2. 2.New York University School of MedicineNew YorkUSA
  3. 3.Department of Epidemiology and Health Promotion, College of DentistryNew York UniversityNew YorkUSA

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