Impact of diet on mortality from stroke: results from the U.S. multiethnic cohort study.
Impact of diet on mortality from stroke: results from the U.S. multiethnic cohort study.
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DOI：
10.1080/07315724.2013.791798
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发表时间：
2013
影响因子：
3.5
通讯作者：
Kolonel LN
中科院分区：
文献类型：
--
作者：
Sharma S;Cruickshank JK;Green DM;Vik S;Tome A;Kolonel LN
中风是美国第四大死因，中风死亡率因种族而异。本研究的目的是调查美国 5 个种族的食物类别消费与中风死亡风险之间的关联。多种族队列包括超过 215,000 名参与者，其中大多数是 1993 年至 1996 年在夏威夷和洛杉矶通过邮件调查招募的非裔美国人、夏威夷原住民、日裔美国人、拉丁裔和白人男性和女性。通过与州死亡档案和美国国家死亡指数的联系来确定中风死亡人数。使用经过验证的食物频率问卷评估饮食。使用多变量 Cox 比例风险模型检查关联性，按种族和性别分层。队列参与者中共有 860 人死于中风。蔬菜摄入量与非裔美国女性致命性中风风险显着降低相关（相对风险 [RR] = 0.60；95% CI：0.36–0.99）。仅在日裔美国女性中，高水果摄入量与中风死亡率风险降低显着相关（RR = 0.43；95% 置信区间 [CI]：0.22–0.85），而肉类摄入量则增加风险（RR = 2.36；95% CI：1.31–4.26）。在男性中，夏威夷原住民的中风死亡率显着降低（RR = 0.26；95% CI：0.07–0.95）。汇总各族裔群体的数据后，研究结果支持总体女性高肉类摄入量的风险较高（RR = 1.56；95% CI：1.12–2.16）；在男性中没有观察到饮食摄入对致命性中风风险的显着影响。尽管在不同种族之间观察到饮食与中风死亡率之间的关联存在一些差异，但研究结果表明这些差异并不显着，可能是由于特定食物亚组的饮食摄入所致。需要进行额外的研究，包括饮食亚组和营养来源，以澄清这些发现。
Stroke is the fourth leading cause of death in the United States and stroke mortality rates vary by ethnicity. The purpose of this study was to examine the associations between food group consumption and risk of death from stroke among 5 ethnic groups in the United States. The Multiethnic Cohort includes >215,000 participants, the majority of whom are African American, Native Hawaiian, Japanese American, Latino, and Caucasian men and women recruited by mail survey in Hawaii and Los Angeles in 1993–1996. Deaths from stroke were identified by linkage to the state death files and the U.S. National Death Index. Diet was assessed using a validated food frequency questionnaire. Associations were examined using multivariable Cox proportional hazards models, stratified by ethnicity and gender. A total of 860 deaths from stroke were identified among the cohort participants. Vegetable intake was associated with a significant reduction in risk for fatal stroke among African American women (relative risk [RR] = 0.60; 95% CI: 0.36–0.99). Among Japanese American women only, high fruit intake was significantly associated with a risk reduction for stroke mortality (RR = 0.43; 95% confidence interval [CI]: 0.22–0.85), whereas meat intake increased risk (RR = 2.36; 95% CI: 1.31–4.26). Among men, a significant reduction in stroke mortality was observed among Native Hawaiians (RR = 0.26; 95% CI: 0.07–0.95). After pooling the data for the ethnic groups, the findings support an elevated risk for high meat intake among women overall (RR = 1.56; 95% CI: 1.12–2.16); no significant effects of dietary intake on risk for fatal stroke were observed among men. Although some variations were observed for the associations between diet and stroke mortality among ethnic groups, the findings suggest that these differences are not substantial and may be due to dietary intake of specific food subgroups. Additional investigations including dietary subgroups and nutrients sources are needed to clarify these findings.
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