Epidemiol Health.  2018;40:e2018021. 10.4178/epih.e2018021.

Associations between dietary risk factors and ischemic stroke: a comparison of regression methods using data from the Multi-Ethnic Study of Atherosclerosis

• Hashemi Nazari SS
• Mokhayeri
• Mansournia MA
• Khodakarim S
• Soori H

• KMID: 2438476
• DOI: http://doi.org/10.4178/epih.e2018021

Abstract

OBJECTIVES
We analyzed dietary patterns using reduced rank regression (RRR), and assessed how well the scores extracted by RRR predicted stroke in comparison to the scores produced by partial least squares and principal component regression models.
METHODS
Dietary data at baseline were used to extract dietary patterns using the 3 methods, along with 4 response variables: body mass index, fibrinogen, interleukin-6, and low-density lipoprotein cholesterol. The analyses were based on 5,468 males and females aged 45-84 years who had no clinical cardiovascular disease, using data from the Multi-Ethnic Study of Atherosclerosis.
RESULTS
The primary factor derived by RRR was positively associated with stroke incidence in both models. The first model was adjusted for sex and race and the second model was adjusted for the variables in model 1 as well as smoking, physical activity, family and sibling history of stroke, the use of any lipid-lowering medication, the use of any anti-hypertensive medication, hypertension, and history of myocardial infarction (model 1: hazard ratio [HR], 7.49; 95% confidence interval [CI], 1.66 to 33.69; p for trend=0.01; model 2: HR, 6.83; 95% CI, 1.51 to 30.87 for quintile 5 compared with the reference category; p for trend=0.02).
CONCLUSIONS
Based primarily on RRR, we identified that a dietary pattern high in fats and oils, poultry, non-diet soda, processed meat, tomatoes, legumes, chicken, tuna and egg salad, and fried potatoes and low in dark-yellow and cruciferous vegetables may increase the incidence of ischemic stroke.

Keyword

Stroke; Risk factors; Diet; Multi-Ethnic Study of Atherosclerosis

MeSH Terms

Atherosclerosis*
Body Mass Index
Cardiovascular Diseases
Chickens
Cholesterol
Continental Population Groups
Diet
Fabaceae
Fats
Female
Fibrinogen
Humans
Hypertension
Incidence
Interleukin-6
Least-Squares Analysis
Lipoproteins
Lycopersicon esculentum
Male
Meat
Methods*
Motor Activity
Myocardial Infarction
Oils
Ovum
Poultry
Risk Factors*
Siblings
Smoke
Smoking
Solanum tuberosum
Stroke*
Tuna
Vegetables
Cholesterol
Fats
Fibrinogen
Interleukin-6
Lipoproteins
Oils
Smoke