Dietary fibre intake and risk of ischaemic and haemorrhagic stroke in the UK Women’s Cohort Study

• Published in: European journal of clinical nutrition Vol. 69; no. 4; pp. 467 - 474
• Main Authors: Threapleton, D E, Burley, V J, Greenwood, D C, Cade, J E
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.04.2015; Nature Publishing Group
• Subjects: 692/499; Adult; Aged; Body Mass Index; Body size; Body Weight; Cereals; Clinical Nutrition; Cohort analysis; Confidence intervals; Cross-Sectional Studies; Density; Diet; Dietary fiber; Dietary Fiber - administration & dosage; Dietary intake; Edible Grain; Epidemiology; Female; Follow-Up Studies; Health aspects; Health risk assessment; Health risks; Humans; Hypertension; Internal Medicine; Intracranial Hemorrhages - prevention & control; Medical research; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Mortality; Motor Activity; original-article; Overweight; Postmenopause; Prospective Studies; Public Health; Risk analysis; Risk assessment; Risk Factors; Socioeconomic Factors; Statistical analysis; Stroke; Stroke - prevention & control; Surveys and Questionnaires; Survival analysis; United Kingdom; Women's health; United Kingdom
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/ejcn.2014.260

Background: Stroke risk is modifiable through many risk factors, one being healthy dietary habits. Fibre intake was associated with a reduced stroke risk in recent meta-analyses; however, data were contributed by relatively few studies, and few examined different stroke types. Methods: A total of 27 373 disease-free women were followed up for 14.4 years. Diet was assessed with a 217-item food frequency questionnaire and stroke cases were identified using English Hospital Episode Statistics and mortality records. Survival analysis was applied to assess the risk of total, ischaemic or haemorrhagic stroke in relation to fibre intake. Results: A total of 135 haemorrhagic and 184 ischaemic stroke cases were identified in addition to 138 cases where the stroke type was unknown or not recorded. Greater intake of total fibre, higher fibre density and greater soluble fibre, insoluble fibre and fibre from cereals were associated with a significantly lower risk for total stroke. For total stroke, the hazard ratio per 6 g/day total fibre intake was 0.89 (95% confidence intervals: 0.81–0.99). Different findings were observed for haemorrhagic and ischaemic stroke in healthy-weight or overweight women. Total fibre, insoluble fibre and cereal fibre were inversely associated with haemorrhagic stroke risk in overweight/obese participants, and in healthy-weight women greater cereal fibre was associated with a lower ischaemic stroke risk. In non-hypertensive women, higher fibre density was associated with lower ischaemic stroke risk. Conclusions: Greater total fibre and fibre from cereals are associated with a lower stroke risk, and associations were more consistent with ischaemic stroke. The different observations by stroke type, body mass index group or hypertensive status indicates potentially different mechanisms.