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November 04, 2014; 83 (19) ArticleOpen Access

Healthy diet and lifestyle and risk of stroke in a prospective cohort of women

Susanna C. Larsson, Agneta Åkesson, Alicja Wolk
First published October 8, 2014, DOI: https://doi.org/10.1212/WNL.0000000000000954
Susanna C. Larsson
From the Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Agneta Åkesson
From the Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Alicja Wolk
From the Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Healthy diet and lifestyle and risk of stroke in a prospective cohort of women
Susanna C. Larsson, Agneta Åkesson, Alicja Wolk
Neurology Nov 2014, 83 (19) 1699-1704; DOI: 10.1212/WNL.0000000000000954

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Abstract

Objective: To investigate the association between a low-risk lifestyle and risk of stroke.

Methods: The study population comprised 31,696 women, in the population-based Swedish Mammography Cohort who at baseline had completed a questionnaire about diet and lifestyle and were free from cardiovascular disease and cancer. We defined a low-risk lifestyle as a healthy diet (top 50% of a Recommended Food Score), moderate alcohol consumption (5–15 g/d), never smoking, physically active (walking/bicycling ≥40 min/d and exercise ≥1 h/wk), and body mass index below 25 kg/m2. Stroke cases were identified from the Swedish National Patient Register and the Swedish Cause of Death Register.

Results: We ascertained 1,554 incident stroke cases, including 1,155 cerebral infarctions, 246 hemorrhagic strokes, and 153 unspecified strokes during 10.4 years of follow-up. The risk of stroke, in particular cerebral infarction, decreased steadily with increasing number of low-risk lifestyle factors. Compared with no low-risk factors, the multivariable relative risks (95% confidence interval) of cerebral infarction across increasing number of low-risk factors (1–5) were 0.72 (0.56–0.93), 0.67 (0.52–0.85), 0.57 (0.44–0.74), 0.54 (0.40–0.73), and 0.38 (0.20–0.73).

Conclusions: These findings indicate that a low-risk lifestyle can substantially reduce the risk of stroke, especially cerebral infarction.

GLOSSARY

BMI=
body mass index;
CI=
confidence interval;
ICD-10=
International Classification of Diseases, tenth revision;
NRFS=
Non-Recommended Food Score;
RFS=
Recommended Food Score;
RR=
relative risk

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article. The Article Processing Charge was paid by the authors.

  • Supplemental data at Neurology.org

  • Received January 20, 2014.
  • Accepted in final form July 29, 2014.
  • © 2014 American Academy of Neurology

This is an open access article distributed under the terms of the Creative Commons Attribution-Noncommercial No Derivative 3.0 License, which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially.

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Disputes & Debates: Rapid online correspondence

  • Response to Braillon
    • Susanna C. Larsson, Researcher, Karolinska Institutetsusanna.larsson@ki.se
    • Agneta Akesson, Stockholm, Sweden
    Submitted March 11, 2015
  • Smoking is the first avoidable cause of stroke and modest alcohol consumption causes cancers.
    • Alain Braillon, Consultant, University hospitalbraillon.alain@gmail.com
    Submitted October 24, 2014
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