Higher habitual dietary intakes of flavanols and anthocyanins differentially associate with lower incidence of ischemic stroke subtypes—a follow-up analysis

Abstract

Background: We previously reported that habitual consumption of dietary flavanol oligomers + polymers and anthocyanins is associated with a lower risk of ischemic stroke. However, no studies have investigated their relationship with ischemic stroke subtypes. Objectives: In this follow-up analysis, we aimed to examine the association of flavanol oligomers + polymers and anthocyanin intake with ischemic stroke subtypes, including the following: 1) large-artery atherosclerosis, 2) cardioembolism, 3) small-vessel occlusion, 4) other determined etiology, and 5) undetermined etiology. Methods: Participants (n = 55,094) from the Danish Diet, Cancer, and Health Study were followed up for <16 y for first-time ischemic stroke events, which were classified according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Intakes of flavanol oligomers + polymers and anthocyanins were calculated from food frequency questionnaires using the Phenol-Explorer database, and their relationships with ischemic stroke subtypes were investigated using restricted cubic splines within Cox proportional hazards models. After multivariable adjustment, higher habitual intakes (quintile 5 compared with quintile 1) of flavanol oligomers + polymers and anthocyanins were associated with a lower risk of specific ischemic stroke subtypes, including large-artery atherosclerosis [flavanol oligomers + polymers, hazard ratio {HR} (95% confidence interval {CI}): 0.64 (0.47, 0.87)], cardioembolism [anthocyanins, HR (95% CI): 0.45 (0.25, 0.82)], and small-vessel occlusion [flavanol oligomers + polymers, HR (95% CI): 0.65 (0.54, 0.80); anthocyanins, HR (95% CI): 0.79 (0.64, 0.97)], but not stroke of other determined or undetermined etiology. Conclusions: Higher habitual intakes of flavanols and anthocyanins are differentially associated with a lower risk of ischemic stroke from atherosclerosis and/or cardioembolism but not with other subtypes.

Document Type

Journal Article

Date of Publication

11-1-2023

Volume

153

Issue

11

PubMed ID

37716608

Publication Title

Journal of Nutrition

Publisher

Elsevier

School

Nutrition and Health Innovation Research Institute

RAS ID

60688

Funders

Danish Cancer Society, Denmark / Australian Government Research Training Program Scholarship / University of Western Australia Postgraduate Research Travel Award / Convocation Postgraduate Research Travel Award / National Heart Foundation Future Leader Fellowship / Royal Perth Hospital Foundation 'Lawrie Beilin' Career Advancement Fellowship

Comments

Parmenter, B. H., Pokharel, P., Dalgaard, F., Murray, K., Cassidy, A., Bondonno, C. P., . . . Bondonno, N. P. (2023). Higher habitual dietary intakes of flavanols and anthocyanins differentially associate with lower incidence of ischemic stroke subtypes—a follow-up analysis. The Journal of Nutrition, 153(11), 3280-3286. https://doi.org/10.1016/j.tjnut.2023.09.011

Copyright

subscription content

First Page

3280

Last Page

3286

Link to Full Text

Share

 
COinS
 

Link to publisher version (DOI)

10.1016/j.tjnut.2023.09.011