Diet Associated with Less Cognitive Decline, Risk for Stroke, Two Studies Show
A diet rich in fruits and vegetables and a history of exercise lowered the risk for stroke in high-risk patients, according to one epidemiological study published in the May 1 online edition of Neurology. In another study, people who reported a healthier diet were less likely to show cognitive decline over a five-year period, according to results published in the May 6 online edition of Neurology. The studies provide yet more evidence for the importance of diet and lifestyle factors in
... g stroke and cognitive decline, experts told Neurology Today. DIET AND STROKE Susanna C. Larsson, PhD, an associate professor in the Institute of Environmental Medicine at the Karolinska Institute in Sweden, obtained information on 11,450 men -participants in the Cohort of Swedish Men study -with a history of high cholesterol, hypertension, diabetes, atrial fibrillation, or heart failure that put them at high risk for stroke. None of the men had suffered a stroke at the start of the study in 1998. The men were asked to fill out a 96-item food frequency questionnaire at the start of the study and provided information on other lifestyle factors. The scientists calculated the number of fruits, vegetables, and processed meats that the men consumed on a weekly basis, their weight and body mass index (BMI), their amount of weekly physical activity, and their drinking and smoking behavior. Almost 10 years after the men entered the study, the scientists reviewed the National Inpatient Register and the Swedish Cause of Death register to see which men had experienced a stroke (ischemic or hemorrhagic) during the follow-up period. The scientists counted 1,062 strokes. The risk of total stroke and both types of stroke were lower in men who reported that they ate five or more servings of fruits and vegetables a day, consumed less than one ounce of processed meat, did not smoke, fell within a normal BMI range, had fewer than two drinks a day, and spent more than 150 minutes a week exercising. There was a 72 percent lower risk in men who reported healthy behavior in all five lifestyle areas compared with men who reported none or only one. The risk for both ischemic and hemorrhagic strokes was reduced equally in men with the healthiest lifestyle behaviors. The corresponding relative risks were 0.31 (95% CI, 0.15-0.66) for ischemic stroke and 0.32 (95% CI, 0.04-2.51) for hemorrhagic stroke. Dr. Larsson and her colleagues noted that men who scored highest on all five healthy lifestyle measures were older and had a higher level of education. They were more likely to be married or living with a partner and less likely to have a family history of myocardial infarction or cardiovascular disease. As with most observational studies, the investigators said, "We cannot rule out the possibility that our results were affected by residual confounding due to unmeasured or imprecise measurement of other risk factors." What' s more, they said, the dietary information was based on selfreported information taken at one point in time and it is impossible to know whether their healthy behaviors continued over the length of the follow-up period. "The findings suggest that we should eat more fruits and vegetables but reduce consumption of red meat, in particular processed meat, to reduce our risk of stroke," said Dr. Larsson. "Lifestyle has a very important impact on the risk of developing stroke," she said, adding that diet, smoking, and body mass index had the largest impact on stroke risk. The Swedish investigators conducted a similar observational study in older women and reported similar results. The study was published last year in Neurology. DIET AND COGNITION In a second study published in the May 6 online issue of Neurology, Andrew Smyth, MD, a research fellow in the Population Health Research Institute at McMaster University in Hamilton, Ontario, and his colleagues analyzed information on diet and cognition amassed during two large clinical trials testing the angiotensin-converting enzyme inhibitor ramipril or angiotensin II receptor antagonist telmisartan alone or in combination in patients at high risk of cardiovascular disease. Study investigators had gained information on baseline dietary intake and repeat measures from the Mini-Mental State Examination (MMSE) in 27,860 men and women enrolled in the two international clinical trials, ONTARGET ARTICLE IN bRIEf 4 A diet rich in fruits and vegetables and a history of exercise lowered the risk for stroke in high-risk patients, according to one epidemiological study. Another study showed that people who reported a healthier diet were less likely to show cognitive decline over a five-year period.