Original Article | Published:

Nutrition Epidemiology Highlights Original Article

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

European Journal of Clinical Nutrition volume 69, pages 467474 (2015) | Download Citation

Subjects

Abstract

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.

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Acknowledgements

The authors thank the participants of the UKWCS and all those who have previously contributed to the initiation, data collection, management and processing of information for the cohort.

Author information

Affiliations

  1. Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK

    • D E Threapleton
    • , V J Burley
    •  & J E Cade
  2. Division of Biostatistics, University of Leeds, Leeds, UK

    • D C Greenwood

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Competing interests

The PhD studentship for D Threapleton was sponsored by Kellogg Sales and Marketing UK Ltd. DCG has held an unrelated research grant (a study of infant diet) funded by Danone and has received personal fees from American Institute for Cancer Research/World Cancer Research Fund, outside the submitted work. Funding bodies played no part in data collection, analysis, interpretation or decision to publish.

Corresponding author

Correspondence to D E Threapleton.

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DOI

https://doi.org/10.1038/ejcn.2014.260

Supplementary Information accompanies this paper on European Journal of Clinical Nutrition website (http://www.nature.com/ejcn)

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