TY - JOUR
T1 - Substitutions between potatoes and other vegetables and risk of ischemic stroke
AU - Hansen, Mette Damborg
AU - Würtz, Anne Mette Lund
AU - Hansen, Camilla Plambeck
AU - Tjønneland, Anne
AU - Rimm, Eric Bruce
AU - Johnsen, Søren Paaske
AU - Schmidt, Erik Berg
AU - Overvad, Kim
AU - Jakobsen, Marianne Uhre
PY - 2021/2
Y1 - 2021/2
N2 - PURPOSE: Intake of vegetables has been associated with a lower risk of ischemic stroke in observational studies controlling for total energy intake. However, adjustment for energy intake introduces a substitution aspect, which affects the interpretation of the results. We investigated replacement of potatoes with other vegetables, substitutions between vegetable subgroups, and risk of ischemic stroke and ischemic stroke subtypes.METHODS: The Danish Diet, Cancer and Health cohort included 57,053 participants aged 50-64 years at recruitment in 1993-1997. Diet was assessed from a validated 192-item semi-quantitative food frequency questionnaire. We calculated hazard ratios (HR) with 95% confidence intervals (CI) for the incidence of ischemic stroke using Cox proportional hazard regression.RESULTS: During 13.5 years of follow-up, 1879 cases of ischemic stroke were identified including 319 cases of large-artery atherosclerosis and 844 cases of small-vessel occlusion. The adjusted HR for total ischemic stroke associated with food substitutions of equal amounts (500 g/week) was 0.86 (95% CI 0.76, 0.97) for replacement of potatoes with fruiting vegetables and 0.92 (95% CI 0.84, 1.02) for replacement of potatoes with other root vegetables. The HR for replacing potatoes with the sum of other vegetables was 0.95 (95% CI 0.90, 1.00). Substitution of cabbage for either potatoes, fruiting vegetables or other root vegetables was associated with a statistically non-significant higher risk of ischemic stroke. The patterns of associations were similar for ischemic stroke subtypes and for equivalent substitutions using isocaloric amounts.CONCLUSION: Replacing potatoes with fruiting vegetables was associated with a lower risk of ischemic stroke.
AB - PURPOSE: Intake of vegetables has been associated with a lower risk of ischemic stroke in observational studies controlling for total energy intake. However, adjustment for energy intake introduces a substitution aspect, which affects the interpretation of the results. We investigated replacement of potatoes with other vegetables, substitutions between vegetable subgroups, and risk of ischemic stroke and ischemic stroke subtypes.METHODS: The Danish Diet, Cancer and Health cohort included 57,053 participants aged 50-64 years at recruitment in 1993-1997. Diet was assessed from a validated 192-item semi-quantitative food frequency questionnaire. We calculated hazard ratios (HR) with 95% confidence intervals (CI) for the incidence of ischemic stroke using Cox proportional hazard regression.RESULTS: During 13.5 years of follow-up, 1879 cases of ischemic stroke were identified including 319 cases of large-artery atherosclerosis and 844 cases of small-vessel occlusion. The adjusted HR for total ischemic stroke associated with food substitutions of equal amounts (500 g/week) was 0.86 (95% CI 0.76, 0.97) for replacement of potatoes with fruiting vegetables and 0.92 (95% CI 0.84, 1.02) for replacement of potatoes with other root vegetables. The HR for replacing potatoes with the sum of other vegetables was 0.95 (95% CI 0.90, 1.00). Substitution of cabbage for either potatoes, fruiting vegetables or other root vegetables was associated with a statistically non-significant higher risk of ischemic stroke. The patterns of associations were similar for ischemic stroke subtypes and for equivalent substitutions using isocaloric amounts.CONCLUSION: Replacing potatoes with fruiting vegetables was associated with a lower risk of ischemic stroke.
KW - Cohort study
KW - Diet
KW - Ischemic stroke
KW - Potatoes
KW - Substitution models
KW - Vegetables
UR - http://www.scopus.com/inward/record.url?scp=85083447100&partnerID=8YFLogxK
U2 - 10.1007/s00394-020-02237-w
DO - 10.1007/s00394-020-02237-w
M3 - Journal article
C2 - 32274553
SN - 1436-6207
VL - 60
SP - 229
EP - 237
JO - European Journal of Nutrition
JF - European Journal of Nutrition
IS - 1
ER -