Abstract 93: Adherence to Mediterranean Diet and Prediction of Incident Stroke

Abstract

Background&Purpose: There are limited diet regarding the potential association of adherence to Mediterranean Diet (MeD) with incident stroke. We sought to determine longitudinally the relationship between higher adherence to Mediterranean diet and lower likelihood of incident stroke before and after controlling for factors that are independently related to cerebrovascular disease burden by capitalizing on the large, geographically dispersed, race- and gender-balanced sample of REGARDS subjects. Subjects&Methods: A prospective, population-based, cohort of individuals enrolled in REGARDS Study was evaluated after excluding participants with history of stroke and missing data with respect to demographic, cognitive or food intake variables. Adherence to a MeD was computed from Food Frequency Questionnaires (FFQ) and was categorized as high, moderate and low using MeD-score tertiles (MeD-score: 6-9, 4-5 & 0-3 respectively). The main outcome of the present analyses was incident stroke that had been diagnosed by a committee of trained clinicians during a mean follow-up period of 5 years. The association of adherence to MeD with incident stroke (ischemic and hemorrhagic) was evaluated using a set of incremental logistic regression models. Results: Incident stroke was identified in 565 (1.9%; 497 cases of ischemic and 68 cases of hemorrhagic stroke) out of 30,239 individuals fulfilling the inclusion criteria. After adjusting for age, race, region, gender, income, education, total energy, smoking status, sedentary behavior, body mass index, waist circumference and vascular risk factors, low adherence to MeD was associated with a higher likelihood of incident ischemic stroke (OR versus high adherence: 1.29; 95%CI:0.99-1.67; p=0.057). A similar relationship was documented for moderate adherence to MeD (OR versus high adherence: 1.25; 95%CI:0.98-1.58; p=0.079). We documented no association of adherence to MeD with incident hemorrhagic stroke (p=0.38). There was no interaction of race (p=0.38) on the association of adherence to MeD with incident ischemic stroke. Conclusions: Low adherence to MeD was associated with a higher likelihood of incident ischemic stroke independent of numerous potential confounders.