Dietary intake of folate and risk of stroke in US men and women: NHANES I Epidemiologic Follow-up Study. National Health and Nutrition Examination Survey.
OBJECTIVE
Few population-based studies have examined the relationship between dietary intake of folate and risk of stroke and cardiovascular disease (CVD). This study examines the association between dietary intake of folate and the subsequent risk of stroke and CVD.


METHODS
Study participants included 9764 US men and women aged 25 to 74 years who participated in the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study (NHEFS) and were free of CVD at baseline. Dietary intake of folate was assessed at baseline using a 24-hour dietary recall and calculated using ESHA software. Incidence data for stroke and CVD were obtained from medical records and death certificates.


RESULTS
Over an average of 19 years of follow-up, 926 incident stroke events and 3758 incident CVD events were documented. The relative risk (RR) was 0.79 (95% confidence interval [CI], 0.63 to 0.99, P=0.03 for trend) for incident stroke events and 0.86 (95% CI: 0.78 to 0.95, P<0.001 for trend) for incident CVD events in the highest quartile of dietary folate intake (median, 405.0 microg/day) compared with those in the lowest quartile (median, 99.0 microg/day), after adjustment for established cardiovascular risk factors and dietary factors.


CONCLUSIONS
Our findings indicate an inverse relationship between dietary intake of folate and subsequent risk of stroke and CVD. Increasing dietary intake of folate from food sources may be an important approach to the prevention of CVD in the US population.
Bazzano
Lydia A
LA
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, La 70112, USA.
He
Jiang
J
Ogden
Lorraine G
LG
Loria
Catherine
C
Vupputuri
Suma
S
Myers
Leann
L
Whelton
Paul K
PK
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D016208:Databases, Factual; D004032:Diet; D004041:Dietary Fats; D002149:Energy Intake; D005260:Female; D005492:Folic Acid; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D016016:Proportional Hazards Models; D011446:Prospective Studies; D044469:Racial Groups; D012306:Risk; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
D004041:Dietary Fats; D005492:Folic Acid