title: Dietary flavonoids and risk of stroke in women.
abstract: OBJECTIVE
  To date, few studies have examined associations between the wide range of flavonoid subclasses and risk of ischemic, hemorrhagic, and total stroke.
  
  
  METHODS
  We conducted a prospective study among 69 622 women from the Nurses' Health Study. Total flavonoid and subclass intakes were calculated from semiquantitative food frequency questionnaires collected every 4 years using an updated and extended US Department of Agriculture flavonoid database.
  
  
  RESULTS
  During 14 years of follow-up, 1803 incident strokes were confirmed. After adjusting for potential confounders, women in the highest compared with the lowest quintile of flavanone intake had a relative risk of ischemic stroke of 0.81 (95% CI, 0.66-0.99; P=0.04). Citrus fruits/juices, the main dietary source of flavanones, tended to be associated with a reduced risk for ischemic stroke (relative risk, 0.90; 95% CI, 0.77-1.05) comparing extreme quintiles.
  
  
  CONCLUSIONS
  Total flavonoid intake was not inversely associated with risk of stroke; however, increased intake of the flavanone subclass was associated with a reduction in the risk of ischemic stroke. Citrus fruit consumption may be associated with a reduction in stroke risk, and experimental data support these epidemiological associations that the flavanone content of citrus fruits may potentially be cardioprotective. Further prospective studies are needed to confirm these associations.
authors.affiliation: Department of Nutrition, Norwich Medical School, University of East Anglia, Norwich, UK. a.cassidy@uea.ac.uk
authors.forename: Aedín
authors.initials: A
authors.lastname: Cassidy
authors.forename: Eric B
authors.initials: EB
authors.lastname: Rimm
authors.forename: Eilis J
authors.initials: EJ
authors.lastname: O'Reilly
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Logroscino
authors.forename: Colin
authors.initials: C
authors.lastname: Kay
authors.forename: Stephanie E
authors.initials: SE
authors.lastname: Chiuve
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Rexrode
mesh_terms: D000328:Adult; D002545:Brain Ischemia / Q000453:epidemiology / Q000517:prevention & control; D002957:Citrus; D019587:Dietary Supplements; D005260:Female; D005419:Flavonoids / Q000008:administration & dosage*; D005500:Follow-Up Studies; D005638:Fruit; D006801:Humans; D015994:Incidence; D020300:Intracranial Hemorrhages / Q000453:epidemiology / Q000517:prevention & control; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000453:epidemiology* / Q000517:prevention & control; D011795:Surveys and Questionnaires; D014481:United States; D016885:United States Department of Agriculture
chemical_list: D005419:Flavonoids