title: Mediterranean Diet in patients with acute ischemic stroke: Relationships between Mediterranean Diet score, diagnostic subtype, and stroke severity index.
abstract: BACKGROUND
  Adherence to a Mediterranean Diet appears to reduce the risk of cardiovascular disease, cancer, Alzheimer's disease, and Parkinson's disease, as well as the risk of death due to cardiovascular disease. No study has addressed the association between diagnostic subtype of stroke and its severity and adherence to a Mediterranean Diet in subjects with acute ischemic stroke.
  
  
  OBJECTIVE
  To evaluate the association between Mediterranean Diet adherence, TOAST subtype, and stroke severity by means of a retrospective study.
  
  
  METHODS
  The type of acute ischemic stroke was classified according to the TOAST criteria. All patients admitted to our ward with acute ischemic stroke completed a 137-item validated food-frequency questionnaire adapted to the Sicilian population. A scale indicating the degree of adherence to the traditional Mediterranean Diet was used (Me-Di score: range 0-9).
  
  
  RESULTS
  198 subjects with acute ischemic stroke and 100 control subjects without stroke. Stroke subjects had a lower mean Mediterranean Diet score compared to 100 controls without stroke. We observed a significant positive correlation between Me-Di score and SSS score, whereas we observed a negative relationship between Me-Di score and NIHSS and Rankin scores. Subjects with atherosclerotic (LAAS) stroke subtype had a lower mean Me-Di score compared to subjects with other subtypes. Multinomial logistic regression analysis in a simple model showed a negative relationship between MeDi score and LAAS subtype vs. lacunar subtype (and LAAS vs. cardio-embolic subtype).
  
  
  CONCLUSIONS
  Patients with lower adherence to a Mediterranean Diet are more likely to have an atherosclerotic (LAAS) stroke, a worse clinical presentation of ischemic stroke at admission and a higher Rankin score at discharge.
authors.affiliation: U.O.C di Medicina Interna e Cardioangiologia, Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Italy. Electronic address: bruno.tuttolomondo@unipa.it.
authors.forename: Antonino
authors.initials: A
authors.lastname: Tuttolomondo
authors.affiliation: Dipartimento di Scienze per la Promozione della Salute e Materno Infantile "G. D'Alessandro", Universita' degli Studi di Palermo, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Casuccio
authors.affiliation: U.O.C di Medicina Interna e Cardioangiologia, Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Italy.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Buttà
authors.affiliation: U.O.C di Medicina Interna e Cardioangiologia, Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Italy.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Pecoraro
authors.affiliation: U.O.C di Medicina Interna e Cardioangiologia, Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Di Raimondo
authors.affiliation: U.O.C di Medicina Interna e Cardioangiologia, Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Italy.
authors.forename: Vittoriano
authors.initials: V
authors.lastname: Della Corte
authors.affiliation: Dipartimento di BioMedicina Sperimentale e Neuroscienze Cliniche, Università degli Studi di Palermo, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Arnao
authors.affiliation: U.O.C di Medicina Interna e Cardioangiologia, Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Clemente
authors.affiliation: U.O.C di Medicina Interna e Cardioangiologia, Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Maida
authors.affiliation: U.O.C di Medicina Interna e Cardioangiologia, Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Simonetta
authors.affiliation: U.O.C di Medicina Interna e Cardioangiologia, Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Miceli
authors.affiliation: U.O.C di Medicina Interna e Cardioangiologia, Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Italy.
authors.forename: Benedetto
authors.initials: B
authors.lastname: Lucifora
authors.affiliation: U.O.C di Medicina Interna e Cardioangiologia, Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Cirrincione
authors.affiliation: Unità Operativa di Immunoematologia e Medicina Trasfusionale, Azienda Ospedaliera Universitaria Policlinico di Palermo, Palermo, Italy.
authors.forename: Danilo
authors.initials: D
authors.lastname: Di Bona
authors.affiliation: U.O.C di Medicina Interna e Cardioangiologia, Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Corpora
authors.affiliation: Dipartimento di BioMedicina Sperimentale e Neuroscienze Cliniche, Sezione di Neurochirurgia, Università di Palermo, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Maugeri
authors.affiliation: Dipartimento di BioMedicina Sperimentale e Neuroscienze Cliniche, Sezione di Neurochirurgia, Università di Palermo, Italy.
authors.forename: Domenico Gerardo
authors.initials: DG
authors.lastname: Iacopino
authors.affiliation: U.O.C di Medicina Interna e Cardioangiologia, Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pinto
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000473:pathology; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D038441:Diet, Mediterranean; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D011795:Surveys and Questionnaires
keywords: Mediterranean Diet; Stroke; TOAST subtype