Dietary antioxidant capacity and risk for stroke in a prospective cohort study of Swedish men and women.
OBJECTIVE
Both observational studies and randomized trials have shown that a diet rich in antioxidants can reduce systemic inflammation and oxidative stress, two conditions that, together with obesity and smoking, are established risk factors for stroke. However, the association between antioxidant intake and risk for stroke is poorly understood, particularly when studying possible interaction with sex. We investigated the relationship of nonenzymatic antioxidant capacity (NEAC) on risk for stroke in a large Swedish prospective cohort.


METHODS
The cohort study included 34 555 men and women from the Swedish National March Cohort. NEAC was assessed using a detailed food frequency questionnaire, collected at baseline. We achieved complete follow-up from enrollment in 1997 through 2010 by record linkage to nationwide registers. We identified 1186 incident cases of a first stroke, of which 860 were ischemic, 201 hemorrhagic, and 125 unspecified. We used multivariable Cox proportional hazards models to estimate adjusted hazard ratios (HR) with 95% confidence intervals (CIs).


RESULTS
Compared with women in the lowest quartile of NEAC, women in the highest quartile had a 27% lower incidence of total stroke (HR, 0.73; 95% CI, 0.53-0.99; Ptrend= 0.03) and 35% lower incidence of ischemic stroke (HR, 0.65; 95% CI, 0.43-0.99; Ptrend= 0.01). Among men, the relationship between NEAC and risk for stroke was not statistically significant and all HRs were close to unity.


CONCLUSIONS
Findings from the present study suggest that dietary antioxidant capacity from different foods and beverages is inversely associated with risk for stroke, more specifically ischemic stroke, in women.
Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.
Luca
L
Colarusso
Functional Food and Metabolic Stress Prevention Laboratory, Center for Food and Nutrition, Council for Agricultural Research and Economics CREA, Rome, Italy.
Mauro
M
Serafini
Department of Medicine, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden; Department of Medicine, Clinic of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital Huddinge, Stockhlom, Sweden.
Ylva Trolle
YT
Lagerros
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Olof
O
Nyren
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Carlo
C
La Vecchia
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Marta
M
Rossi
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Weimin
W
Ye
Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy.
Alessandra
A
Tavani
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts.
Hans-Olov
HO
Adami
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Alessandra
A
Grotta
Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Electronic address: rino.bellocco@unimib.it.
Rino
R
Bellocco
D000328:Adult; D000975:Antioxidants / Q000008:administration & dosage / Q000627:therapeutic use*; D002545:Brain Ischemia / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control*; D015331:Cohort Studies; D004032:Diet / Q000208:ethnology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D020300:Intracranial Hemorrhages / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control*; D013548:Sweden / Q000453:epidemiology
D000975:Antioxidants
Antioxidant effects; Atherosclerosis; Cohort studies; Dietary habits; Epidemiology; Risk factors; Stroke