Substitutions between potatoes and other vegetables and risk of ischemic stroke
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Substitutions between potatoes and other vegetables and risk of ischemic stroke. / Hansen, Mette Damborg; Würtz, Anne Mette Lund; Hansen, Camilla Plambeck; Tjønneland, Anne; Rimm, Eric Bruce; Johnsen, Søren Paaske; Schmidt, Erik Berg; Overvad, Kim; Jakobsen, Marianne Uhre.
In: European Journal of Nutrition, Vol. 60, 2021, p. 229–237.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Substitutions between potatoes and other vegetables and risk of ischemic stroke
AU - Hansen, Mette Damborg
AU - Würtz, Anne Mette Lund
AU - Hansen, Camilla Plambeck
AU - Tjønneland, Anne
AU - Rimm, Eric Bruce
AU - Johnsen, Søren Paaske
AU - Schmidt, Erik Berg
AU - Overvad, Kim
AU - Jakobsen, Marianne Uhre
PY - 2021
Y1 - 2021
N2 - Purpose: Intake of vegetables has been associated with a lower risk of ischemic stroke in observational studies controlling for total energy intake. However, adjustment for energy intake introduces a substitution aspect, which affects the interpretation of the results. We investigated replacement of potatoes with other vegetables, substitutions between vegetable subgroups, and risk of ischemic stroke and ischemic stroke subtypes. Methods: The Danish Diet, Cancer and Health cohort included 57,053 participants aged 50–64 years at recruitment in 1993–1997. Diet was assessed from a validated 192-item semi-quantitative food frequency questionnaire. We calculated hazard ratios (HR) with 95% confidence intervals (CI) for the incidence of ischemic stroke using Cox proportional hazard regression. Results: During 13.5 years of follow-up, 1879 cases of ischemic stroke were identified including 319 cases of large-artery atherosclerosis and 844 cases of small-vessel occlusion. The adjusted HR for total ischemic stroke associated with food substitutions of equal amounts (500 g/week) was 0.86 (95% CI 0.76, 0.97) for replacement of potatoes with fruiting vegetables and 0.92 (95% CI 0.84, 1.02) for replacement of potatoes with other root vegetables. The HR for replacing potatoes with the sum of other vegetables was 0.95 (95% CI 0.90, 1.00). Substitution of cabbage for either potatoes, fruiting vegetables or other root vegetables was associated with a statistically non-significant higher risk of ischemic stroke. The patterns of associations were similar for ischemic stroke subtypes and for equivalent substitutions using isocaloric amounts. Conclusion: Replacing potatoes with fruiting vegetables was associated with a lower risk of ischemic stroke.
AB - Purpose: Intake of vegetables has been associated with a lower risk of ischemic stroke in observational studies controlling for total energy intake. However, adjustment for energy intake introduces a substitution aspect, which affects the interpretation of the results. We investigated replacement of potatoes with other vegetables, substitutions between vegetable subgroups, and risk of ischemic stroke and ischemic stroke subtypes. Methods: The Danish Diet, Cancer and Health cohort included 57,053 participants aged 50–64 years at recruitment in 1993–1997. Diet was assessed from a validated 192-item semi-quantitative food frequency questionnaire. We calculated hazard ratios (HR) with 95% confidence intervals (CI) for the incidence of ischemic stroke using Cox proportional hazard regression. Results: During 13.5 years of follow-up, 1879 cases of ischemic stroke were identified including 319 cases of large-artery atherosclerosis and 844 cases of small-vessel occlusion. The adjusted HR for total ischemic stroke associated with food substitutions of equal amounts (500 g/week) was 0.86 (95% CI 0.76, 0.97) for replacement of potatoes with fruiting vegetables and 0.92 (95% CI 0.84, 1.02) for replacement of potatoes with other root vegetables. The HR for replacing potatoes with the sum of other vegetables was 0.95 (95% CI 0.90, 1.00). Substitution of cabbage for either potatoes, fruiting vegetables or other root vegetables was associated with a statistically non-significant higher risk of ischemic stroke. The patterns of associations were similar for ischemic stroke subtypes and for equivalent substitutions using isocaloric amounts. Conclusion: Replacing potatoes with fruiting vegetables was associated with a lower risk of ischemic stroke.
KW - Cohort study
KW - Diet
KW - Ischemic stroke
KW - Potatoes
KW - Substitution models
KW - Vegetables
U2 - 10.1007/s00394-020-02237-w
DO - 10.1007/s00394-020-02237-w
M3 - Journal article
C2 - 32274553
AN - SCOPUS:85083447100
VL - 60
SP - 229
EP - 237
JO - European Journal of Nutrition
JF - European Journal of Nutrition
SN - 1436-6207
ER -
ID: 247381142