Intakes of vegetables and related nutrients such as vitamin B complex, potassium, and calcium, are negatively correlated with risk of stroke in Korea

Folic acid for the primary prevention of stroke: a systematic review and meta-analysis

Objectives

Results from studies were inconsistent with regard to the effect of folic acid on the primary prevention of stroke. The aim of this study was to analyze the association between folic acid and the primary prevention of stroke using the data from observational studies and randomized controlled trials (RCTs).

Methods

Eligible publications published until June 2024 were searched in the database of PubMed, Web of Science and Embase. This study included all observational studies and RCTs of folic acid with first stroke as the reporting endpoints. Relative risks (RRs) and 95% confidence intervals (CIs) were pooled in the random-effects model to assess the effect of folic acid on the primary prevention of stroke.

Results

Results from 12 observational publications with 16 research, including 312,320 participants, were combined to explore the association between dietary folic acid intake and the primary prevention of stroke. The results showed that high dietary folic acid intake was associated with a 17% reduction in stroke incidence (RR:0.83; 95% CI: 0.73-0.94), and the effect of dietary folic acid was greater in areas without grain fortification (RR:0.80; 95% CI: 0.67-0.95). The pooled results from 12 RCTs, totaling 75,042 participants, indicated that folic acid supplementation was not associated with the stroke primary prevention (RR:0.92; 95% CI: 0.80-1.05), but folic acid supplementation was effective in areas without grain fortification (RR:0.78; 95% CI: 0.68-0.89).

Conclusion

Our meta-analysis demonstrated that dietary folic acid is effective in stroke primary prevention, and folic acid supplementation is effective in stroke primary prevention only in areas without grain fortification.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/#myprospero, identifier CRD42024516991.

Associations of dietary intakes of vitamins B1 and B3 with risk of mortality from CVD among Japanese men and women: the Japan Collaborative Cohort study

The evidence on the association between B vitamins and the risk of CVD is inconclusive. We aimed to examine the association of dietary vitamins B1 and B3 intakes with risk of CVD mortality among 58 302 Japanese men and women aged 40-79 years participated in the Japan Collaborative Cohort (JACC) study. The Cox proportional hazard model estimated the hazard ratios (HR) and 95% CI of CVD mortality across increasing energy-adjusted quintiles of dietary vitamins B1 and B3 intakes. During 960 225 person-years of follow-up, we documented a total of 3371 CVD deaths. After adjustment for age, sex, and other CVD risk factors, HR of mortality from ischemic heart disease, myocardial infarction, and heart failure in the highest v. lowest vitamin B1 intake quintiles were 0.57 (95 % CI 0·40, 0·80; Pfor trend < 0·01), 0.56 (95 % CI 0·37, 0·82; Pfor trend < 0·01), and 0.65 (95 % CI 0·45, 0·96; Pfor trend = 0·13). The multivariable HR of myocardial infarction mortality in the highest v. lowest vitamin B3 intake quintiles was 0.66 (95 % CI 0·48, 0·90; Pfor trend = 0·02). Atendency towards a reduced risk of haemorrhagic stroke mortality was observed with a higher dietary intake of vitamin B3 (HR: 0·74 (95 % CI 0·55, 1·01)) but not vitamin B1. In conclusion, higher dietary intakes of vitamins B1 and B3 were inversely associated with mortality from ischemic heart disease and a higher dietary intake of vitamin B1 was inversely associated with a reduced risk of mortality from heart failure among Japanese men and women.

Dietary Vitamin B6 Intake Associated with a Decreased Risk of Cardiovascular Disease: A Prospective Cohort Study

Although the biological mechanisms underlying the beneficial effects of vitamin B₆ on cardiovascular disease (CVD) have been reported on, epidemiological studies have yielded controversial results, and data on the Korean population are limited. This study examined the association between dietary vitamin B₆ intake and CVD incidence in Koreans. A total of 9142 participants of the Korean Genome and Epidemiology Study, aged 40–69 years, who did not have CVD or cancer at the baseline were included in the analysis. Dietary data were assessed using a validated semi-quantitative food frequency questionnaire. CVD incidence was assessed using biennial questionnaires and confirmed through repeated personal interviews. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard regression models. After multivariate adjustment, a higher vitamin B₆ intake was significantly associated with a decreased CVD risk in men (HR: 0.44; 95% CI: 0.25–0.78); no such association was observed in women. Dose-response analysis confirmed the presence of inverse linearity between vitamin B₆ intake and CVD incidence in men (p for nonlinearity = 0.3). A higher dietary intake level of vitamin B₆ was associated with a reduced CVD risk in Korean men. These observations require further verification in other populations.

Effects of Vegetables on Cardiovascular Diseases and Related Mechanisms

Epidemiological studies have shown that vegetable consumption is inversely related to the risk of cardiovascular diseases. Moreover, research has indicated that many vegetables like potatoes, soybeans, sesame, tomatoes, dioscorea, onions, celery, broccoli, lettuce and asparagus showed great potential in preventing and treating cardiovascular diseases, and vitamins, essential elements, dietary fibers, botanic proteins and phytochemicals were bioactive components. The cardioprotective effects of vegetables might involve antioxidation; anti-inflammation; anti-platelet; regulating blood pressure, blood glucose, and lipid profile; attenuating myocardial damage; and modulating relevant enzyme activities, gene expression, and signaling pathways as well as some other biomarkers associated to cardiovascular diseases. In addition, several vegetables and their bioactive components have been proven to protect against cardiovascular diseases in clinical trials. In this review, we analyze and summarize the effects of vegetables on cardiovascular diseases based on epidemiological studies, experimental research, and clinical trials, which are significant to the application of vegetables in prevention and treatment of cardiovascular diseases.

Vegetable intake is associated with lower Frammingham risk scores in Korean men: Korea National Health and Nutrition Survey 2007-2009

BACKGROUND/OBJECTIVES

Observational studies suggest that an association between vegetable consumption and coronary heart disease (CHD). However, the results are inconsistent. This study aimed to investigate the daily intake of vegetables on a national level and its effect on the risk of CHD risk, as determined by the Framingham Risk Score (FRS).

SUBJECTS/METHODS

This study was conducted a cross-sectional design of 2,510 male adults 40-64y of age who participated in the 2007-2009 Korean National Health and Nutrition Examination Survey. Daily intake of vegetable was assessed by 24-h recall, and the consumption frequency of vegetables was determined using a food frequency questionnaire. The odd ratio of CHD risk according to daily intake and frequency of vegetables was analyzed.

RESULTS

Total vegetable intake was inversely and significantly associated with the risk of CHD (Model 1: 4th vs. 1st quartile, OR = 0.74, 95% CI = 0.58-0.96, P for trend = 0.0015), and the significant relationship with CHD risk remained even after adjusting for potential confounders (Model 3: 4th vs. 1st quartile, adjusted OR [aOR] = 0.69, 95% CI = 0.49-0.95, P for trend = 0.0492). Subjects in the higher quartiles of non-salted vegetable intake had 31% lower odds of the risk of CHD compared to those in the lowest quartile after adjusting for various potential confounders in model 3 (aOR = 0.69; 95% CI = 0.49-0.97, P for trend = 0.0478). No significant associations between the frequency of vegetable intake (total, green, white and red vegetable) and the risk of CHD were found.

CONCLUSIONS

The major results of this study indicate that higher vegetable intake may help prevent CHD in Korean men.

Relationship between 24 h urinary potassium and diet quality in the adult Spanish population

Objective

To study the relationship between diet quality and 24 h urinary K excretion.

Design

K was measured in 24 h urine samples, while diet was studied using a 24 h recall method over two consecutive days. Diet quality was determined using the Healthy Eating Index (HEI). The body weight, height and body composition of all participants were recorded, and the BMI of each calculated.

Setting

Representative members of the adult Spanish population from the FANPE Study (‘Fuentes Alimentarias de Nutrientes en Población Española’; Dietary Sources of Nutrients in the Spanish Population).

Subjects

The final sample size was 329 participants aged 18–60 years.

Results

Participants with a 24 h urinary K excretion ≥93 mmol/d (group AP = adequate potassium) had greater self-reported K intakes, consumed more fruit and vegetables, had a more varied diet and had better HEI scores than those with a 24 h urinary K excretion <93 mmol/d (group IP = inadequate potassium). A significant positive correlation was seen between 24 h urinary K and dietary variety and the number of servings of fruits, vegetables and dairy products consumed, and between each of these and the HEI after correcting for age, sex, BMI, coefficient of activity, energy intake and the under-reporting of energy intake. AP participants were less likely to have an inadequate diet (HEI score <50) than IP participants (OR =0·439; 95 % CI 0·201, 0·961;P=0·039).

Conclusions

Diet quality, measured by the HEI, is correlated with 24 h urinary K excretion in Spanish adults.

Can Alzheimer's disease be prevented?

Alzheimer's disease (AD) is the most common form of dementia. Survival time for an AD patient is generally 4 to 6 years after diagnosis, however, survival time can be as long as 20 years from the detection of initial symptoms, which can surface in the 30s, 40s, and beyond. This window of opportunity suggests that many people can prolong their life with life-changing choices related to diet, exercise, nutritional supplements, and nutraceuticals. This was emphasized in many recent studies and was described in detail in the book "Minimizing the Risk of Alzheimer's Disease" published in the USA in 2012.

B Vitamins and Antioxidants Intake is Negatively Correlated with Risk of Stroke in Iran

BACKGROUND

Stroke is a leading cause of death in developed countries. However, current therapeutic strategies for stroke have been largely unsuccessful. Several studies have reported important benefits on reducing the risk of stroke and improving the post-stroke-associated functional declines in patients who ate foods rich in micronutrients, including B vitamins. Folic acid, vitamin B6, and vitamin B12 are all cofactors in homocysteine metabolism. Growing interest has been paid to hyperhomocyste inemia as a risk factor for stroke. Experimental studies suggest that oxidative stress plays an important role in the pathogenesis of ischemic cerebral injury, and higher intake of antioxidants has been associated with a lower risk of stroke in large population studies. The aim of this study was to examine whether the dietary intake of B vitamins and antioxidants in patients with stroke were comparatively worse than those in patients without stroke.

METHODS

In this case control study, 69 stroke patients (46 male, age = 56 ± 18 years and 23 female, age = 52 ± 7 years) admitted to Azzahra hospital between April 2009 and May 2010 were matched for age and sex with 60 patients (30 male and 30 female) from the same hospital who were not affected with acute cerebrovascular diseases and did not have a history of stroke. Dietary intake was assessed with a validated self-administered food frequency questionnaire (FFQ). FFQ was collected conducting face-to-face interview with one of the patients' close relatives. Food intakes, translated into nutrient data, were compared between the two groups and with the recommended values.

RESULTS

Intake of folic acid in men with stroke and vitamin B12 in women with stroke was significantly lower than that in the patients without stroke (P < 0.05), but there was no significant difference between the two groups in the level of antioxidant consumption in women and men (P > 0.05).

CONCLUSIONS

Our findings suggest that increased folic acid, vitamin B12, and vitamin E, C intake may be associated with decreased risk of stroke.

Dietary pattern, nutritional density, and dietary quality were low in patients with cerebral infarction in Korea

The aim of this study was to examine if the dietary quality of patients with cerebral infarction (CI) was comparatively worse than those of non-CI subjects in Korea. This case-control study included 146 subjects recruited between May and July 2007 from Kyung Hee University Medical Center (Seoul, Korea). The eating habits, nutritional adequacies, dietary patterns, and overall dietary quality of the subjects were investigated. Patients with CI more frequently skipped meals, had more irregular meal times, and preferred saltier and spicier foods than non-CI subjects. Nutritional densities (vitamin C, vitamin B(1), vitamin B(2), folate, and calcium) and overall dietary quality measures of CI subjects were lower than for non-CI subjects. Frequencies in omission of food groups, particularly the fruit and dairy groups, and the number of food items consumed daily by CI subjects were significantly lower than non-CI subjects (P < .01). After controlling for age, sex, disease, and other health-related factors, high dietary quality scores, especially the variety and adequacy components (desirable diet patterns and quality) had a lower CI incidence (P < .05). In conclusion, we found that Korean patients with CI had a comparatively worse diet quality. Therefore, we suggest active medical nutrition therapy for patients with CI in clinical settings to manage diet quality.