Adherence to the EAT-Lancet diet and risk of stroke and stroke subtypes: A Danish cohort study

Objective To investigate the association between adherence to the EAT-Lancet diet, a sustainable and mostly plant-based diet, and risk of stroke and subtypes of stroke in a Danish population. For comparison, we also investigated the Alternate Healthy Eating Index-2010 (AHEI). Methods We used the Danish Diet, Cancer and Health cohort (n=55,016) including adults aged 50-64 years at baseline (1993-1997). A food frequency questionnaire was used to assess dietary intake and group participants according to adherence to the diets. Stroke cases were identified using a national registry and subsequently validated by review of medical records (n=2253). Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for associations with the EAT-Lancet diet or the AHEI and risk of stroke and stroke subtypes. Results Adherence to the EAT-Lancet diet was associated with a lower risk of stroke, although not statistically significant (highest vs lowest adherence: HR 0.91; 95% CI 0.76, 1.09). A lower risk was observed for the AHEI (0.75; 0.64, 0.87). For stroke subtypes we found that adherence to the EAT-Lancet diet was associated with a lower risk of subarachnoid hemorrhage (0.30; 0.12, 0.73) and the AHEI was associated with a lower risk of ischemic stroke (0.76; 0.64, 0.90) and intracerebral hemorrhage (0.58; 0.36, 0.93). Conclusions Adherence to the EAT-Lancet diet was associated with a lower risk of subarachnoid stroke and the AHEI was associated with a lower risk of total stroke, mainly ischemic stroke and intracerebral hemorrhage.

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