Healthy diet and lifestyle and risk of stroke in a prospective cohort of women.

Abstract

To investigate the association between a low-risk lifestyle and risk of stroke. The study population comprised 31,696 women, in the population-based Swedish Mammography Cohort who at baseline had completed a questionnaire about diet and lifestyle and were free from cardiovascular disease and cancer. We defined a low-risk lifestyle as a healthy diet (top 50% of a Recommended Food Score), moderate alcohol consumption (5-15 g/d), never smoking, physically active (walking/bicycling ≥40 min/d and exercise ≥1 h/wk), and body mass index below 25 kg/m(2). Stroke cases were identified from the Swedish National Patient Register and the Swedish Cause of Death Register. We ascertained 1,554 incident stroke cases, including 1,155 cerebral infarctions, 246 hemorrhagic strokes, and 153 unspecified strokes during 10.4 years of follow-up. The risk of stroke, in particular cerebral infarction, decreased steadily with increasing number of low-risk lifestyle factors. Compared with no low-risk factors, the multivariable relative risks (95% confidence interval) of cerebral infarction across increasing number of low-risk factors (1-5) were 0.72 (0.56-0.93), 0.67 (0.52-0.85), 0.57 (0.44-0.74), 0.54 (0.40-0.73), and 0.38 (0.20-0.73). These findings indicate that a low-risk lifestyle can substantially reduce the risk of stroke, especially cerebral infarction.