Dietary amino acids and risk of stroke subtypes: a prospective analysis of 356,000 participants in seven European countries
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Published:2023-10-07
Issue:1
Volume:63
Page:209-220
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ISSN:1436-6207
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Container-title:European Journal of Nutrition
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language:en
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Short-container-title:Eur J Nutr
Author:
Tong Tammy Y. N.ORCID, Clarke Robert, Schmidt Julie A., Huybrechts Inge, Noor Urwah, Forouhi Nita G., Imamura Fumiaki, Travis Ruth C., Weiderpass Elisabete, Aleksandrova Krasimira, Dahm Christina C., van der Schouw Yvonne T., Overvad Kim, Kyrø Cecilie, Tjønneland Anne, Kaaks Rudolf, Katzke Verena, Schiborn Catarina, Schulze Matthias B., Mayen-Chacon Ana-Lucia, Masala Giovanna, Sieri Sabina, de Magistris Maria Santucci, Tumino Rosario, Sacerdote Carlotta, Boer Jolanda M. A., Verschuren W. M. Monique, Brustad Magritt, Nøst Therese Haugdahl, Crous-Bou Marta, Petrova Dafina, Amiano Pilar, Huerta José María, Moreno-Iribas Conchi, Engström Gunnar, Melander Olle, Johansson Kristina, Lindvall Kristina, Aglago Elom K., Heath Alicia K., Butterworth Adam S., Danesh John, Key Timothy J.
Abstract
Abstract
Purpose
Previously reported associations of protein-rich foods with stroke subtypes have prompted interest in the assessment of individual amino acids. We examined the associations of dietary amino acids with risks of ischaemic and haemorrhagic stroke in the EPIC study.
Methods
We analysed data from 356,142 participants from seven European countries. Dietary intakes of 19 individual amino acids were assessed using validated country-specific dietary questionnaires, calibrated using additional 24-h dietary recalls. Multivariable-adjusted Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of ischaemic and haemorrhagic stroke in relation to the intake of each amino acid. The role of blood pressure as a potential mechanism was assessed in 267,642 (75%) participants.
Results
After a median follow-up of 12.9 years, 4295 participants had an ischaemic stroke and 1375 participants had a haemorrhagic stroke. After correction for multiple testing, a higher intake of proline (as a percent of total protein) was associated with a 12% lower risk of ischaemic stroke (HR per 1 SD higher intake 0.88; 95% CI 0.82, 0.94). The association persisted after mutual adjustment for all other amino acids, systolic and diastolic blood pressure. The inverse associations of isoleucine, leucine, valine, phenylalanine, threonine, tryptophan, glutamic acid, serine and tyrosine with ischaemic stroke were each attenuated with adjustment for proline intake. For haemorrhagic stroke, no statistically significant associations were observed in the continuous analyses after correcting for multiple testing.
Conclusion
Higher proline intake may be associated with a lower risk of ischaemic stroke, independent of other dietary amino acids and blood pressure.
Funder
Medical Research Council Cancer Research UK Wellcome Trust
Publisher
Springer Science and Business Media LLC
Subject
Nutrition and Dietetics,Medicine (miscellaneous)
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