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Dagelijks eten van groente en fruit verkleint
kans op beroertes met wel 25-35%.*
Eating fruits and green or
yellow vegetables daily may protect against both major types of stroke. The
findings are according to a study of Japanese people reported in yesterday's
rapid access issue of Stroke: Journal of the American Heart Association.
Previous prospective studies
indicated that vegetables and fruit might be protective, but the studies were
limited to one gender, one stroke type or to total stroke only.
There are two major types of
stroke. Hemorrhagic stroke occurs when a blood vessel ruptures within the brain.
Ischemic stroke, or cerebral infarction, results when a blood clot blocks a
blood vessel bringing oxygen and nutrients to the brain.
"The two main stroke
subtypes are actually two different diseases, with somewhat different risk
factors, but fruits and vegetables protect against both," said Catherine
Sauvaget, M.D., Ph.D., research scientist in epidemiology of the Radiation
Effects Research Foundation in Hiroshima, Japan.
This large analysis involved a
subset of participants in The Life Span Study, which tracked the health of
120,321 survivors of the atomic bombings at Hiroshima and Nagasaki since 1950.
Some participants had been exposed to radiation and some had not.
The 14,966 men (average age
54) and 23,471 women (average age 58) were all stroke-free. In 1980-81, they
completed questionnaires that included dietary and lifestyle factors,
socio-demographic information and medical history. Participants rated their
consumption of green-yellow vegetables and fruits such as spinach, carrots and
pumpkin as: "almost daily," "two - four times a week,"
"once or less per week," or "do not eat."
Death certificates were
examined for all who died during a follow-up period lasting until 1998. During
that time, she said 1,926 participants died of stroke: 48 percent from cerebral
infarction, 24 percent from intracerebral hemorrhage, 8 percent from
subarachnoid hemorrhage, in which a blood vessel on the brain's surface ruptures
and bleeds into the space between the skull and the brain, and 21 percent from
other cerebrovascular diseases eventually resulting in stroke.
Almost-daily consumption of
green-yellow vegetables reduced the risk of death from any stroke type by 26
percent, in both men and women, compared with those who ate vegetables no more
than once a week. Almost-daily fruit intake reduced the risk of stroke death by
35 percent in men and 25 percent in women. Frequent fruit and vegetable intake
protected against death from both cerebral infarction and intracerebral
hemorrhage, with a slightly stronger and clearer reduction in the risk of
cerebral infarction. Protective effects were similar in men and women.
People eating diets rich in
fruits and vegetables often have other healthy habits, Sauvaget said. However,
the lower risk was still present after adjusting the data for several other
factors, including weight, smoking and alcohol consumption, education,
consumption of animal products, and a history of hypertension, diabetes, or
heart attack.
The researchers acknowledge
that their study is limited by use of a one-time dietary questionnaire that
included a restricted number of food types and no information on portion size.
Although the study population
is unique in having been exposed to the atomic bombings in 1945, neither stroke
death nor dietary patterns were found to be related to radiation dose, the
researchers note. During the three decades, total strokes in Japan have
dramatically declined due to a drop in hemorrhagic strokes. However, cerebral
infarcts have increased.
Because the Japanese diet has
become more Westernized and the treatment of high blood pressure has improved,
Japanese stroke rates now resemble those of the United States and other Western
countries, Sauvaget notes.
"I think the results are
applicable to the general Japanese population," Sauvaget said.
Stroke is currently the
third-leading cause of death in the United States, and is a major cause of
serious, long- term disability.
Co-authors are Jun Nagano,
M.D., Ph.D.; Naomi Allen, Ph.D.; and Kazunori Kodama, M.D., Ph.D.
2003 American Heart Association