Epidemiology and Health

Original Articles

Associations between dietary risk factors and ischemic stroke: a comparison of regression methods using data from the Multi-Ethnic Study of Atherosclerosis: Seyed Saeed Hashemi Nazari, Yaser Mokhayeri, Mohammad Ali Mansournia, Soheila Khodakarim, Hamid Soori; Epidemiol Health. 2018;40:e2018021. Published online May 21, 2018; DOI: https://doi.org/10.4178/epih.e2018021

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Abstract

OBJECTIVES
We analyzed dietary patterns using reduced rank regression (RRR), and assessed how well the scores extracted by RRR predicted stroke in comparison to the scores produced by partial least squares and principal component regression models.

METHODS

Dietary data at baseline were used to extract dietary patterns using the 3 methods, along with 4 response variables: body mass index, fibrinogen, interleukin-6, and low-density lipoprotein cholesterol. The analyses were based on 5,468 males and females aged 45-84 years who had no clinical cardiovascular disease, using data from the Multi-Ethnic Study of Atherosclerosis.

RESULTS

The primary factor derived by RRR was positively associated with stroke incidence in both models. The first model was adjusted for sex and race and the second model was adjusted for the variables in model 1 as well as smoking, physical activity, family and sibling history of stroke, the use of any lipid-lowering medication, the use of any anti-hypertensive medication, hypertension, and history of myocardial infarction (model 1: hazard ratio [HR], 7.49; 95% confidence interval [CI], 1.66 to 33.69; p for trend=0.01; model 2: HR, 6.83; 95% CI, 1.51 to 30.87 for quintile 5 compared with the reference category; p for trend=0.02).

CONCLUSIONS

Based primarily on RRR, we identified that a dietary pattern high in fats and oils, poultry, non-diet soda, processed meat, tomatoes, legumes, chicken, tuna and egg salad, and fried potatoes and low in dark-yellow and cruciferous vegetables may increase the incidence of ischemic stroke.

Summary

Citations

Citations to this article as recorded by

Comparison of data-driven identified hypertension-protective dietary patterns among Chinese adults: based on a nationwide study
Yuxiang Yang, Wei Piao, Shuya Cai, Kun Huang, Changzheng Yuan, Xue Cheng, Ling Zhang, Yuge Li, Liyun Zhao, Dongmei Yu
European Journal of Nutrition.2023; 62(7): 2805. CrossRef
Associations between dietary patterns and cardiovascular disease risk in Canadian adults: a comparison of partial least squares, reduced rank regression, and the simplified dietary pattern technique
Svilena V Lazarova, Mahsa Jessri
The American Journal of Clinical Nutrition.2022; 116(2): 362. CrossRef
Association Between Dietary Quality Indices and Atherosclerosis Risk: A Case-Control Study
Mahsa Samadani, Anahita Mansoori, Habib Haybar, Fatemeh Haidari, Majid Mohammadshahi
Nutrition and Metabolic Insights.2022; 15: 117863882211119. CrossRef
Visceral adiposity-related dietary patterns and the risk of cardiovascular disease in Iranian adults: A population-based cohort study
Nazanin Moslehi, Fatemeh Rahimi Sakak, Maryam Mahdavi, Parvin Mirmiran, Fereidoun Azizi
Frontiers in Nutrition.2022;[Epub] CrossRef
Dietary patterns derived by reduced rank regression and non-communicable disease risk
Carmen Piernas, Min Gao, Susan A. Jebb
Proceedings of the Nutrition Society.2022; : 1. CrossRef
Dietary patterns related to cardiovascular disease based on reduced rank regression analysis of healthy middle-aged Koreans: data from the community-based Korean Genome and Epidemiology Study (KoGES) cohort
Hye Ah Lee, Hyoin An, EunJin Lee
The American Journal of Clinical Nutrition.2020; 111(6): 1159. CrossRef
Interaction between an ATP-Binding Cassette A1 (ABCA1) Variant and Egg Consumption for the Risk of Ischemic Stroke and Carotid Atherosclerosis: a Family-Based Study in the Chinese Population
Jing Song, Xia Jiang, Yaying Cao, Juan Juan, Tao Wu, Yonghua Hu
Journal of Atherosclerosis and Thrombosis.2019; 26(9): 835. CrossRef

Adjusting for reverse causation to estimate the effect of obesity on mortality after incident heart failure in the Atherosclerosis Risk in Communities (ARIC) study: Maryam Shakiba, Hamid Soori, Mohammad Ali Mansournia, Seyed Saeed Hashemi Nazari, Yahya Salimi; Epidemiol Health. 2016;38:e2016025. Published online June 4, 2016; DOI: https://doi.org/10.4178/epih.e2016025

15,852 View
243 Download
4 Web of Science
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Abstract PDF

Abstract

OBJECTIVES
The lower mortality rate of obese patients with heart failure (HF) has been partly attributed to reverse causation bias due to weight loss caused by disease. Using data about weight both before and after HF, this study aimed to adjust for reverse causation and examine the association of obesity both before and after HF with mortality.

METHODS

Using the Atherosclerosis Risk in Communities (ARIC) study, 308 patients with data available from before and after the incidence of HF were included. Pre-morbid and post-morbid obesity were defined based on body mass index measurements at least three months before and after incident HF. The associations of pre-morbid and post-morbid obesity and weight change with survival after HF were evaluated using a Cox proportional hazard model.

RESULTS

Pre-morbid obesity was associated with higher mortality (hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.04 to 2.49) but post-morbid obesity was associated with increased survival (HR, 0.57; 95% CI, 0.37 to 0.88). Adjusting for weight change due to disease as a confounder of the obesity-mortality relationship resulted in the absence of any significant associations between post-morbid obesity and mortality.

CONCLUSIONS

This study demonstrated that controlling for reverse causality by adjusting for the confounder of weight change may remove or reverse the protective effect of obesity on mortality among patients with incident HF.

Summary

Citations

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Nutrition, Metabolism and Cardiovascular Diseases.2024; 34(5): 1325. CrossRef
Impact of body mass index on cardiac adrenergic derangement in heart failure patients: a 123I-mIBG imaging study
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European Journal of Nuclear Medicine and Molecular Imaging.2020; 47(7): 1713. CrossRef
Impact of prior bariatric surgery on outcomes of hospitalized patients with heart failure: a population-based study
Hedong Han, Tiantian Zhu, Yibin Guo, Yiming Ruan, Eyal Herzog, Jia He
Surgery for Obesity and Related Diseases.2019; 15(3): 469. CrossRef
Body mass index and all-cause mortality in patients with atrial fibrillation: insights from the China atrial fibrillation registry study
Lu Wang, Xin Du, Jian-Zeng Dong, Wen-Na Liu, Ying-Chun Zhou, Song-Nan Li, Xue-Yuan Guo, Chen-Xi Jiang, Rong-Hui Yu, Cai-Hua Sang, Ri-Bo Tang, De-Yong Long, Nian Liu, Rong Bai, Laurent Macle, Chang-Sheng Ma
Clinical Research in Cardiology.2019; 108(12): 1371. CrossRef
The Effects of Reverse Causality and Selective Attrition on the Relationship Between Body Mass Index and Mortality in Postmenopausal Women
Hailey R Banack, Jennifer W Bea, Jay S Kaufman, Andrew Stokes, Candyce H Kroenke, Marcia L Stefanick, Shirley A Beresford, Chloe E Bird, Lorena Garcia, Robert Wallace, Robert A Wild, Bette Caan, Jean Wactawski-Wende
American Journal of Epidemiology.2019; 188(10): 1838. CrossRef

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