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Epidemiology and Health 2018;e2018021.
DOI: https://doi.org/10.4178/epih.e2018021    [Accepted] Published online May 21, 2018.
Association Between Dietary-related Risk Factors and Ischemic Stroke Using Reduced Rank Regression: The Multi-Ethnic Study of Atherosclerosis (MESA), USA
Seyed Saeed Hashemi Nazari1  , Yaser Mokhayeri1  , Mohammad Ali Mansournia4  , Soheila Khodakarim2  , Hamid Soori3 
1Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2Department of Epidemiology, School of Paramedical Science, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Correspondence  Yaser Mokhayeri ,Tel: (+98) 21 22431993 , Fax: (+98) 22432040, Email: yasermokhayeri@yahoo.com
Submitted: March 1, 2018  Accepted after revision: May 21, 2018
Some studies shed light on the association between dietary patterns and stroke, though, none of them applied reduced rank regression (RRR). Therefore, we sought to extract dietary patterns using RRR, and showed how well the extracted scores by RRR predict stroke in comparison to those scores produced by partial least squares (PLS) and principal components regression (PCR).
Diet data at baseline with four response variables including body mass index (BMI), fibrinogen, IL-6, low-density lipoprotein (LDL) cholesterol were used to extract dietary patterns. Analyses were based on 5468 men and women aged 45–84 y who had no clinical cardiovascular diseases (CVD) from Multi-Ethnic Study of Atherosclerosis (MESA). Dietary patterns were created by three methods: RRR, PLS, and PCR.
The RRR1 was positively associated with stroke incidence in both models (for model 1 hazard ratio (HR): 7.49; 95% CI: 1.66, 33.69 P for trend = 0.01 and for model 2 HR: 6.83; 95% CI: 1.51, 30.87 for quintile 5 compared with the reference category P for trend = 0.02). The RRR1, PLS1, and PCR1 were high in fats and oils, poultry, tomatoes, fried potato and processed meat. Additionally, RRR1 and PLS1 were high in dark-yellow and cruciferous vegetables which negatively were correlated with the first dietary pattern.
Mainly according to the RRR, we identified that a dietary pattern high in fats and oil, poultry, non-diet soda, processed meat, tomatoes, legumes, chicken, tuna and egg salad, fried potato and low in dark-yellow and cruciferous vegetables may increase the incidence of stroke.
Keywords: Stroke ; Risk Factors ; Diet


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