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

 

 

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