Risk Factors and Diet Components Determining Adherence to the Mediterranean Diet in Acute Ischemic Stroke Patients: A Cross-Sectional Analysis of a Prospective Hospital Register Study
Date
2021
Type:
Article
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Abstract
Objectives: Low adherence to a Mediterranean diet (MeDi) is associated with
increased incidence, mortality, and severity of acute ischemic strokes (AIS).
Nevertheless, the explanatory factors associated with such results are unclear.
Our aim was to investigate stroke risk factors associated with adherence to a
MeDi in a prospective cohort of AIS patients. Materials and Methods: Patients
admitted from February 2017 to February 2020 were included in this study.
Adherence was measured using the 14-point Mediterranean Diet Adherence
Screener (MEDAS). Demographic and clinical characteristics were compared
with adherence with a univariate analysis. A binomial regression was used to
investigate the independent association of premorbid factors and MeDi compo-
nents with adherence. Results: There were 413 patients. Mean age was 68.6
(17.4), 176 (42.6%) women. Median MEDAS score was 6 (IQR 47) points. 253
patients (61.2%) had a low adherence (MEDAS 6). In the univariate analysis,
a low MEDAS was associated with lower education, diabetes, sedentary life-
style, greater body mass index (BMI), lower alcohol consumption, and higher
LDLc. In the regression analysis, younger age, lower education, functional dis-
ability, hypertension, sedentary lifestyle, and higher BMI were associated with
lower MEDAS scores. Six MeDi components had particularly low patient
adherence: seafood, legumes, olive oil, nuts, wine, and fruit. Discussion: These
data indicate low adherence to MeDi in younger patients who are less educated
and have existing cardiovascular risk factors, in particular hypertension, sed-
entary lifestyle, and higher BMI. Some components of the diet had a particu-
larly low adherence. Conclusions: Tailoring diet prevention interventions to
these specific populations, focusing on components with known less adher-
ence, could improve adherence to a MeDi and the opportunity for secondary
stroke prevention.
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Citation
Olavarría, V. V., Navia, V. H., Mazzon, E., Rojo, A., Brunser, A. M., & Lavados, P. M. (2022). Risk Factors and Diet Components Determining Adherence to the Mediterranean Diet in Acute Ischemic Stroke Patients: A Cross-Sectional Analysis of a Prospective Hospital Register Study. Journal of Stroke and Cerebrovascular Diseases, 31(1). https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106154
Keywords
Mediterranean diet, Adherence, Ischemic stroke, Acute stroke, Risk factors