Dietary Patterns in Relation to Stroke among Iranians: A Case-Control Study

Background: Although several studies have linked dietary patterns to the risk of stroke in Western countries, we are aware of no report in Middle Eastern populations with regard to this association. Objective: The aim of this study was to examine the association between major dietary patterns and risk of stroke among a group of Iranian population. Methods: In a hospital-based case-control study, 195 stroke patients, hospitalized in Alzahra University Hospital in 2008, were selected as cases and 195 control subjects from patients hospitalized in orthopedic or surgical wards with no history of cerebrovascular diseases or neurologic disorders were recruited. Usual dietary intakes of participants were assessed by means of a validated 168-item semiquantitative food frequency questionnaire. To identify major dietary patterns, principal component analysis was used and each participant received a factor score for each identified pattern. Results: We identified 3 major dietary patterns: high carbohydrate-low fat dietary pattern, sweet-fatty dietary pattern, and traditional dietary pattern. Those in the highest quartile of traditional dietary pattern were 4.48times more likely to have stroke compared to those in the lowest quartile. After adjustment for confounders, the association was attenuated. A significant association between high carbohydrate-low fat dietary pattern and stroke was also observed after controlling for potential confounding factors (odds ratio = 2.19, 95% confidence interval, 1.08-4.44). Consumption in the sweet-fatty food pattern was not associated with the risk of stroke either in crude or in adjusted models. Conclusion: Major dietary patterns identified by principal components analysis are significantly associated with stroke in a Middle Eastern population.