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dc.contributor.authorTong, Tammy Y. N.
dc.contributor.authorClarke, Robert Michael
dc.contributor.authorSchmidt, Julie A.
dc.contributor.authorHuybrechts, Inge
dc.contributor.authorNoor, Urwah
dc.contributor.authorForouhi, Nita G.
dc.contributor.authorImamura, Fumiaki
dc.contributor.authorTravis, Ruth C.
dc.contributor.authorWeiderpass Vainio, Elisabete
dc.contributor.authorAleksandrova, Krasimira
dc.contributor.authorDahm, Christina C.
dc.contributor.authorvan der Schouw, Yvonne T.
dc.contributor.authorOvervad, Kim
dc.contributor.authorKyrø, Cecilie
dc.contributor.authorTjønneland, Anne
dc.contributor.authorKaaks, Rudolf
dc.contributor.authorKatzke, Verena
dc.contributor.authorSchiborn, Catarina
dc.contributor.authorSchulze, Matthias B.
dc.contributor.authorMayen-Chacon, Ana-Lucia
dc.contributor.authorMasala, Giovanna
dc.contributor.authorSieri, Sabina
dc.contributor.authorde Magistris, Maria Santucci
dc.contributor.authorTumino, Rosario
dc.contributor.authorSacerdote, Carlotta
dc.contributor.authorBoer, Jolanda M. A.
dc.contributor.authorVerschuren, W. M. Monique
dc.contributor.authorBrustad, Magritt
dc.contributor.authorNøst, Therese Haugdahl
dc.contributor.authorCrous-Bou, Marta
dc.contributor.authorPetrova, Dafina
dc.contributor.authorAmiano, Pilar
dc.contributor.authorHuerta, José María
dc.contributor.authorMoreno-Iribas, Conchi
dc.contributor.authorEngström, Gunnar
dc.contributor.authorMelander, Olle
dc.contributor.authorJohansson, Kristina
dc.contributor.authorLindvall, Kristina
dc.contributor.authorAglago, Elom K.
dc.contributor.authorHeath, Alicia K.
dc.contributor.authorButterworth, Adam S.
dc.contributor.authorDanesh, John
dc.contributor.authorKey, Timothy J.
dc.date.accessioned2023-12-04T14:12:21Z
dc.date.available2023-12-04T14:12:21Z
dc.date.issued2023-10-07
dc.description.abstractPurpose - Previously reported associations of protein-rich foods with stroke subtypes have prompted interest in the assessment of individual amino acids. We examined the associations of dietary amino acids with risks of ischaemic and haemorrhagic stroke in the EPIC study.<p> <p>Methods - We analysed data from 356,142 participants from seven European countries. Dietary intakes of 19 individual amino acids were assessed using validated country-specific dietary questionnaires, calibrated using additional 24-h dietary recalls. Multivariable-adjusted Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of ischaemic and haemorrhagic stroke in relation to the intake of each amino acid. The role of blood pressure as a potential mechanism was assessed in 267,642 (75%) participants.<p> <p>Results - After a median follow-up of 12.9 years, 4295 participants had an ischaemic stroke and 1375 participants had a haemorrhagic stroke. After correction for multiple testing, a higher intake of proline (as a percent of total protein) was associated with a 12% lower risk of ischaemic stroke (HR per 1 SD higher intake 0.88; 95% CI 0.82, 0.94). The association persisted after mutual adjustment for all other amino acids, systolic and diastolic blood pressure. The inverse associations of isoleucine, leucine, valine, phenylalanine, threonine, tryptophan, glutamic acid, serine and tyrosine with ischaemic stroke were each attenuated with adjustment for proline intake. For haemorrhagic stroke, no statistically significant associations were observed in the continuous analyses after correcting for multiple testing.<p> <p>Conclusion - Higher proline intake may be associated with a lower risk of ischaemic stroke, independent of other dietary amino acids and blood pressure.en_US
dc.identifier.citationTong, Clarke, Schmidt, Huybrechts, Noor, Forouhi, Imamura, Travis, Weiderpass Vainio, Aleksandrova, Dahm, van der Schouw, Overvad, Kyrø, Tjønneland, Kaaks, Katzke, Schiborn, Schulze, Mayen-Chacon, Masala, Sieri, de Magistris, Tumino, Sacerdote, Boer, Verschuren, Brustad, Nøst, Crous-Bou, Petrova, Amiano, Huerta, Moreno-Iribas, Engström, Melander, Johansson, Lindvall, Aglago, Heath, Butterworth, Danesh, Key. Dietary amino acids and risk of stroke subtypes: a prospective analysis of 356,000 participants in seven European countries. European Journal of Nutrition. 2023en_US
dc.identifier.cristinIDFRIDAID 2189748
dc.identifier.doi10.1007/s00394-023-03251-4
dc.identifier.issn1436-6207
dc.identifier.issn1436-6215
dc.identifier.urihttps://hdl.handle.net/10037/31920
dc.language.isoengen_US
dc.publisherSpringer Natureen_US
dc.relation.journalEuropean Journal of Nutrition
dc.relation.projectIDinfo:eu-repo/grantAgreement/EC/FP7-HEALTH/279233/Norway/EPIC-CVD: Individualised CVD risk assessment: tailoring targeted and cost-effective approaches to Europe's diverse populations/EPIC-CVD/en_US
dc.relation.projectIDinfo:eu-repo/grantAgreement/EC/FP6/?/?/?/?/en_US
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2023 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0en_US
dc.rightsAttribution 4.0 International (CC BY 4.0)en_US
dc.titleDietary amino acids and risk of stroke subtypes: a prospective analysis of 356,000 participants in seven European countriesen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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