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1. Cognitive Behavioral Therapy Reduces Benzodiazepine Anxiolytics Use in Japanese Patients with Mood and Anxiety Disorders: A Retrospective Observational Study

Author

Nakajima A, Kanie A, Ito M, Hirabayashi N, Imamura F, Takebayashi Y, and Horikoshi M

Subjects
psychiatric diseases, depression, acquired dependency, discontinuation, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571, Neurology. Diseases of the nervous system, RC346-429
Abstract

Aiichiro Nakajima,1 Ayako Kanie,1 Masaya Ito,1 Naotsugu Hirabayashi,2 Fumi Imamura,3 Yoshitake Takebayashi,1,4 Masaru Horikoshi1 1National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan; 2Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan; 3Department of Clinical Psychology, National Center of Neurology and Psychiatry, Tokyo, Japan; 4Department of Health Risk Communication, School of Medicine, Fukushima Medical University, Fukushima, JapanCorrespondence: Aiichiro NakajimaNational Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo 187-8551, JapanTel +81-42-341-2711Fax +81-42-346-1944Email aiichiro.nakajima@ncnp.go.jpPurpose: Benzodiazepines (BZDs) are prescribed to treat psychiatric diseases. However, many guidelines recommend limiting the use of BZDs because of side effects and lack of evidence regarding long-term efficacy. Moreover, reducing BZDs’ use is difficult because of dependency and the severity of withdrawal symptoms. The efficacy of cognitive behavioral therapy (CBT) for mood and anxiety disorders has been demonstrated. However, there is scant evidence that CBT has effectively reduced BZDs use, especially in Japan, where the BZDs prescription rate is high. Therefore, we sought to examine the impact of CBT on reducing BZDs use in a Japanese psychiatric setting.Patients and Methods: Participants were outpatients with mood and anxiety disorders who were prescribed BZD anxiolytics. We retrospectively reviewed changes in BZD anxiolytics prescription dosages during CBT (66 patients; mean number of CBT sessions, 14.6) from our hospital record between April 2015 and September 2017. We checked prescriptions at four time points: at first interview for judging adaptation of CBT (baseline), at the first CBT session, at the last CBT session, and 3 months after the last CBT session.Results: A total of 13 of 66 patients discontinued BZD anxiolytics during CBT, and 21 of 66 reduced their prescribed dosage by 50%. The association between discontinuation and dose-reduction and assessment period was modeled simultaneously using Bayesian hierarchical hurdle model. Results from the modeling showed a significant discontinuation at post-CBT and at 3 months post-CBT session compared to baseline (estimated median odds ratio [OR] post-CBT = 9.79 [95% CI: 4.65– 20.45]; OR at 3 months post-CBT = 11.53 [95% CI: 6.06– 22.33]). Moreover, a significant dose reduction was observed post-intervention (estimated median relative risk = 0.845 [95% CI: 0.729– 0.982]), with a median reduction of 1.7 mg (diazepam conversion) in BZD use.Conclusion: Our results suggest that CBT possibly aids in reducing and discontinuing BZD anxiolytics use for Japanese patients.Keywords: psychiatric diseases, depression, acquired dependency, discontinuation

Published
2020

2. Role of Polyunsaturated Fat in Modifying Cardiovascular Risk Associated With Family History of Cardiovascular Disease : Pooled De Novo Results From 15 Observational Studies

Author

Laguzzi, F., Åkesson, A., Marklund, Matti, Qian, F., Gigante, B., Bartz, T. M., Bassett, J. K., Birukov, A., Campos, H., Hirakawa, Y., Imamura, F., Jäger, S., Lankinen, M., Murphy, R. A., Senn, M., Tanaka, T., Tintle, N., Virtanen, J. K., Yamagishi, K., Allison, M., Brouwer, I. A., De Faire, U., Eiriksdottir, G., Ferrucci, L., Forouhi, N. G., Geleijnse, J. M., Hodge, A. M., Kimura, H., Laakso, M., Risérus, Ulf, van Westing, A. C., Bandinelli, S., Baylin, A., Giles, G. G., Gudnason, V., Iso, H., Lemaitre, R. N., Ninomiya, T., Post, W. S., Psaty, B. M., Salonen, J. T., Schulze, M. B., Tsai, M. Y., Uusitupa, M., Wareham, N. J., Oh, S.-W., Wood, A. C., Harris, W. S., Siscovick, D., Mozaffarian, D., Leander, K., Laguzzi, F., Åkesson, A., Marklund, Matti, Qian, F., Gigante, B., Bartz, T. M., Bassett, J. K., Birukov, A., Campos, H., Hirakawa, Y., Imamura, F., Jäger, S., Lankinen, M., Murphy, R. A., Senn, M., Tanaka, T., Tintle, N., Virtanen, J. K., Yamagishi, K., Allison, M., Brouwer, I. A., De Faire, U., Eiriksdottir, G., Ferrucci, L., Forouhi, N. G., Geleijnse, J. M., Hodge, A. M., Kimura, H., Laakso, M., Risérus, Ulf, van Westing, A. C., Bandinelli, S., Baylin, A., Giles, G. G., Gudnason, V., Iso, H., Lemaitre, R. N., Ninomiya, T., Post, W. S., Psaty, B. M., Salonen, J. T., Schulze, M. B., Tsai, M. Y., Uusitupa, M., Wareham, N. J., Oh, S.-W., Wood, A. C., Harris, W. S., Siscovick, D., Mozaffarian, D., and Leander, K.

Abstract

BACKGROUND: It is unknown whether dietary intake of polyunsaturated fatty acids (PUFA) modifies the cardiovascular disease (CVD) risk associated with a family history of CVD. We assessed interactions between biomarkers of low PUFA intake and a family history in relation to long-term CVD risk in a large consortium. METHODS: Blood and tissue PUFA data from 40 885 CVD-free adults were assessed. PUFA levels ≤25th percentile were considered to reflect low intake of linoleic, alpha-linolenic, and eicosapentaenoic/docosahexaenoic acids (EPA/DHA). Family history was defined as having ≥1 first-degree relative who experienced a CVD event. Relative risks with 95% CI of CVD were estimated using Cox regression and meta-analyzed. Interactions were assessed by analyzing product terms and calculating relative excess risk due to interaction. RESULTS: After multivariable adjustments, a significant interaction between low EPA/DHA and family history was observed (product term pooled RR, 1.09 [95% CI, 1.02-1.16]; P=0.01). The pooled relative risk of CVD associated with the combined exposure to low EPA/DHA, and family history was 1.41 (95% CI, 1.30-1.54), whereas it was 1.25 (95% CI, 1.16-1.33) for family history alone and 1.06 (95% CI, 0.98-1.14) for EPA/DHA alone, compared with those with neither exposure. The relative excess risk due to interaction results indicated no interactions. CONCLUSIONS: A significant interaction between biomarkers of low EPA/DHA intake, but not the other PUFA, and a family history was observed. This novel finding might suggest a need to emphasize the benefit of consuming oily fish for individuals with a family history of CVD.

Published
2024
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3. Replacement of saturated fatty acids from meat by dairy sources in relation to incident cardiovascular disease: The European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk study

Author

Vogtschmidt, Y.D., Soedamah-Muthu, S.S., Imamura, F., Givens, D.I., Lovegrove, J.A., Vogtschmidt, Y.D., Soedamah-Muthu, S.S., Imamura, F., Givens, D.I., and Lovegrove, J.A.

Abstract

Background Prospective observational data revealed lower cardiovascular disease (CVD) incidence with modeled replacement of saturated fatty acids (SFA) from total meat by total dairy, but it is unknown what the associations are of replacing SFA from types of meat by types of dairy with CVD incidence. Objectives This study aimed to investigate the associations of replacing SFA from total, red, processed, and poultry meat by SFA from total dairy, milk, cheese, and yogurt with the incidence of CVD. Methods We analyzed longitudinal data from 21,841 participants of the European Prospective Investigation into Cancer and Nutrition-Norfolk study (56.4% female; age, 40-79 years). Dietary data were collected by food frequency questionnaires at baseline (1993-1997). Incident fatal or nonfatal CVD (n = 5902), coronary artery disease (CAD; n = 4215), stroke (total: n = 2544; ischemic: n = 1113; hemorrhagic: n = 449) were identified up to 2018. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression for the risk associated with replacement of 2.5% of energy from SFA from meat by dairy, adjusted for sociodemographic, lifestyle, energy, dietary, and cardiometabolic factors. Results Replacing SFA from total meat by total dairy was associated with a lower CVD incidence (HR: 0.89; 95% CI: 0.82, 0.96) and CAD (HR: 0.88; 95% CI: 0.80, 0.96). Replacing SFA from processed meat by cheese was associated with lower CVD (HR: 0.77; 95% CI: 0.68, 0.88); CAD (HR: 0.77; 95% CI: 0.66, 0.90), and stroke (HR: 0.81; 95% CI: 0.67, 0.99). Similarly, replacing SFA from red meat by cheese was associated with lower CVD (HR: 0.86; 95% CI: 0.76, 0.97). Higher incidence of stroke was found with replacement of SFA from poultry by milk (HR: 2.06; 95% CI: 1.09, 3.89), yogurt (HR: 2.55; 95% CI: 1.27, 5.13), or cheese (HR: 1.96; 95% CI: 1.04, 3.70), but the CI were relatively large, owing to low, narrow range of poultry SFA intake.

Published
2024

4. Contributors

Author

Albertão, G.A., primary, Andrade, C., additional, Bourgeois, J., additional, Cita, M.B., additional, Costa, P.J.M., additional, Dawson, A.G., additional, Feist, L., additional, Fujino, S., additional, Fujiwara, O., additional, Goto, K., additional, Higman, B., additional, Ichihara, T., additional, Imamura, F., additional, Jarupongsakul, T., additional, Kamataki, T., additional, Keerthi, N., additional, Kunthasap, P., additional, Marini, F., additional, Martins, P.P., additional, Matsui, T., additional, Minoura, K., additional, Murayama, M., additional, Nanayama, F., additional, Naruse, H., additional, Nishimura, Y., additional, Reicherter, K., additional, Ruangrassamee, A., additional, Scheffers, A., additional, Shiki, T., additional, Stewart, I., additional, Sugawara, D., additional, Supharatid, S., additional, Suphawajruksakul, A., additional, Tachibana, T., additional, Tada, R., additional, Tajika, E., additional, Tsuji, Y., additional, and Yamazaki, T., additional

Published
2021
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7. 3.11 Densho Road Promotion Organization to transfer experiences and lessons

Author

Imamura, F.

Abstract

In the areas affected by the 2011 Tohoku Earthquake and tsunami, there are remains of earthquake disasters and traditional facilities scattered over a vast area spanning multiple prefectures in Tohoku, and it is not easy to visit them in a limited amount of time. Therefore, it is necessary to classify and provide information on traditional facilities, install guide maps and signs, and create a network so that visitors can visit and inspect facilities efficiently according to their purpose and time. The 3.11 Densho Road Promotion Organization, a general foundation, was started. In order to learn the lessons of the 2011, we aim to carry out various activities and projects related to disaster prevention by utilizing the network of disaster lore facilities. There are many remains and exhibition facilities for learning the actual situation and lessons of the disaster. Based on its facilities and networks, this promotion organization plays a central role in carrying out various initiatives and projects related to "learning" and "preparation" for disaster prevention, mitigation, and tsunamis. It is very important to convey the damage situation and experience of the great earthquake, the emergency response at the time, and the ongoing recovery and reconstruction activities both domestically and internationally and leave them to future generations.&nbsp, The 28th IUGG General Assembly (IUGG2023) (Berlin 2023)

Published
2023
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8. Effective visitor learning from disaster tourism in the 2011 Tohoku Earthquake and Tsunami

Author

Watanabe, Y., Sato, S., and Imamura, F.

Abstract

The importance of passing on lessons from the disaster has been emphasized in the areas affected by the 2011 Tohoku earthquake and tsunami. Since then, efforts have been made to promote the dissemination of disaster learning. However, it is unclear what kind of disaster education/learning is effective in changing behavior for disaster risk reduction and whether the content of effective disaster tourism differs depending on the content disseminated, visitors' interest, awareness of the disaster, preparedness, and the purpose of their visit. In this study, we aim to analyze the effectiveness of disaster learning and which contents of learning and experiences effectively change their actions to reduce disaster risk. We conducted an online survey among visitors (N=1,175) to the disaster-affected areas from the 2011 event to understand the contents of their learning and how their learning experience has influenced their actions to reduce their disaster risk. The main findings are as follows: 1) visiting the interior of the earthquake ruins, seeing the townscape that was cleared before the earthquake, and listening to the stories of locals who experienced the disaster was found to be most effective in promoting learning, regardless of the visitor's disaster preparedness or purpose; 2) informal and interactive interactions with locals who experienced the disaster may be effective for visitors whose purpose is not to learn about the disaster. Finally, two measures are proposed to enhance the effective communication of disaster memories and disaster risk reduction in the future., The 28th IUGG General Assembly (IUGG2023) (Berlin 2023)

Published
2023
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9. Proposal of disaster risk reduction learning program through interviews with disaster survivors at junior high school in the affected area

Author

Shinka, A., Sato, S., and Imamura, F.

Abstract

An appropriate tsunami evacuation behavior is effective in reducing human casualties from tsunamis. One of the ways to promote their behaviors is learning about disaster risk reduction especially preparedness before a disaster occurs. Thus, many elementary schools and junior high schools in Japan have been conducting disaster education programs to learn about disaster risks in their community. In this study, we incorporate interview survey into disaster education program and study the learning effects of interviewing residents who experienced disaster about their experiences at the time of a disaster to be shared for the future. By concentrating on the residents’ experiences during the disaster, it is expected that the interviewer will be able to relive the residents’ behavior during the disaster. Furthermore, the interviewed residents’ experiences of disasters are expected to provide lessons on what actions to take and how to prepare for disasters, and to improve individual disaster preparedness. In addition to learning disaster risk reduction, it is expected that students will acquire abilities necessary for living, such as the ability to understand people's stories and the ability to communicate with others, through interviews. By conducting a questionnaire survey before and after the disaster education and statistically analyzing, we will clarify the effects of the disaster education including interviews on the ability to cope with disasters and on other abilities necessary for students’ life., The 28th IUGG General Assembly (IUGG2023) (Berlin 2023)

Published
2023
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13. Field Survey of the 2003 Tokachi-Oki Earthquake Tsunami and Simulation at the Ootsu Harbor Located at the Pacific Coast of Hokkaido, Japan

Author

Tanioka, Y., Nishimura, Y., Hirakawa, K., Imamura, F., Abe, I., Abe, Y., Shindou, K., Matsutomi, H., Takahashi, T., Imai, K., Fujima, K., Harada, K., Namegaya, F., Hasegawa, Y., Hayashi, Y., Yoshikawa, A., Siga, T., Kamikawa, A., Kobayash, M., Masaka, S., Kamataki, T., Nanayama, F., Satake, K., Kawata, Y., Fukasawa, Y., Koshimura, S., Hada, Y., Azumai, Y., Hirata, K., and Satake, Kenji, editor

Published
2005
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20. Milk intake and incident stroke and CHD in populations of European descent: A Mendelian randomisation study

Author

Cardiovasculaire Epi Team 1, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Circulatory Health, Public Health Practice, Public Health Epidemiologie, Vissers, L. E.T., Sluijs, I., Burgess, S., Forouhi, N. G., Freisling, H., Imamura, F., Nilsson, T. K., Renström, F., Weiderpass, E., Aleksandrova, K., Dahm, C. C., Perez-Cornago, A., Schulze, M. B., Tong, T. Y.N., Aune, D., Bonet, C., Boeing, H., Chirlaque, M. D., Conchi, M. I., Imaz, L., Jäger, S., Krogh, V., Kyrø, C., Masala, G., Melander, O., Overvad, K., Panico, S., Sánches, M. J., Sonestedt, E., Tjønneland, A., Tzoulaki, I., Verschuren, W. M.M., Riboli, E., Wareham, N. J., Danesh, J., Butterworth, A. S., Van Der Schouw, Y. T., Cardiovasculaire Epi Team 1, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Circulatory Health, Public Health Practice, Public Health Epidemiologie, Vissers, L. E.T., Sluijs, I., Burgess, S., Forouhi, N. G., Freisling, H., Imamura, F., Nilsson, T. K., Renström, F., Weiderpass, E., Aleksandrova, K., Dahm, C. C., Perez-Cornago, A., Schulze, M. B., Tong, T. Y.N., Aune, D., Bonet, C., Boeing, H., Chirlaque, M. D., Conchi, M. I., Imaz, L., Jäger, S., Krogh, V., Kyrø, C., Masala, G., Melander, O., Overvad, K., Panico, S., Sánches, M. J., Sonestedt, E., Tjønneland, A., Tzoulaki, I., Verschuren, W. M.M., Riboli, E., Wareham, N. J., Danesh, J., Butterworth, A. S., and Van Der Schouw, Y. T.

Published
2022

27. Milk intake and incident stroke and coronary heart disease in populations of European descent: A Mendelian Randomization study

Author

Vissers, L.E.T., Sluijs, I., Burgess, S., Forouhi, N.G., Freisling, H., Imamura, F., Nilsson, Torbjörn K., Renström, Frida, Weiderpass, E., Aleksandrova, K., Dahm, C.C., Perez-Cornago, A., Schulze, M.B., Tong, T.Y.N., Aune, D., Bonet, C., Boer, J.M.A., Boeing, H., Chirlaque, M.D., Conchi, M.I., Imaz, L., Jäger, S., Krogh, V., Kyrø, C., Masala, G., Melander, O., Overvad, K., Panico, S., Sánches, M.J., Sonestedt, E., Tjønneland, A., Tzoulaki, I., Verschuren, W.M.M., Riboli, E., Wareham, N.J., Danesh, J., Butterworth, A.S., and Van Der Schouw, Y.T.

Subjects
Näringslära, Nutrition and Dietetics, CHD, Milk, Mendelian Randomization, dairy, stroke
Abstract

Higher milk intake has been associated with a lower stroke risk, but not with risk of coronary heart disease (CHD). Residual confounding or reverse causation cannot be excluded. Therefore, we estimated the causal association of milk consumption with stroke and CHD risk through instrumental variable (IV) and gene-outcome analyses. IV analysis included 29,328 participants (4,611 stroke; 9,828 CHD) of the EPIC-CVD (8 European countries) and EPIC-NL case-cohort studies. rs4988235, a lactase persistence (LP) single nucleotide polymorphism which enables digestion of lactose in adulthood was used as genetic instrument. Intake of milk was first regressed on rs4988235 in a linear regression model. Next, associations of genetically predicted milk consumption with stroke and CHD were estimated using Prentice-weighted Cox regression. Gene-outcome analysis included 777,024 participants (50,804 cases) from MEGASTROKE (including EPIC-CVD), UK Biobank and EPIC-NL for stroke, and 483,966 participants (61,612 cases) from CARDIoGRAM, UK Biobank and EPIC-CVD and EPIC-NL for CHD. In IV analyses, each additional LP allele was associated with a higher intake of milk in EPIC-CVD (β=13.7 g/day; 95%CI: 8.4-19.1) and EPIC-NL (36.8 g/day; 20.0-53.5). Genetically predicted milk intake was not associated with stroke (HR per 25 g/day 1.05; 95%CI: 0.94-1.16) or CHD (1.02; 0.96-1.08). In gene-outcome analyses, there was no association of rs4988235 with risk of stroke (odds ratios 1.02; 0.99-1.05) or CHD (0.99; 0.95-1.03). Current Mendelian Randomization analysis does not provide evidence for a causal inverse relationship between milk consumption and stroke or CHD risk. MEGASTROKE

Published
2021
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30. Milk intake and incident stroke and CHD in populations of European descent: a Mendelian randomisation study.

Author

Vissers, L. E. T., Sluijs, I., Burgess, S., Forouhi, N. G., Freisling, H., Imamura, F., Nilsson, T. K., Renström, F., Weiderpass, E., Aleksandrova, K., Dahm, C. C., Perez-Cornago, A., Schulze, M. B., Tong, T. Y. N., Aune, D., Bonet, C., Boer, J. M. A., Boeing, H., Chirlaque, M. D., and Conchi, M. I.

Subjects
CORONARY heart disease risk factors, STROKE risk factors, CARDIOVASCULAR diseases risk factors, RELATIVE medical risk, GENETICS, CONFIDENCE intervals, MILK, ALLELES, DAIRY products, RISK assessment, DESCRIPTIVE statistics, ODDS ratio, DATA analysis software, PROPORTIONAL hazards models
Abstract

Higher milk intake has been associated with a lower stroke risk, but not with risk of CHD. Residual confounding or reverse causation cannot be excluded. Therefore, we estimated the causal association of milk consumption with stroke and CHD risk through instrumental variable (IV) and gene-outcome analyses. IV analysis included 29 328 participants (4611 stroke; 9828 CHD) of the European Prospective Investigation into Cancer and Nutrition (EPIC)-CVD (eight European countries) and European Prospective Investigation into Cancer and Nutrition-Netherlands (EPIC-NL) case-cohort studies. rs4988235, a lactase persistence (LP) SNP which enables digestion of lactose in adulthood was used as genetic instrument. Intake of milk was first regressed on rs4988235 in a linear regression model. Next, associations of genetically predicted milk consumption with stroke and CHD were estimated using Prentice-weighted Cox regression. Gene-outcome analysis included 777 024 participants (50 804 cases) from MEGASTROKE (including EPIC-CVD), UK Biobank and EPIC-NL for stroke, and 483 966 participants (61 612 cases) from CARDIoGRAM, UK Biobank, EPIC-CVD and EPIC-NL for CHD. In IV analyses, each additional LP allele was associated with a higher intake of milk in EPIC-CVD (β = 13·7 g/d; 95 % CI 8·4, 19·1) and EPIC-NL (36·8 g/d; 95 % CI 20·0, 53·5). Genetically predicted milk intake was not associated with stroke (HR per 25 g/d 1·05; 95 % CI 0·94, 1·16) or CHD (1·02; 95 % CI 0·96, 1·08). In gene-outcome analyses, there was no association of rs4988235 with risk of stroke (OR 1·02; 95 % CI 0·99, 1·05) or CHD (OR 0·99; 95 % CI 0·95, 1·03). Current Mendelian randomisation analysis does not provide evidence for a causal inverse relationship between milk consumption and stroke or CHD risk. [ABSTRACT FROM AUTHOR]

Published
2022
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33. Milk intake and incident stroke and CHD in populations of European descent: a Mendelian randomisation study

Author

Vissers, L. E. T., primary, Sluijs, I., additional, Burgess, S., additional, Forouhi, N. G., additional, Freisling, H., additional, Imamura, F., additional, Nilsson, T. K., additional, Renström, F., additional, Weiderpass, E., additional, Aleksandrova, K., additional, Dahm, C. C., additional, Perez-Cornago, A., additional, Schulze, M. B., additional, Tong, T. Y. N., additional, Aune, D., additional, Bonet, C., additional, Boer, J. M. A., additional, Boeing, H., additional, Chirlaque, M. D., additional, Conchi, M. I., additional, Imaz, L., additional, Jäger, S., additional, Krogh, V., additional, Kyrø, C., additional, Masala, G., additional, Melander, O., additional, Overvad, K., additional, Panico, S., additional, Sánches, M. J., additional, Sonestedt, E., additional, Tjønneland, A., additional, Tzoulaki, I., additional, Verschuren, W. M. M., additional, Riboli, E., additional, Wareham, N. J., additional, Danesh, J., additional, Butterworth, A. S., additional, and van der Schouw, Y. T., additional

Published
2021
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34. Fatty acids in the de novo lipogenesis pathway and incidence of type 2 diabetes: A pooled analysis of prospective cohort studies.

Author

Imamura F., Fretts A.M., Marklund M., Ardisson Korat A.V., Yang W.-S., Lankinen M., Qureshi W., Helmer C., Chen T.-A., Virtanen J.K., Wong K., Bassett J.K., Murphy R., Tintle N., Yu C.I., Brouwer I.A., Chien K.-L., Chen Y.-Y., Wood A.C., del Gobbo L.C., Djousse L., Geleijnse J.M., Giles G.G., de Goede J., Gudnason V., Harris W.S., Hodge A., Hu F., Koulman A., Laakso M., Lind L., Lin H.-J., McKnight B., Rajaobelina K., Riserus U., Robinson J.G., Samieri C., Senn M., Siscovick D.S., Soedamah-Muthu S.S., Sotoodehnia N., Sun Q., Tsai M.Y., Tuomainen T.-P., Uusitupa M., Wagenknecht L.E., Wareham N.J., Wu J.H.Y., Micha R., Lemaitre R.N., Mozaffarian D., Forouhi N.G., Imamura F., Fretts A.M., Marklund M., Ardisson Korat A.V., Yang W.-S., Lankinen M., Qureshi W., Helmer C., Chen T.-A., Virtanen J.K., Wong K., Bassett J.K., Murphy R., Tintle N., Yu C.I., Brouwer I.A., Chien K.-L., Chen Y.-Y., Wood A.C., del Gobbo L.C., Djousse L., Geleijnse J.M., Giles G.G., de Goede J., Gudnason V., Harris W.S., Hodge A., Hu F., Koulman A., Laakso M., Lind L., Lin H.-J., McKnight B., Rajaobelina K., Riserus U., Robinson J.G., Samieri C., Senn M., Siscovick D.S., Soedamah-Muthu S.S., Sotoodehnia N., Sun Q., Tsai M.Y., Tuomainen T.-P., Uusitupa M., Wagenknecht L.E., Wareham N.J., Wu J.H.Y., Micha R., Lemaitre R.N., Mozaffarian D., and Forouhi N.G.

Abstract

Background De novo lipogenesis (DNL) is the primary metabolic pathway synthesizing fatty acids from carbohydrates, protein, or alcohol. Our aim was to examine associations of in vivo levels of selected fatty acids (16:0, 16:1n7, 18:0, 18:1n9) in DNL with incidence of type 2 diabetes (T2D). Methods and findings Seventeen cohorts from 12 countries (7 from Europe, 7 from the United States, 1 from Australia, 1 from Taiwan; baseline years = 1970-1973 to 2006-2010) conducted harmonized individual-level analyses of associations of DNL-related fatty acids with incident T2D. In total, we evaluated 65,225 participants (mean ages = 52.3-75.5 years; % women = 20.4%-62.3% in 12 cohorts recruiting both sexes) and 15,383 incident cases of T2D over the 9-year follow-up on average. Cohort-specific association of each of 16:0, 16:1n7, 18:0, and 18:1n9 with incident T2D was estimated, adjusted for demographic factors, socioeconomic characteristics, alcohol, smoking, physical activity, dyslipidemia, hypertension, menopausal status, and adiposity. Cohort-specific associations were meta-analyzed with an inverse-variance-weighted approach. Each of the 4 fatty acids positively related to incident T2D. Relative risks (RRs) per cohort-specific range between midpoints of the top and bottom quintiles of fatty acid concentrations were 1.53 (1.41-1.66; p < 0.001) for 16:0, 1.40 (1.33-1.48; p < 0.001) for 16:1n-7, 1.14 (1.05-1.22; p = 0.001) for 18:0, and 1.16 (1.07-1.25; p < 0.001) for 18:1n9. Heterogeneity was seen across cohorts (I2 = 51.1%-73.1% for each fatty acid) but not explained by lipid fractions and global geographical regions. Further adjusted for triglycerides (and 16:0 when appropriate) to evaluate associations independent of overall DNL, the associations remained significant for 16:0, 16:1n7, and 18:0 but were attenuated for 18:1n9 (RR = 1.03, 95% confidence interval (CI) = 0.94-1.13). These findings had limitations in potential reverse causation and residual confounding by impreci

Published
2021

35. N-3 fatty acid biomarkers and incident type 2 diabetes: An individual participant-level pooling project of 20 prospective cohort studies.

Author

Qian F., Ardisson Korat A.V., Imamura F., Marklund M., Tintle N., Virtanen J.K., Zhou X., Bassett J.K., Lai H., Hirakawa Y., Chien K.-L., Wood A.C., Lankinen M., Murphy R.A., Samieri C., Pertiwi K., de Mello V.D., Guan W., Forouhi N.G., Wareham N., Consortium I., Hu F.B., Riserus U., Lind L., Harris W.S., Shadyab A.H., Robinson J.G., Steffen L.M., Hodge A., Giles G.G., Ninomiya T., Uusitupa M., Tuomilehto J., Lindstrom J., Laakso M., Siscovick D.S., Helmer C., Geleijnse J.M., Wu J.H.Y., Fretts A., Lemaitre R.N., Micha R., Mozaffarian D., Sun Q., Qian F., Ardisson Korat A.V., Imamura F., Marklund M., Tintle N., Virtanen J.K., Zhou X., Bassett J.K., Lai H., Hirakawa Y., Chien K.-L., Wood A.C., Lankinen M., Murphy R.A., Samieri C., Pertiwi K., de Mello V.D., Guan W., Forouhi N.G., Wareham N., Consortium I., Hu F.B., Riserus U., Lind L., Harris W.S., Shadyab A.H., Robinson J.G., Steffen L.M., Hodge A., Giles G.G., Ninomiya T., Uusitupa M., Tuomilehto J., Lindstrom J., Laakso M., Siscovick D.S., Helmer C., Geleijnse J.M., Wu J.H.Y., Fretts A., Lemaitre R.N., Micha R., Mozaffarian D., and Sun Q.

Abstract

OBJECTIVE Prospective associations between n-3 fatty acid biomarkers and type 2 diabetes (T2D) risk are not consistent in individual studies. We aimed to summarize the prospective associations of biomarkers of a-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) with T2D risk through an individual participant-level pooled analysis. RESEARCH DESIGN AND METHODS For our analysis we incorporated data from a global consortium of 20 prospective studies from 14 countries. We included 65,147 participants who had blood measurements of ALA, EPA, DPA, or DHA and were free of diabetes at baseline. De novo harmonized analyses were performed in each cohort following a prespecified protocol, and cohort-specific associations were pooled using inverse variance-weighted meta-analysis. RESULTS A total of 16,693 incident T2D cases were identified during follow-up (median follow-up ranging from 2.5 to 21.2 years). In pooled multivariable analysis, per interquintile range (difference between the 90th and 10th percentiles for each fatty acid), EPA, DPA, DHA, and their sum were associated with lower T2D incidence, with hazard ratios (HRs) and 95% CIs of 0.92 (0.87, 0.96), 0.79 (0.73, 0.85), 0.82 (0.76, 0.89), and 0.81 (0.75, 0.88), respectively (all P < 0.001). ALA was not associated with T2D (HR 0.97 [95% CI 0.92, 1.02]) per interquintile range. Associations were robust across prespecified subgroups as well as in sensitivity analyses. CONCLUSIONS Highercirculating biomarkers of seafood-derivedn-3 fattyacids, including EPA,DPA, DHA, and their sum, were associated with lower risk of T2D in a global consortium of prospective studies. The biomarker of plant-derived ALA was not significantly associated with T2D risk.Copyright © 2021 by the American Diabetes Association.

Published
2021

36. n-3 Fatty Acid Biomarkers and Incident Type 2 Diabetes: An Individual Participant-Level Pooling Project of 20 Prospective Cohort Studies.

Author

Fretts A., Sun Q., Qian F., Ardisson Korat A.V., Imamura F., Marklund M., Tintle N., Mozaffarian D., Virtanen J.K., Zhou X., Bassett J.K., Lai H., Hirakawa Y., Chien K.-L., Wood A.C., Lankinen M., Murphy R.A., Samieri C., Micha R., Lemaitre R.N., Pertiwi K., de Mello V.D., Guan W., Forouhi N.G., Wareham N., Hu I.C.F.B., Riserus U., Lind L., Harris W.S., Shadyab A.H., Robinson J.G., Steffen L.M., Hodge A., Giles G.G., Ninomiya T., Uusitupa M., Tuomilehto J., Lindstrom J., Laakso M., Siscovick D.S., Helmer C., Geleijnse J.M., Wu J.H.Y., Fretts A., Sun Q., Qian F., Ardisson Korat A.V., Imamura F., Marklund M., Tintle N., Mozaffarian D., Virtanen J.K., Zhou X., Bassett J.K., Lai H., Hirakawa Y., Chien K.-L., Wood A.C., Lankinen M., Murphy R.A., Samieri C., Micha R., Lemaitre R.N., Pertiwi K., de Mello V.D., Guan W., Forouhi N.G., Wareham N., Hu I.C.F.B., Riserus U., Lind L., Harris W.S., Shadyab A.H., Robinson J.G., Steffen L.M., Hodge A., Giles G.G., Ninomiya T., Uusitupa M., Tuomilehto J., Lindstrom J., Laakso M., Siscovick D.S., Helmer C., Geleijnse J.M., and Wu J.H.Y.

Abstract

OBJECTIVE: Prospective associations between n-3 fatty acid biomarkers and type 2 diabetes (T2D) risk are not consistent in individual studies. We aimed to summarize the prospective associations of biomarkers of alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) with T2D risk through an individual participant-level pooled analysis. RESEARCH DESIGN AND METHODS: For our analysis we incorporated data from a global consortium of 20 prospective studies from 14 countries. We included 65,147 participants who had blood measurements of ALA, EPA, DPA, or DHA and were free of diabetes at baseline. De novo harmonized analyses were performed in each cohort following a prespecified protocol, and cohort-specific associations were pooled using inverse variance-weighted meta-analysis. RESULT(S): A total of 16,693 incident T2D cases were identified during follow-up (median follow-up ranging from 2.5 to 21.2 years). In pooled multivariable analysis, per interquintile range (difference between the 90th and 10th percentiles for each fatty acid), EPA, DPA, DHA, and their sum were associated with lower T2D incidence, with hazard ratios (HRs) and 95% CIs of 0.92 (0.87, 0.96), 0.79 (0.73, 0.85), 0.82 (0.76, 0.89), and 0.81 (0.75, 0.88), respectively (all P < 0.001). ALA was not associated with T2D (HR 0.97 [95% CI 0.92, 1.02]) per interquintile range. Associations were robust across prespecified subgroups as well as in sensitivity analyses. CONCLUSION(S): Higher circulating biomarkers of seafood-derived n-3 fatty acids, including EPA, DPA, DHA, and their sum, were associated with lower risk of T2D in a global consortium of prospective studies. The biomarker of plant-derived ALA was not significantly associated with T2D risk.Copyright © 2021 by the American Diabetes Association.

Published
2021

37. Associations of Total Legume, Pulse, and Soy Consumption with Incident Type 2 Diabetes: Federated Meta-Analysis of 27 Studies from Diverse World Regions

Author

Pearce, M, Fanidi, A, Bishop, TRP, Sharp, SJ, Imamura, F, Dietrich, S, Akbaraly, T, Bes-Rastrollo, M, Beulens, JWJ, Byberg, L, Canhada, S, Molina, MDCB, Chen, Z, Cortes-Valencia, A, Du, H, Duncan, BB, Harkanen, T, Hashemian, M, Kim, J, Kim, MK, Kim, Y, Knekt, P, Kromhout, D, Lassale, C, Lopez Ridaura, R, Magliano, DJ, Malekzadeh, R, Marques-Vidal, P, Angel Martinez-Gonzalez, M, O'Donoghue, G, O'Gorman, D, Shaw, JE, Soedamah-Muthu, SS, Stern, D, Wolk, A, Woo, HW, Wareham, NJ, Forouhi, NG, Pearce, M, Fanidi, A, Bishop, TRP, Sharp, SJ, Imamura, F, Dietrich, S, Akbaraly, T, Bes-Rastrollo, M, Beulens, JWJ, Byberg, L, Canhada, S, Molina, MDCB, Chen, Z, Cortes-Valencia, A, Du, H, Duncan, BB, Harkanen, T, Hashemian, M, Kim, J, Kim, MK, Kim, Y, Knekt, P, Kromhout, D, Lassale, C, Lopez Ridaura, R, Magliano, DJ, Malekzadeh, R, Marques-Vidal, P, Angel Martinez-Gonzalez, M, O'Donoghue, G, O'Gorman, D, Shaw, JE, Soedamah-Muthu, SS, Stern, D, Wolk, A, Woo, HW, Wareham, NJ, and Forouhi, NG

Abstract

BACKGROUND: The consumption of legumes is promoted as part of a healthy diet in many countries but associations of total and types of legume consumption with type 2 diabetes (T2D) are not well established. Analyses across diverse populations are lacking despite the availability of unpublished legume consumption data in prospective cohort studies. OBJECTIVE: To examine the prospective associations of total and types of legume intake with the risk of incident T2D. METHODS: Meta-analyses of associations between total legume, pulse, and soy consumption and T2D were conducted using a federated approach without physical data-pooling. Prospective cohorts were included if legume exposure and T2D outcome data were available and the cohort investigators agreed to participate. We estimated incidence rate ratios (IRRs) and CIs of associations using individual participant data including ≤42,473 incident cases among 807,785 adults without diabetes in 27 cohorts across the Americas, Eastern Mediterranean, Europe, and Western Pacific. Random-effects meta-analysis was used to combine effect estimates and estimate heterogeneity. RESULTS: Median total legume intake ranged from 0-140 g/d across cohorts. We observed a weak positive association between total legume consumption and T2D (IRR = 1.02, 95% CI: 1.01 to 1.04) per 20 g/d higher intake, with moderately high heterogeneity (I2 = 74%). Analysis by region showed no evidence of associations in the Americas, Eastern Mediterranean, and Western Pacific. The positive association in Europe (IRR = 1.05, 95% CI: 1.01 to 1.10, I2 = 82%) was mainly driven by studies from Germany, UK, and Sweden. No evidence of associations was observed for the consumption of pulses or soy. CONCLUSIONS: These findings suggest no evidence of an association of legume intakes with T2D in several world regions. The positive association observed in some European studies warrants further investigation relating to overall dietary contexts in which legumes are consumed

Published
2021

38. Blood n-3 fatty acid levels and total and cause-specific mortality from 17 prospective studies

Author

Harris, WS, Tintle, NL, Imamura, F, Qian, F, Korat, AVA, Marklund, M, Djousse, L, Bassett, JK, Carmichael, P-H, Chen, Y-Y, Hirakawa, Y, Kupers, LK, Laguzzi, F, Lankinen, M, Murphy, RA, Samieri, C, Senn, MK, Shi, P, Virtanen, JK, Brouwer, IA, Chien, K-L, Eiriksdottir, G, Forouhi, NG, Geleijnse, JM, Giles, GG, Gudnason, V, Helmer, C, Hodge, A, Jackson, R, Khaw, K-T, Laakso, M, Lai, H, Laurin, D, Leander, K, Lindsay, J, Micha, R, Mursu, J, Ninomiya, T, Post, W, Psaty, BM, Riserus, U, Robinson, JG, Shadyab, AH, Snetselaar, L, Sala-Vila, A, Sun, Y, Steffen, LM, Tsai, MY, Wareham, NJ, Wood, AC, Wu, JHY, Hu, F, Sun, Q, Siscovick, DS, Lemaitre, RN, Mozaffarian, D, Harris, WS, Tintle, NL, Imamura, F, Qian, F, Korat, AVA, Marklund, M, Djousse, L, Bassett, JK, Carmichael, P-H, Chen, Y-Y, Hirakawa, Y, Kupers, LK, Laguzzi, F, Lankinen, M, Murphy, RA, Samieri, C, Senn, MK, Shi, P, Virtanen, JK, Brouwer, IA, Chien, K-L, Eiriksdottir, G, Forouhi, NG, Geleijnse, JM, Giles, GG, Gudnason, V, Helmer, C, Hodge, A, Jackson, R, Khaw, K-T, Laakso, M, Lai, H, Laurin, D, Leander, K, Lindsay, J, Micha, R, Mursu, J, Ninomiya, T, Post, W, Psaty, BM, Riserus, U, Robinson, JG, Shadyab, AH, Snetselaar, L, Sala-Vila, A, Sun, Y, Steffen, LM, Tsai, MY, Wareham, NJ, Wood, AC, Wu, JHY, Hu, F, Sun, Q, Siscovick, DS, Lemaitre, RN, and Mozaffarian, D

Abstract

The health effects of omega-3 fatty acids have been controversial. Here we report the results of a de novo pooled analysis conducted with data from 17 prospective cohort studies examining the associations between blood omega-3 fatty acid levels and risk for all-cause mortality. Over a median of 16 years of follow-up, 15,720 deaths occurred among 42,466 individuals. We found that, after multivariable adjustment for relevant risk factors, risk for death from all causes was significantly lower (by 15-18%, at least p < 0.003) in the highest vs the lowest quintile for circulating long chain (20-22 carbon) omega-3 fatty acids (eicosapentaenoic, docosapentaenoic, and docosahexaenoic acids). Similar relationships were seen for death from cardiovascular disease, cancer and other causes. No associations were seen with the 18-carbon omega-3, alpha-linolenic acid. These findings suggest that higher circulating levels of marine n-3 PUFA are associated with a lower risk of premature death.

Published
2021

39. Evaluating Current Research Status and Identifying Most Important Future Research Themes

Author

Tatano, H., Collins, A., James, W., Kantoush, S., Li, W.i-S., Ishikawa, H., Sumi, T., Takara, K., Herath, S., Mosalam, K., Mori, J., Imamura, F., Yoshimura, R., Berryman, K., Chigira, M., Matsushi, Y., Peek, L., Samaddar, S., Onishi, M., De Groeve, T., Ono, Y., Scawthorn, C., Hochrainer-Stigler, S., Yokomatsu, M., Suzuki, K., Ayala, I., Maki, N., Hatayama, M., Tatano, H., Collins, A., James, W., Kantoush, S., Li, W.i-S., Ishikawa, H., Sumi, T., Takara, K., Herath, S., Mosalam, K., Mori, J., Imamura, F., Yoshimura, R., Berryman, K., Chigira, M., Matsushi, Y., Peek, L., Samaddar, S., Onishi, M., De Groeve, T., Ono, Y., Scawthorn, C., Hochrainer-Stigler, S., Yokomatsu, M., Suzuki, K., Ayala, I., Maki, N., and Hatayama, M.

Abstract

This chapter focuses on group discussion sessions targeting the Priority Areas of the Sendai Framework for Disaster Risk Reduction 2015–2030. Day one group discussion session efforts were on Priority Area One—Understanding Disaster Risks; and Day two emphasis was on Priority Areas 2, 3 and 4.

Published
2021

40. Associations of total legume, pulse, and soy consumption with incident type 2 diabetes: Federated meta-analysis of 27 studies from diverse world regions

Author

Pearce, M., Fanidi, A., Bishop, T.R.P., Sharp, S.J., Imamura, F., Dietrich, S., Akbaraly, T., Bes-Rastrollo, M., Beulens, J.W.J., Byberg, L., Canhada, S., Molina, M., Chen, Z., Cortes-Valencia, A., Du, H., Duncan, B.B., Harkanen, T., Hashemian, M., Kim, J., Kim, M.K., Kim, Y., Knekt, P., Kromhout, D., Lassale, C., Ridaura, R.L., Magliano, D.J., Malekzadeh, R., Marquez-Vidal, P., Martinez-Gonzalez, M.A., O'Donoghue, G., O'Gorman, D., Shaw, J.E., Soedamah-Muthu, S.S., Stern, D., Wolk, A., Woo, H.W., Wareham, N.J., Forouhi, N.G., Pearce, M., Fanidi, A., Bishop, T.R.P., Sharp, S.J., Imamura, F., Dietrich, S., Akbaraly, T., Bes-Rastrollo, M., Beulens, J.W.J., Byberg, L., Canhada, S., Molina, M., Chen, Z., Cortes-Valencia, A., Du, H., Duncan, B.B., Harkanen, T., Hashemian, M., Kim, J., Kim, M.K., Kim, Y., Knekt, P., Kromhout, D., Lassale, C., Ridaura, R.L., Magliano, D.J., Malekzadeh, R., Marquez-Vidal, P., Martinez-Gonzalez, M.A., O'Donoghue, G., O'Gorman, D., Shaw, J.E., Soedamah-Muthu, S.S., Stern, D., Wolk, A., Woo, H.W., Wareham, N.J., and Forouhi, N.G.

Abstract

Background The consumption of legumes is promoted as part of a healthy diet in many countries but associations of total and types of legume consumption with type 2 diabetes (T2D) are not well established. Analyses across diverse populations are lacking despite the availability of unpublished legume consumption data in prospective cohort studies. Objective To examine the prospective associations of total and types of legume intake with the risk of incident T2D. Methods Meta-analyses of associations between total legume, pulse, and soy consumption and T2D were conducted using a federated approach without physical data-pooling. Prospective cohorts were included if legume exposure and T2D outcome data were available and the cohort investigators agreed to participate. We estimated incidence rate ratios (IRRs) and CIs of associations using individual participant data including ≤42,473 incident cases among 807,785 adults without diabetes in 27 cohorts across the Americas, Eastern Mediterranean, Europe, and Western Pacific. Random-effects meta-analysis was used to combine effect estimates and estimate heterogeneity. Results Median total legume intake ranged from 0–140 g/d across cohorts. We observed a weak positive association between total legume consumption and T2D (IRR = 1.02, 95% CI: 1.01 to 1.04) per 20 g/d higher intake, with moderately high heterogeneity (I2 = 74%). Analysis by region showed no evidence of associations in the Americas, Eastern Mediterranean, and Western Pacific. The positive association in Europe (IRR = 1.05, 95% CI: 1.01 to 1.10, I2 = 82%) was mainly driven by studies from Germany, UK, and Sweden. No evidence of associations was observed for the consumption of pulses or soy. Conclusions These findings suggest no evidence of an association of legume intakes with T2D in several world regions. The positive association observed in some European studies warrants further investigation relating to ove

Published
2021

45. CONTRIBUTORS

Author

Albertão, G.A., primary, Bourgeois, J., additional, Cita, M.B., additional, Dawson, A.G., additional, Fujino, S., additional, Fujiwara, O., additional, Goto, K., additional, Helsley, C.E., additional, Higman, B., additional, Ichihara, T., additional, Imamura, F., additional, Jarupongsakul, T., additional, Kamataki, T., additional, Keating, B.H., additional, Keerthi, N., additional, Kunthasap, P., additional, Marini, F., additional, Martins, P.P., additional, Matsui, T., additional, Minoura, K., additional, Murayama, M., additional, Nanayama, F., additional, Naruse, H., additional, Nishimura, Y., additional, Ruangrassamee, A., additional, Scheffers, A., additional, Shiki, T., additional, Stewart, I., additional, Sugawara, D., additional, Supharatid, S., additional, Suphawajruksakul, A., additional, Tachibana, T., additional, Tada, R., additional, Tajika, E., additional, Tsuji, Y., additional, Wanink, M., additional, and Yamazaki, T., additional

Published
2008
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49. Frühe Clearance von Plasma-EGFR-Mutationen als Prädiktor für das Ansprechen auf Osimertinib und Vergleichs-EGFR-TKIs in der FLAURA-Studie

Author

Bohnet, S, additional, Zhou, C, additional, Imamura, F, additional, Cheng, Y, additional, Okamoto, I, additional, Cho, BC, additional, Lin, MC, additional, Majem, M, additional, Gautschi, O, additional, Gray, JE, additional, Boyer, MJ, additional, Chmielecki, J, additional, Hartmaier, R, additional, Bulusu, K, additional, Barrett, JC, additional, Hodge, R, additional, Saggese, M, additional, McKeown, A, additional, Ramalingam, SS, additional, and Bischoff, H, additional

Published
2020
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50. The associations of major foods and fibre with risks of ischaemic and haemorrhagic stroke: A prospective study of 418 329 participants in the EPIC cohort across nine European countries

Author

Tong, T.Y.N. Appleby, P.N. Key, T.J. Dahm, C.C. Overvad, K. Olsen, A. Tjønneland, A. Katzke, V. Kühn, T. Boeing, H. Karakatsani, A. Peppa, E. Trichopoulou, A. Weiderpass, E. Masala, G. Grioni, S. Panico, S. Tumino, R. Boer, J.M.A. Verschuren, W.M.M. Quirós, J.R. Agudo, A. Rodríguez-Barranco, M. Imaz, L. Chirlaque, M.-D. Moreno-Iribas, C. Engström, G. Sonestedt, E. Lind, M. Otten, J. Khaw, K.-T. Aune, D. Riboli, E. Wareham, N.J. Imamura, F. Forouhi, N.G. Di Angelantonio, E. Wood, A.M. Butterworth, A.S. Perez-Cornago, A.

Abstract

Aim: To investigate the associations between major foods and dietary fibre with subtypes of stroke in a large prospective cohort. Methods and results: We analysed data on 418 329 men and women from nine European countries, with an average of 12.7 years of follow-up. Diet was assessed using validated country-specific questionnaires which asked about habitual intake over the past year, calibrated using 24-h recalls. Multivariable-adjusted Cox regressions were used to estimate hazard ratios (HRs) for ischaemic and haemorrhagic stroke associated with consumption of red and processed meat, poultry, fish, dairy foods, eggs, cereals, fruit and vegetables, legumes, nuts and seeds, and dietary fibre. For ischaemic stroke (4281 cases), lower risks were observed with higher consumption of fruit and vegetables combined (HR; 95% CI per 200 g/day higher intake, 0.87; 0.82-0.93, P-trend < 0.001), dietary fibre (per 10 g/day, 0.77; 0.69-0.86, P-trend < 0.001), milk (per 200 g/day, 0.95; 0.91-0.99, P-trend = 0.02), yogurt (per 100 g/day, 0.91; 0.85-0.97, P-trend = 0.004), and cheese (per 30 g/day, 0.88; 0.81-0.97, P-trend = 0.008), while higher risk was observed with higher red meat consumption which attenuated when adjusted for the other statistically significant foods (per 50 g/day, 1.07; 0.96-1.20, P-trend = 0.20). For haemorrhagic stroke (1430 cases), higher risk was associated with higher egg consumption (per 20 g/day, 1.25; 1.09-1.43, P-trend = 0.002). Conclusion: Risk of ischaemic stroke was inversely associated with consumption of fruit and vegetables, dietary fibre, and dairy foods, while risk of haemorrhagic stroke was positively associated with egg consumption. The apparent differences in the associations highlight the importance of examining ischaemic and haemorrhagic stroke subtypes separately. © 2020 The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.

Published
2020

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