• adult
• atherosclerosis
• cardiovascular disease
• clinical guideline
• counseling
• primary prevention
• risk assessment
• systematic review

• antioxidant activity
• cleaner label
• improvement of lipid profile
• lipid oxidation
• natural antioxidants
• prickly pear

• #2020/04544-9 and #2021/09467-5 São Paulo Research Foundation (FAPESP, Brazil)
• 001 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES)

• Diabetes
• Empagliflozin
• Mouse
• Sodium-glucose cotransporter 2 inhibitors
• Stroke recovery

• Humans
• Mice
• Animals
• Sodium-Glucose Transporter 2 Inhibitors/pharmacology
• Sodium-Glucose Transporter 2 Inhibitors/therapeutic use
• Diabetes Mellitus, Experimental/complications
• Diabetes Mellitus, Experimental/drug therapy
• Diabetes Mellitus, Type 2/complications
• Diabetes Mellitus, Type 2/drug therapy
• Diabetes Mellitus, Type 2/metabolism
• Glucosides/pharmacology
• Glucosides/therapeutic use
• Benzhydryl Compounds/pharmacology
• Benzhydryl Compounds/therapeutic use

• 2022-01273 Foundation for Geriatric Diseases at Karolinska Institutet
• 951953 ALF Stockholm
• 2022-00577 Swedish Medical Research Council
• Swedish Stroke Foundation
• Ulla Hamberg Angeby och Lennart Angebys Stiftelse
• Swedish Heart-Lung Foundation
• FANG Foundation and Hjärnfonden/The Swedish Brain Foundation
• Karolinska Institute

• Acquired brain injury
• Biomarkers
• Metabolomics
• Stroke
• Weight

• Adult
• Humans
• Vascular Endothelial Growth Factor A
• Stroke/diagnosis
• Stroke/prevention & control
• Healthy Lifestyle
• Life Style
• Biomarkers

• Mediterranean dietary pattern
• blood pressure
• cardiovascular risk
• salt
• sodium

• Cardiovascular disease
• Coronary heart disease
• Evidence grading
• Food group
• Hypertension

• Cardiovascular Diseases/epidemiology
• Cardiovascular Diseases/etiology
• Cardiovascular Diseases/prevention & control
• Diet/adverse effects
• Dietary Fiber
• Fruit
• Hypertension/epidemiology
• Hypertension/etiology
• Hypertension/prevention & control
• Risk Factors
• Humans
• Meta-Analysis as Topic

• diabetes
• dietary potassium
• glucose metabolism
• meta-analysis
• potassium consumption
• potassium intake

• Humans
• Prospective Studies
• Potassium, Dietary
• Risk Factors
• Diabetes Mellitus/epidemiology
• Diabetes Mellitus/prevention & control
• Surveys and Questionnaires

Diet and physical activity (PA) are modifiable risk factors thought to influence the risk of ischemic stroke (IS). However, few studies have examined their effect on different subtypes of IS.

To examine components of overall diet quality and different types of PA in relation to the risk of atherothrombotic IS (aIS).

The study population included 23,797 participants (mean age 58 years; 63% women) from the Malmö Diet and Cancer Study cohort. Participants were enrolled between 1991 and 1996 and followed until end of 2016 (median follow-up 21.5 years). Incident aIS events were identified using national registries (total cases 1,937). Measures of PA (total, leisure-time, occupational, and domestic) were assessed using a baseline questionnaire and dietary intakes were estimated using a modified diet history method. Overall diet quality was assessed using a diet quality index. Intake of key food groups and beverages associated with overall diet quality were investigated separately. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using multivariable Cox regression models adjusting for confounders.

A high diet quality with high intake of fruit and vegetables, fish and shellfish and low intake of sugar-sweetened beverages and red and processed meat compared to a low diet quality was associated with lower risk of aIS (HR = 0.82, 95% CI = 0.69–0.97; p = 0.015). Leisure-time PA was associated with reduced risk of aIS (HR = 0.95 per SD increase in MET-hours/week, 95% CI = 0.91–0.99; p = 0.028) with null associations observed for total, occupational and domestic PA level. We observed no significant interaction between diet and PA on the risk of aIS. The standardized 20-year risk of aIS among subjects with low leisure-time PA and low diet quality was 8.1% compared to 6.1% among those with high leisure-time PA and high diet quality.

Several components of a healthy diet and being physically active may reduce the risk of aIS, however, the absolute risk reduction observed was modest. A high diet quality seemed to have a risk reducing effect regardless of level of PA suggesting that individuals with a sedentary lifestyle may still gain some positive health benefits through a healthy diet.

• atherothrombotic ischemic stroke
• cohort study
• epidemiology
• healthy diet
• lifestyle
• physical activity

• Cancer
• Cardiovascular disease
• Dietary recommendations
• Healthy dietary patterns

• Cardiovascular Diseases/prevention & control
• Diet
• Heart Diseases/prevention & control
• Humans
• Neoplasms/epidemiology
• Neoplasms/prevention & control
• Nutritional Status
• Risk Factors

• Stroke
• brain ischemia
• gut microbiome
• pathophysiology
• preclinical models
• therapeutic target

• Nutritional quality
• Senatore Cappelli pasta
• food structure
• glycaemic index
• glycaemic load
• total polyphenols and total flavonoids

• Flour/analysis
• Nutritive Value
• Polyphenols
• Triticum
• Whole Grains

• Cardiovascular disease
• Diet
• Firefighters
• Heart disease
• Nutrition
• Wellness program

• Cardiovascular Diseases/epidemiology
• Cardiovascular Diseases/etiology
• Cardiovascular Diseases/prevention & control
• Eating
• Firefighters
• Humans
• Life Style
• Risk Factors

• alcohol
• epidemiologic evidence
• health outcomes
• meta-analysis
• umbrella review

• Humans
• Alcohol Drinking/adverse effects
• Alcohol Drinking/mortality
• Disease/etiology
• Mortality
• Outcome Assessment, Health Care
• Prospective Studies
• Meta-Analysis as Topic

Cerebral ischemic complications are common after revascularization in patients with moyamoya disease (MMD). Risk factors from specific laboratory variables have only been assessed by limited research. This study was to investigate the association between postoperative cerebral ischemia and nutritional blood parameters and examine predictive values of such risk factors in adults.

Preoperative demographics and nutritional blood parameters of patients with MMD who received revascularization at our institution from 2012 to 2021 were retrospectively reviewed. Univariate analysis and multivariable logistic regression were used to identify independent risk factors for the onset of postoperative cerebral ischemic complications. Predictive values were tested and a model incorporating these independent risk factors was created using the R program. Area under the receiver operating characteristic curve (AUC) was used for testing its discriminability.

Postoperative cerebral ischemic complications occurred in 32 patients of 100 included procedures. Surgery on the left hemisphere, lower admission modified Rankin Scale (mRS) score, aberrant nutritional parameters including low white blood cell (WBC), and high total cholesterol (TC) were significantly associated with cerebral ischemic complications after revascularization. The intriguing role of WBC might be explained by altered immunomodulation. The AUC of this model with novel nutritional parameters yielded a value of 0.811, presenting better predictive accuracy. Additionally, the model was visualized in the form of a nomogram and translated into a user-friendly calculator to generate individual risk.

Surgical side, admission mRS score, WBC, and TC were independent risk factors for postoperative cerebral ischemic complications. The model composed of these four parameters was promising to be adopted in clinical practice.

• National Natural Science Foundation of China

Excess sodium consumption and insufficient potassium intake contribute to high blood pressure and thus increase the risk of heart disease and stroke. In low-sodium salt, a portion of the sodium in salt (the amount varies, typically ranging from 10 to 50%) is replaced with minerals such as potassium chloride. Low-sodium salt may be an effective, scalable, and sustainable approach to reduce sodium and therefore reduce blood pressure and cardiovascular disease at the population level. Low-sodium salt programs have not been widely scaled up, although they have the potential to both reduce dietary sodium intake and increase dietary potassium intake. This article proposes a framework for a successful scale-up of low-sodium salt use in the home through four core strategies: availability, awareness and promotion, affordability, and advocacy. This framework identifies challenges and potential solutions within the core strategies to begin to understand the pathway to successful program implementation and evaluation of low-sodium salt use.

• cardiovascular disease
• hypertension
• low-sodium salt
• sodium
• sodium reduction

• Diet, Sodium-Restricted
• Health Promotion
• Hypertension/diet therapy
• Hypertension/prevention & control
• Potassium, Dietary/administration & dosage
• Sodium Chloride, Dietary/administration & dosage
• Sodium, Dietary/administration & dosage

• DPI
• Dietary phytochemical index
• case-control
• diet quality
• dietry intakes
• epidemiologic study
• food frequency questionnaire
• stroke

• aged
• cardiovascular diseases
• diabetes mellitus
• diet
• risk factors
• stroke

Risk factors for ischemic stroke is suggested to differ by etiologic subtypes. The purpose of this study was to examine the associations between modifiable and non-modifiable risk factors and atherothrombotic stroke (i.e., excluding cardioembolic stroke), and to examine if the potential benefit of modifiable lifestyle factors differs among subjects with and without predisposing comorbidities. After a median follow-up of 21.2 years, 2339 individuals were diagnosed with atherothrombotic stroke out of 26,547 study participants from the Malmö Diet and Cancer study. Using multivariable Cox regression, we examined non-modifiable (demographics and family history of stroke), semi-modifiable comorbidities (hypertension, dyslipidemia, diabetes mellitus and atherosclerotic disease), and modifiable (smoking, body mass index, diet quality, physical activity, and alcohol intake) risk factors in relation to atherothrombotic stroke. Higher age, male gender, family history of stroke, and low educational level increased the risk of atherothrombotic stroke as did predisposing comorbidities. Non-smoking (hazard ratio (HR) = 0.62, 95% confidence interval (CI) 0.56–0.68), high diet quality (HR = 0.83, 95% CI 0.72–0.97) and high leisure-time physical activity (HR = 0.89, 95% CI 0.80–0.98) decreased the risk of atherothrombotic ischemic stroke independent of established risk factors, with non-significant associations with body mass index and alcohol intake. The effect of the lifestyle factors was independent of predisposing comorbidities at baseline. The adverse effects of several cardiovascular risk factors were confirmed in this study of atherothrombotic stroke. Smoking cessation, improving diet quality and increasing physical activity level is likely to lower risk of atherothrombotic stroke in the general population as well as in patient groups at high risk.

• atherothrombotic
• diet
• epidemiology
• ischemic stroke
• lifestyle
• physical activity
• risk factors

• Outcome-wide
• Poultry
• Processed meat
• Prospective cohort study
• Red meat
• Risk
• UK Biobank

• Animals
• Biological Specimen Banks
• Female
• Humans
• Male
• Middle Aged
• Prospective Studies
• Red Meat/adverse effects
• Risk Factors
• United Kingdom

• MC_PC_17228 Medical Research Council
• 205212/Z/16/Z Wellcome Trust
• Wellcome Trust
• MR/M012190/1 MRF
• MR/M012190/1 Medical Research Council
• MC_QA137853 Medical Research Council
• C8211/A19170 Cancer Research UK
• 29017 Cancer Research UK
• C8221/A29017 Cancer Research UK
• 2019/1953 Cancer Research UK
• C60192/A28516 Cancer Research UK
• Medical Research Foundation

Neurological disorders pose a substantial health and economic burden to the individual and society, necessitating strategies for effective prevention and disease management. Lifestyle behaviours play a role in risk and management of some neurological disorders; however, overlap between lifestyle behaviours across disorders has not been well explored. We used log-binomial regression to assess associations of selected lifestyle behaviours in community-dwelling Australians (n = 192,091), some of whom self-reported Alzheimer’s disease (AD), motor neurone disease (MND), multiple sclerosis (MS), Parkinson’s disease (PD) or stroke. Of six lifestyle behaviours, undertaking physical activity was inversely associated with the presence of all neurological disorders except PD. Smoking was positively associated with MND and stroke, and inversely associated with PD. Participants with AD and stroke shared inverse associations with cognitive engagement, face-to-face social interaction and stress-reducing activities, and MS was positively associated with online social interaction and stress-reduction activities. Of eleven food and beverage consumption categories, no associations were seen in MND, ten categories were inversely associated with people with AD or stroke, and six of these with PD. Vegetable and soft drink consumption were associated with MS. Further detailed assessment of commonalities in lifestyle behaviours across neurological disorders may inform potential strategies for risk reduction across disorders.

• cross-sectional
• diet
• lifestyle behaviours
• neurological disorders
• population study

• Calcium
• Calcium dietary intake
• Calcium rich food
• Calcium supplements
• Clinical audit
• General population
• Vitamin D
• Vitamin D supplement

• Adult
• Aged
• Calcium/administration & dosage
• Calcium/deficiency
• Calcium, Dietary/administration & dosage
• Diet, Healthy
• Dietary Supplements
• Drug Prescriptions
• Drug Utilization
• Education, Medical, Continuing
• Feeding Behavior
• Female
• General Practitioners/education
• Health Knowledge, Attitudes, Practice
• Humans
• Italy
• Male
• Medical Audit
• Middle Aged
• Practice Patterns, Physicians'
• Recommended Dietary Allowances

The novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 has created a life-threatening world pandemic. Unfortunately, this disease can be worse in older patients or individuals with comorbidities, having dangerous consequences, including stroke. COVID-19–associated stroke widely increases the risk of death from COVID-19. In addition to the personal hygiene protocols and preventive policies, it has been proven that immune-compromised, oxidative, and pro-coagulant conditions make a person more susceptible to severe COVID-19 complications, such as stroke; one of the most effective and modifiable risk factors is poor nutritional status. Previous literature has shown that healthy dietary patterns, such as the Mediterranean diet, some food groups, and specific micronutrients, reduce the risk of ischemic and hemorrhagic stroke. In this work, for the first time, we hypothesized that a healthy diet could also be a protective/preventive factor against COVID-19–associated stroke risk. In order to prove this hypothesis, it is required to study nutritional intake and dietary patterns in patients suffering from COVID-19–associated stroke. If this hypothesis is proven, the chronic supportive role of a healthy diet in critical situations will be highlighted once again.

• COVID-19
• COVID-19–associated stroke
• Nutrition
• Dietary patterns
• Food group
• Inflammation

• Epidemiological survey
• Nephrolithiasis
• Osteoporosis

• Absorptiometry, Photon
• Adult
• Bone Density
• Female
• General Practice
• Humans
• Italy/epidemiology
• Longitudinal Studies
• Male
• Nephrolithiasis/epidemiology
• Osteoporosis/epidemiology
• Retrospective Studies

Idiopathic osteoporosis and nephrolithiasis are formidable health problems showing a progressive increase in their incidence and prevalence in the last decades. These temporal trends were observed in both pediatric and adult populations worldwide. Epidemiological and experimental studies indicate that both disorders show several common pathogenic environmental and genetic factors. In this review, we analyzed the clinical characteristics common to the two disorders and the state-of-the-art knowledge regarding the genetic predisposition and the environmental factors recognized as triggers in adult and pediatric ages. As a result of this work, we propose to consider idiopathic nephrolithiasis and osteoporosis as two possible expressions of a unique clinical syndrome. Accordingly, the clinical approach to both disorders should be modified in order to program an efficient primary and secondary prevention strategy.

• adult
• children
• nephrolithiasis
• osteoporosis

• Genetic Predisposition to Disease
• Humans
• Kidney Calculi/genetics
• Kidney Calculi/pathology
• Kidney Calculi/physiopathology
• Nephrolithiasis/etiology
• Nephrolithiasis/genetics
• Nephrolithiasis/physiopathology
• Osteoporosis/etiology
• Osteoporosis/genetics
• Osteoporosis/physiopathology
• Risk Factors

The aim of this study was to further examine the relationship between milk intake and stroke mortality among the Japanese population. We used data from the Japan Collaborative Cohort (JACC) Study (total number of participants = 110,585, age range: 40–79) to estimate the posterior acceleration factors (AF) as well as the hazard ratios (HR) comparing individuals with different milk intake frequencies against those who never consumed milk at the study baseline. These estimations were computed through a series of Bayesian survival models that employed a Markov Chain Monte Carlo simulation process. In total, 100,000 posterior samples were generated separately through four independent chains after model convergency was confirmed. Posterior probabilites that daily milk consumers had lower hazard or delayed mortality from strokes compared to non-consumers was 99.0% and 78.0% for men and women, respectively. Accordingly, the estimated posterior means of AF and HR for daily milk consumers were 0.88 (95% Credible Interval, CrI: 0.81, 0.96) and 0.80 (95% CrI: 0.69, 0.93) for men and 0.97 (95% CrI: 0.88, 1.10) and 0.95 (95% CrI: 0.80, 1.17) for women. In conclusion, data from the JACC study provided strong evidence that daily milk intake among Japanese men was associated with delayed and lower risk of mortality from stroke especially cerebral infarction.

• Bayesian survival anlysis
• JACC study
• milk intake
• mortality
• stroke
• time-to-event data

• Adult
• Aged
• Animals
• Bayes Theorem
• Diet/mortality
• Eating/physiology
• Female
• Humans
• Japan/epidemiology
• Male
• Markov Chains
• Middle Aged
• Milk/statistics & numerical data
• Proportional Hazards Models
• Risk Factors
• Stroke/mortality

• Review
• Stroke
• Young adults

• Diet
• Fibre
• Fruit
• Haemorrhagic stroke
• Ischaemic stroke
• Vegetables

• Animals
• Brain Ischemia/epidemiology
• Brain Ischemia/etiology
• Diet
• Dietary Fiber
• Europe/epidemiology
• Female
• Hemorrhagic Stroke
• Humans
• Male
• Prospective Studies
• Risk Factors
• Stroke/epidemiology
• Stroke/etiology

• RG/13/13/30194 British Heart Foundation
• 570/A16491 Cancer Research UK
• 268834 European Research Council
• G0401527 Medical Research Council
• G1000143 Medical Research Council
• 14136 Cancer Research UK
• Wellcome Trust
• 001 World Health Organization
• MR/M012190/1 Medical Research Council
• RG13/13/30194 British Heart Foundation
• C8221/A19170 Cancer Research UK
• MC_UU_00006/1 Medical Research Council
• MR/L003120/1 Medical Research Council
• G0700463 Medical Research Council
• G0800270 Medical Research Council
• MC_UU_12015/1 Medical Research Council
• MR/N003284/1 Medical Research Council
• SP/09/002 British Heart Foundation
• RG/08/014 British Heart Foundation
• MC_UU_12015/5 Medical Research Council
• MC_UU_00006/3 Medical Research Council
• 205212/Z/16/Z Wellcome Trust
• Our Planet Our Health, Livestock Environment and People
• European Union Framework 7
• National Institute of Health Research
• EU Sixth Framework Programme
• Medical Research Council Epidemiology Unit
• European Commission
• International Agency for Research on Cancer
• Danish Cancer Society
• Ligue Contre le Cancer, Institut Gustave Roussy
• Mutuelle Générale de l’Education Nationale
• Institut National de la Santé et de la Recherche Médicale
• German Cancer Aid, German Cancer Research Center
• Federal Ministry of Education and Research
• Deutsche Krebshilfe
• Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research
• Hellenic Health Foundation
• Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy
• National Research Council
• Dutch Ministry of Public Health, Welfare and Sports
• EPIC-Oxford
• NIHR
• Biomedical Research Centre Cambridge: Nutrition, Diet, and Lifestyle Research Theme
• MRC Epidemiology Unit Cambridge

The aim of this study is to evaluate the changes in the nutritional behavior of the Greek EPIC (European Prospective Investigation into Cancer and Nutrition) cohort participants regarding the consumption of basic food groups, during a 14-year period (1997–2011). In the Greek segment of the EPIC cohort study (EPIC-Greece), the changes in dietary habits of 23,505 participants regarding several food items/groups (vegetables, legumes, fruits, nuts, dairy, cereal, meat, fish/seafood, olive oil) were recorded repeatedly over time and compared to the baseline assessment (1994–1997), using a short, qualitative, follow-up questionnaire. Descriptive statistics were used to study the trends in nutritional behavior over time and ordinal logistic regression models to study the associations between the ordered responses of the questionnaire and sociodemographic and health factors. More participants reported an increase rather than a decrease in the consumption of vegetables, fruits, fish/seafood, whilst the inverse was observed for dairy products, nuts, cereals, and meat. No prevailing trend was noted for legumes and olive oil. Factors such as being female and having high education relate to more positive (healthy) changes in nutritional behavior. There seems to be primarily a change to a more healthy nutritional behavior of the EPIC-Greece participants over the follow-up period, with different participant subgroups presenting different degrees of nutritional changes.

• EPIC
• follow-up dietary data
• food questionnaire
• nutritional behavior
• ordinal regression

Naturopathy is a distinct system of traditional and complementary medicine recognized by the World Health Organization and defined by its philosophic approach to patient care, rather than the treatments used by practitioners. Worldwide, over 98 countries have practicing naturopaths, representing 36% of all countries and every world region. The contributions of naturopaths to healthcare delivery services internationally has not been previously examined. Thus, the primary intention of this research was to conduct an international survey of naturopathic practice and patient characteristics in order to gain insight to the breadth of their practices and the type of clinical conditions routinely encountered.

The cross-sectional study was conducted in naturopathic clinics in 14 countries within 4 world regions including the European (Portugal, United Kingdom, Switzerland, Spain), Americas (Canada, United States, Chile, Brazil), Western Pacific (Hong Kong, Australia, New Zealand) and African (South Africa). Naturopathic practitioners in each country were invited to prospectively complete an online survey for 20 consecutive cases. The survey was administered in four languages.

A total of 56 naturopaths from 14 countries participated in the study, providing a mean of 15.1 cases each (SD 7.6) and 851 cases in total. Most patients were female (72.6%) and all age categories were represented with a similar proportion for 36–45 years (20.2%), 46–55 years (19.5%), and 56–65 years (19.3%). A substantial majority (75%) of patients were considered by the participant to be presenting with chronic health conditions. The most prevalent category of health conditions were musculoskeletal (18.5%), gastrointestinal (12.2%), and mental illness (11.0%). The most common treatment categories prescribed or recommended to patients by the participants were dietary changes (60.5%), lifestyle and behaviour changes (56.9%), herbal medicines (54.2%) and nutritional supplements (52.1%). Many patients were known by participants to be receiving care from a general practitioner (43.2%) or a specialist medical practitioner (27.8%).

Naturopathic practitioners provide health care for diverse health conditions in patients in different age groups. The global population would benefit from researchers and policy makers paying closer attention to the potential risks, benefits, challenges and opportunities of the provision of naturopathic care within the community.

• Health services research
• Naturopathy
• Practice behaviours
• Primary care
• Survey

• bread
• breakfast
• diet
• meals
• yogurt

• geographical areas
• meta-analyses
• nutrition
• overview
• stroke

• General population
• Meal patterns
• Psychosocial factors
• Socioeconomic factors
• Whole grain

• Adolescent
• Adolescent Behavior
• Adult
• Aged
• Aged, 80 and over
• Child
• Child Behavior
• Child, Preschool
• Cross-Sectional Studies
• Diet, Healthy
• Educational Status
• Exercise
• Feeding Behavior
• Female
• Health Behavior
• Humans
• Italy
• Male
• Meals
• Middle Aged
• Nutrition Surveys
• Nutritive Value
• Recommended Dietary Allowances
• Screen Time
• Time Factors
• Whole Grains
• Young Adult

• Alcohol consumption
• alcohol-related diseases
• cancer
• hospitalization
• neurodegenerative diseases
• vascular diseases

• Cohort studies
• Hemorrhagic stroke
• Ischemic stroke
• Mediterranean diet
• Meta-analysis

• atherosclerosis
• cardiovascular disease
• endothelial dysfunction
• mediterranean diet
• olive oil
• oxidative stress
• reactive oxygen species

• Diet
• Humans
• Italy
• Nutritional Status
• Primary Prevention
• Stroke

• Diet
• Humans
• Nutritional Status
• Primary Prevention
• Stroke