Fiber-rich diet can reduce ischaemic stroke risk, European-wide cohort study finds

24 Feb 2020 --- Increased daily fiber intake is associated with a 23 percent lower risk of ischaemic stroke, while extra egg consumption can lead to a 25 percent higher risk of hemorrhagic stroke. This is according to a newly published European cohort study, which investigated ischaemic stroke and hemorrhagic stroke separately, as opposed to previous studies conducting research on dietary intake and total stroke. Targeted dietary intervention may help patients prevent stroke risk more independently, as the World Health Organization (WHO) data indicates that cerebrovascular accidents are the second leading cause of death and the third leading cause of disability worldwide.

“The main finding from this study was that high intake of dietary fiber and fruit and vegetables was associated with lower risk of ischaemic stroke. Therefore, strategies from the nutrition industry to encourage consumption of these foods would be beneficial,” lead study author Dr. Tammy Tong, Nutritional Epidemiologist at the Nuffield Department of Population Health, University of Oxford, UK, tells NutritionInsight. 

Fruits and dairy consumption led to a lower risk of ischaemic stroke in the study.Given the observational nature of the study, Dr. Tong does not believe the study can inform national dietary guidelines just yet. However, she does encourage consumers to increase their consumption of these foods if they are not meeting the nutritional recommendations already.

Dr. Tong’s research team analyzed data from 418,329 women and men from Denmark, Germany, Greece, Italy, the Netherlands, Norway, Spain, Sweden and the UK who were recruited to the European Prospective Investigation into Cancer and Nutrition (EPIC) study between 1992 and 2000. During the follow-up period of 12.7 years, they reported a total of 4,281 incident cases of fatal or non-fatal ischaemic stroke, 1430 cases of hemorrhagic stroke and 7,378 cases of total stroke – ischaemic, hemorrhagic and unspecified combined.

You are what you eat
The study noted its participants reduced their ischaemic stroke risk by increasing their fiber intake from fruit, vegetables, cereal, legumes, nuts and seeds. Fruits and vegetables alone were associated with a 13 percent lower risk for every 200 g eaten daily. While no foods were linked to a statistically significant higher risk of ischaemic stroke, the study simultaneously observed a higher risk rate with greater red meat consumption.

Egg consumption was not only associated with higher risk of hemorrhagic stroke, but also marginally higher blood pressure and lower non-high density lipoprotein cholesterol (HDL-C). However, the study further notes that egg consumption in the study population was low overall, at less than 20 g per day, compared with an average large egg of 60 g.

The health benefits and risks of egg consumption have previously sparked a heated debate. A Finnish study from last May contradicts the current study’s findings, as it did not establish an association between an elevated risk of stroke and moderately high intake of dietary cholesterol, equivalent to the consumption of up to one egg per day.

“The health effects of eggs also require further study, as there has been limited evidence on the associations of eggs with hemorrhagic stroke previously and evidence on the other health effects of eggs has also been inconsistent,” Dr. Tong maintains. 

Meanwhile, high egg intake was linked to a higher risk of hemorrhagic stroke.Commenting on the study, Dr. Richard Francis, Head of Research at the Stroke Association, London, UK, notes that dietizing specific foods is not enough to prevent stroke risks. “Although this research found specific foods may be linked to risk of stroke, it’s better to look at your eating and drinking habits overall. It is not the case that removing one type of food, such as eggs, from your diet will stop you from having a stroke.”

Fiber fad
High fiber intake has been linked to lower risks of other health outcomes, including heart disease, diabetes and diverticular disease, Dr. Tong highlights. “Therefore, increasing fiber intake is likely to be beneficial for overall health and people should continue to be encouraged to incorporate more high fiber foods in their diets.” 

The use of fibers in food and beverage launches is increasing globally, featuring a 12 percent year-over-year growth when comparing 2018 and 2017 launches, according to Innova Market Insights data. In 2018, the top categories of global product launches tracked with fibers were Bakery (13 percent), Dairy (12 percent) and Desserts & Ice Cream (9 percent). 

Booming industry innovation in the fiber space is particularly due to its health halo. Earlier this year, Netherlands-based Fooditive launched a natural fiber sweetener produced from apple and pear leftovers. “As it is actually a fiber, it can easily leave the body without causing any harm,” Founder Moayad Abushokhedim told NutritionInsight.

Meanwhile, US-based natural fiber brand Bellway introduced a “next-generation” soluble fiber that is suitable for keto, paleo and gluten-free diets. Israeli company Galam recently showcased its novel prebiotic fiber ingredient at ProSweets in Cologne, Germany, which is touted for its potential in reducing sugar content as well as improving gut health.

By Anni Schleicher