STROKE:较大量膳食纤维摄入或降低首次卒中危险

　　英国一项荟萃分析表明，较大量的膳食纤维摄入与首次卒中危险降低显著相关。研究进一步支持了增加总体膳食纤维摄入的饮食推荐。但有关纤维类型与卒中关系的资料匮乏，有必要对上述关系进行进一步的研究，以分别明确缺血性和出血性卒中的危险与纤维类型的关系。相关论文3月28日在线发表于《卒中》（Stroke）。
研究者在多个电子数据库查询了于1990—1012年发表的关于健康受试者纤维摄入与首次缺血性或出血性卒中发病的相关性研究。结果共纳入8项队列研究，这些研究来自美国、北欧、澳大利亚和日本。
研究者发现，总体膳食纤维摄入与出血性和缺血性卒中发生危险呈负相关，研究间有一定的异质性。4 g/d可溶的纤维摄入与卒中危险降低不相关，研究间具有低异质性，相对危险度为0.94。鲜有研究显示卒中危险降低与可溶纤维或来自谷物、水果及蔬菜的纤维有关。
与卒中相关的拓展阅读：

• 维生素D缺乏卒中患者或更易他汀不耐受
• 卒中前应用他汀可改善老年患者短期转归
• Neurology：和肽素有助判断缺血性卒中的预后
• Stroke：血管内卒中治疗合用替罗非班增加脑出血风险
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Dietary Fiber Intake and Risk of First Stroke: A Systematic Review and Meta-Analysis.
BACKGROUND AND PURPOSE
Fiber intake is associated with reduced stroke risk in prospective studies, but no meta-analysis has been published to date.
METHODS
Multiple electronic databases were searched for healthy participant studies reporting fiber intake and incidence of first hemorrhagic or ischemic stroke, published between January 1990 and May 2012.
RESULTS
Eight cohort studies from the United States, northern Europe, Australia, and Japan met inclusion criteria. Total dietary fiber intake was inversely associated with risk of hemorrhagic plus ischemic stroke, with some evidence of heterogeneity between studies (I2; relative risk per 7 g/day, 0.93; 95% confidence interval, 0.88-0.98; I2=59%). Soluble fiber intake, per 4 g/day, was not associated with stroke risk reduction with evidence of low heterogeneity between studies, relative risk 0.94 (95% confidence interval, 0.88-1.01; I2=21%). There were few studies reporting stroke risk in relation to insoluble fiber or fiber from cereals, fruit, or vegetables.
CONCLUSIONS
Greater dietary fiber intake is significantly associated with lower risk of first stroke. Overall, findings support dietary recommendations to increase intake of total dietary fiber. However, a paucity of data on fiber from different foods precludes conclusions regarding the association between fiber type and stroke. There is a need for future studies to focus on fiber type and to examine risk for ischemic and hemorrhagic strokes separately.