Alexander E. Merkler, MD

Haring B, Misialek JR, Rebholz CM, Petruski-Ivleva N, Gottesman RF, Mosley TH, and Alonso A. Association of Dietary Protein Consumption With Incident Silent Cerebral Infarcts and Stroke: The Atherosclerosis Risk in Communities (ARIC) Stud
y. Stroke. 2015

Diet is an increasingly important topic in the field of cerebrovascular disease. The current study adds to the growing body of evidence that red and processed meat consumption increases the risk of stroke.

Dr. Haring et al evaluated the relationship between dietary protein consumption and stroke using the Atherosclerosis Risk in Communities Study (ARIC). More than 11,000 patients were enrolled in ARIC, a prospective study of middle aged adults, performed at four socioeconomically diverse locations in the United States. Patients included had no history of prior stroke and had no history of diabetes or cardiovascular disease so as to exclude patients that may lead to changes in diet. Dietary protein consumption use was assessed using questionnaires at the initial enrollment visit and then again six to eight years later.

Patients were followed for a median of 22 years. Overall, neither total protein intake nor animal protein consumption was associated with total, ischemic, or hemorrhagic stroke. On the other hand, higher intake of processed meat or red meat was significantly associated with an increased risk of stroke. Furthermore, only red meat consumption was associated with the development of ischemic stroke. No association was found between fish, nut, or low-fat dairy consumption and overall stroke risk.

Limitations include 1) Dietary protein was assessed at only one or two visits early on in the study and dietary habits may have changed over the ensuing years; 2) lack of adjustment for typical vascular risk factors; 3) lack of information regarding the etiology of stroke.

Overall, diet is an extremely important and modifiable stroke risk factor. Further research is warranted to help guide dietary modifications for both primary and secondary stroke counseling.