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Published in: Nutrition Journal 1/2009

Open Access 01-12-2009 | Research

Stroke and plasma markers of milk fat intake – a prospective nested case-control study

Authors: Eva Warensjö, Annika Smedman, Birgitta Stegmayr, Göran Hallmans, Lars Weinehall, Bengt Vessby, Ingegerd Johansson

Published in: Nutrition Journal | Issue 1/2009

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Abstract

Background

Dairy products are high in saturated fat and are traditionally a risk factor for vascular diseases. The fatty acids 15:0 and 17:0 of plasma lipids are biomarkers of milk fat intake. The aim of the present study was to evaluate the risk of a first-ever stroke in relation to the plasma milk fat biomarkers.

Methods

A prospective case-control study was nested within two population based health surveys in Northern Sweden. Among 129 stroke cases and 257 matched controls, plasma samples for fatty acid analyses were available in 108 cases and 216 control subjects. Proportions of 15:0 and 17:0 of plasma lipids, weight, height, blood lipids, blood pressures, and lifestyle data were employed in conditional logistic regression modelling.

Results

The proportions of fatty acids 17:0 and 15:0+17:0 of total plasma phospholipids were significantly higher in female controls than cases, but not in men. 17:0 and 15:0+17:0 were significantly and inversely related to stroke in the whole study sample as well as in women. The standardised odds ratio (95% CI) in women to have a stroke was 0.41 (0.24–0.69) for 17:0 in plasma phospholipids. Adjustment for traditional cardiovascular risk factors, physical activity and diet had marginal effects on the odds ratios. A similar, but non-significant, trend was seen in men.

Conclusion

It is hypothesised that dairy or milk fat intake may be inversely related to the risk of a first event of stroke. The intriguing results of this study should be interpreted with caution. Follow up studies with greater power, and where intakes are monitored both by dietary recordings and fatty acid markers are needed.
Appendix
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Literature
1.
go back to reference Warlow C, Sudlow C, Dennis M, Wardlaw J, Sandercock P: Stroke. Lancet. 2003, 362 (9391): 1211-1224. 10.1016/S0140-6736(03)14544-8.CrossRefPubMed Warlow C, Sudlow C, Dennis M, Wardlaw J, Sandercock P: Stroke. Lancet. 2003, 362 (9391): 1211-1224. 10.1016/S0140-6736(03)14544-8.CrossRefPubMed
2.
go back to reference Vessby B: Dietary fat, fatty acid composition in plasma and the metabolic syndrome. Curr Opin Lipidol. 2003, 14 (1): 15-19. 10.1097/00041433-200302000-00004.CrossRefPubMed Vessby B: Dietary fat, fatty acid composition in plasma and the metabolic syndrome. Curr Opin Lipidol. 2003, 14 (1): 15-19. 10.1097/00041433-200302000-00004.CrossRefPubMed
3.
go back to reference Wiberg B, Sundstrom J, Arnlov J, Terent A, Vessby B, Zethelius B, Lind L: Metabolic risk factors for stroke and transient ischemic attacks in middle-aged men: a community-based study with long-term follow-up. Stroke. 2006, 37 (12): 2898-2903. 10.1161/01.STR.0000249056.24657.8b.CrossRefPubMed Wiberg B, Sundstrom J, Arnlov J, Terent A, Vessby B, Zethelius B, Lind L: Metabolic risk factors for stroke and transient ischemic attacks in middle-aged men: a community-based study with long-term follow-up. Stroke. 2006, 37 (12): 2898-2903. 10.1161/01.STR.0000249056.24657.8b.CrossRefPubMed
4.
go back to reference Hu FB, Manson JE, Willett WC: Types of dietary fat and risk of coronary heart disease: a critical review. J Am Coll Nutr. 2001, 20 (1): 5-19.CrossRefPubMed Hu FB, Manson JE, Willett WC: Types of dietary fat and risk of coronary heart disease: a critical review. J Am Coll Nutr. 2001, 20 (1): 5-19.CrossRefPubMed
5.
go back to reference Tholstrup T: Dairy products and cardiovascular disease. Curr Opin Lipidol. 2006, 17 (1): 1-10.PubMed Tholstrup T: Dairy products and cardiovascular disease. Curr Opin Lipidol. 2006, 17 (1): 1-10.PubMed
6.
go back to reference Keys A, Menotti A, Karvonen MJ, Aravanis C, Blackburn H, Buzina R, Djordjevic BS, Dontas AS, Fidanza F, Keys MH, et al: The diet and 15-year death rate in the seven countries study. Am J Epidemiol. 1986, 124 (6): 903-915.PubMed Keys A, Menotti A, Karvonen MJ, Aravanis C, Blackburn H, Buzina R, Djordjevic BS, Dontas AS, Fidanza F, Keys MH, et al: The diet and 15-year death rate in the seven countries study. Am J Epidemiol. 1986, 124 (6): 903-915.PubMed
7.
go back to reference Alvarez-Leon EE, Roman-Vinas B, Serra-Majem L: Dairy products and health: a review of the epidemiological evidence. Br J Nutr. 2006, 96 (Suppl 1): S94-99.CrossRefPubMed Alvarez-Leon EE, Roman-Vinas B, Serra-Majem L: Dairy products and health: a review of the epidemiological evidence. Br J Nutr. 2006, 96 (Suppl 1): S94-99.CrossRefPubMed
8.
go back to reference Elwood PC, Pickering JE, Fehily AM, Hughes J, Ness AR: Milk drinking, ischaemic heart disease and ischaemic stroke I. Evidence from the Caerphilly cohort. Eur J Clin Nutr. 2004, 58 (5): 711-717. 10.1038/sj.ejcn.1601868.CrossRefPubMed Elwood PC, Pickering JE, Fehily AM, Hughes J, Ness AR: Milk drinking, ischaemic heart disease and ischaemic stroke I. Evidence from the Caerphilly cohort. Eur J Clin Nutr. 2004, 58 (5): 711-717. 10.1038/sj.ejcn.1601868.CrossRefPubMed
9.
go back to reference Elwood PC, Pickering JE, Hughes J, Fehily AM, Ness AR: Milk drinking, ischaemic heart disease and ischaemic stroke II. Evidence from cohort studies. Eur J Clin Nutr. 2004, 58 (5): 718-724. 10.1038/sj.ejcn.1601869.CrossRefPubMed Elwood PC, Pickering JE, Hughes J, Fehily AM, Ness AR: Milk drinking, ischaemic heart disease and ischaemic stroke II. Evidence from cohort studies. Eur J Clin Nutr. 2004, 58 (5): 718-724. 10.1038/sj.ejcn.1601869.CrossRefPubMed
10.
go back to reference Elwood PC, Strain JJ, Robson PJ, Fehily AM, Hughes J, Pickering J, Ness A: Milk consumption, stroke, and heart attack risk: evidence from the Caerphilly cohort of older men. Journal of epidemiology and community health. 2005, 59 (6): 502-505. 10.1136/jech.2004.027904.CrossRefPubMedPubMedCentral Elwood PC, Strain JJ, Robson PJ, Fehily AM, Hughes J, Pickering J, Ness A: Milk consumption, stroke, and heart attack risk: evidence from the Caerphilly cohort of older men. Journal of epidemiology and community health. 2005, 59 (6): 502-505. 10.1136/jech.2004.027904.CrossRefPubMedPubMedCentral
11.
go back to reference Arab L: Biomarkers of fat and fatty acid intake. J Nutr. 2003, 133 (Suppl 3): 925S-932S.PubMed Arab L: Biomarkers of fat and fatty acid intake. J Nutr. 2003, 133 (Suppl 3): 925S-932S.PubMed
12.
go back to reference Johansson G, Wikman A, Ahrén A, Hallmans G, Johansson I: Underreporting of energy intake in repeated 24-h recalls related to gender, age, weight status, day of interview, educational level, reported food intake, smoking habits and area of living. Public Health Nutr. 2001, 919-927. 4 Johansson G, Wikman A, Ahrén A, Hallmans G, Johansson I: Underreporting of energy intake in repeated 24-h recalls related to gender, age, weight status, day of interview, educational level, reported food intake, smoking habits and area of living. Public Health Nutr. 2001, 919-927. 4
13.
go back to reference Johansson I, Hallmans G, Wikman A, Biessy C, Riboli E, Kaaks R: Validation and Calibration of food-frequency questionnaire in the Northern Sweden Health and Disease Cohort. Public Health Nutr. 2002, 5 (3): 487-496. 10.1079/PHN2001315.CrossRefPubMed Johansson I, Hallmans G, Wikman A, Biessy C, Riboli E, Kaaks R: Validation and Calibration of food-frequency questionnaire in the Northern Sweden Health and Disease Cohort. Public Health Nutr. 2002, 5 (3): 487-496. 10.1079/PHN2001315.CrossRefPubMed
14.
go back to reference Livingstone MB, Black AE: Markers of the validity of reported energy intake. J Nutr. 2003, 133 (Suppl 3): 895S-920S.PubMed Livingstone MB, Black AE: Markers of the validity of reported energy intake. J Nutr. 2003, 133 (Suppl 3): 895S-920S.PubMed
15.
go back to reference Smedman AE, Gustafsson IB, Berglund LG, Vessby BO: Pentadecanoic acid in serum as a marker for intake of milk fat: relations between intake of milk fat and metabolic risk factors. Am J Clin Nutr. 1999, 69 (1): 22-29.PubMed Smedman AE, Gustafsson IB, Berglund LG, Vessby BO: Pentadecanoic acid in serum as a marker for intake of milk fat: relations between intake of milk fat and metabolic risk factors. Am J Clin Nutr. 1999, 69 (1): 22-29.PubMed
16.
go back to reference Wennberg M, Vessby B, Johansson I: Evaluation of relative intake of fatty acids according to the Northern Sweden FFQ with fatty acid level in erythrocyte membranes as biomarkers. Public Health Nutr. 2009, Wennberg M, Vessby B, Johansson I: Evaluation of relative intake of fatty acids according to the Northern Sweden FFQ with fatty acid level in erythrocyte membranes as biomarkers. Public Health Nutr. 2009,
17.
go back to reference Wolk A, Furuheim M, Vessby B: Fatty acid composition of adipose tissue and serum lipids are valid biological markers of dairy fat intake in men. J Nutr. 2001, 131 (3): 828-833.PubMed Wolk A, Furuheim M, Vessby B: Fatty acid composition of adipose tissue and serum lipids are valid biological markers of dairy fat intake in men. J Nutr. 2001, 131 (3): 828-833.PubMed
18.
go back to reference Wolk A, Vessby B, Ljung H, Barrefors P: Evaluation of a biological marker of dairy fat intake. Am J Clin Nutr. 1998, 68 (2): 291-295.PubMed Wolk A, Vessby B, Ljung H, Barrefors P: Evaluation of a biological marker of dairy fat intake. Am J Clin Nutr. 1998, 68 (2): 291-295.PubMed
19.
go back to reference Asplund K, Eliasson M, Janlert U, Stegmayr B: What the MONICA project has taught us about cardiovascular disease-society, public health and health care. Läkartidningen. 2006, 103 (40): 3006-3010.PubMed Asplund K, Eliasson M, Janlert U, Stegmayr B: What the MONICA project has taught us about cardiovascular disease-society, public health and health care. Läkartidningen. 2006, 103 (40): 3006-3010.PubMed
20.
go back to reference Tunstall-Pedoe H: Monitoring trends in cardiovascular disease and risk factors: the WHO "Monica" project. WHO chronicle. 1985, 39 (1): 3-5.PubMed Tunstall-Pedoe H: Monitoring trends in cardiovascular disease and risk factors: the WHO "Monica" project. WHO chronicle. 1985, 39 (1): 3-5.PubMed
21.
go back to reference Weinehall L, Hallgren C-G, Westman G, Janlert U, Wall S: Reduction of selection bias in primary prevention of cardiovascular disease through involvement of primary health care. Scandiavian Journal of Primary Health Care. 1998, 16: 171-176. 10.1080/028134398750003133.CrossRef Weinehall L, Hallgren C-G, Westman G, Janlert U, Wall S: Reduction of selection bias in primary prevention of cardiovascular disease through involvement of primary health care. Scandiavian Journal of Primary Health Care. 1998, 16: 171-176. 10.1080/028134398750003133.CrossRef
22.
go back to reference Stegmayr B, Lundberg V, Asplund K: The events registration and survey procedures in the Northern Sweden MONICA project. Scand J Public Health. 2003, 9-17. 10.1080/14034950310001441. Supplement 61 Stegmayr B, Lundberg V, Asplund K: The events registration and survey procedures in the Northern Sweden MONICA project. Scand J Public Health. 2003, 9-17. 10.1080/14034950310001441. Supplement 61
23.
go back to reference The World Health Organization MONICA Project (monitoring trends and determinants in cardiovascular disease): a major international collaboration. WHO MONICA Project Principal Investigators. Journal of clinical epidemiology. 1988, 41 (2): 105-114. 10.1016/0895-4356(88)90084-4. The World Health Organization MONICA Project (monitoring trends and determinants in cardiovascular disease): a major international collaboration. WHO MONICA Project Principal Investigators. Journal of clinical epidemiology. 1988, 41 (2): 105-114. 10.1016/0895-4356(88)90084-4.
24.
go back to reference Stegmayr B, Asplund K: Stroke in Northern Sweden. Scand J Public Health. 2003, 60-69. 10.1080/14034950310001379. Supplement 61 Stegmayr B, Asplund K: Stroke in Northern Sweden. Scand J Public Health. 2003, 60-69. 10.1080/14034950310001379. Supplement 61
25.
go back to reference Ohgren B, Weinehall L, Stegmayr B, Boman K, Hallmans G, Wall S: What else adds to hypertension in predicting stroke? An incident case-referent study. J Intern Med. 2000, 248 (6): 475-482. 10.1046/j.1365-2796.2000.00746.x.CrossRefPubMed Ohgren B, Weinehall L, Stegmayr B, Boman K, Hallmans G, Wall S: What else adds to hypertension in predicting stroke? An incident case-referent study. J Intern Med. 2000, 248 (6): 475-482. 10.1046/j.1365-2796.2000.00746.x.CrossRefPubMed
26.
go back to reference Boberg M, Croon LB, Gustafsson IB, Vessby B: Platelet fatty acid composition in relation to fatty acid composition in plasma and to serum lipoprotein lipids in healthy subjects with special reference to the linoleic acid pathway. Clin Sci (Lond). 1985, 68 (5): 581-587.CrossRef Boberg M, Croon LB, Gustafsson IB, Vessby B: Platelet fatty acid composition in relation to fatty acid composition in plasma and to serum lipoprotein lipids in healthy subjects with special reference to the linoleic acid pathway. Clin Sci (Lond). 1985, 68 (5): 581-587.CrossRef
27.
go back to reference Biong AS, Veierod MB, Ringstad J, Thelle DS, Pedersen JI: Intake of milk fat, reflected in adipose tissue fatty acids and risk of myocardial infarction: a case-control study. Eur J Clin Nutr. 2006, 60 (2): 236-244. 10.1038/sj.ejcn.1602307.CrossRefPubMed Biong AS, Veierod MB, Ringstad J, Thelle DS, Pedersen JI: Intake of milk fat, reflected in adipose tissue fatty acids and risk of myocardial infarction: a case-control study. Eur J Clin Nutr. 2006, 60 (2): 236-244. 10.1038/sj.ejcn.1602307.CrossRefPubMed
28.
go back to reference Warensjö E, Jansson JH, Berglund L, Boman K, Ahren B, Weinehall L, Lindahl B, Hallmans G, Vessby B: Estimated intake of milk fat is negatively associated with cardiovascular risk factors and does not increase the risk of a first acute myocardial infarction. A prospective case-control study. Br J Nutr. 2004, 91 (4): 635-642. 10.1079/BJN20041080.CrossRefPubMed Warensjö E, Jansson JH, Berglund L, Boman K, Ahren B, Weinehall L, Lindahl B, Hallmans G, Vessby B: Estimated intake of milk fat is negatively associated with cardiovascular risk factors and does not increase the risk of a first acute myocardial infarction. A prospective case-control study. Br J Nutr. 2004, 91 (4): 635-642. 10.1079/BJN20041080.CrossRefPubMed
29.
go back to reference Krachler B, Norberg M, Eriksson J, Hallmans G, Johansson I, Vessby B, Weinehall L, Lindahl B: Fatty acid profile of erythrocyte membrane preceding development of Type 2 diabetes mellitus. Nutrition, Metabolism and Cardiovascular Diseases. 2008, 18 (7): 503-510. 10.1016/j.numecd.2007.04.005.CrossRefPubMed Krachler B, Norberg M, Eriksson J, Hallmans G, Johansson I, Vessby B, Weinehall L, Lindahl B: Fatty acid profile of erythrocyte membrane preceding development of Type 2 diabetes mellitus. Nutrition, Metabolism and Cardiovascular Diseases. 2008, 18 (7): 503-510. 10.1016/j.numecd.2007.04.005.CrossRefPubMed
30.
go back to reference Krachler B, Eliasson MC, Johansson I, Hallmans G, Lindahl B: Trends in food intakes in Swedish adults 1986–1999: findings from the Northern Sweden MONICA (Monitoring of Trends and Determinants in Cardiovascular Disease) Study. Public Health Nutr. 2005, 8 (6): 628-635. 10.1079/PHN2004710.CrossRefPubMed Krachler B, Eliasson MC, Johansson I, Hallmans G, Lindahl B: Trends in food intakes in Swedish adults 1986–1999: findings from the Northern Sweden MONICA (Monitoring of Trends and Determinants in Cardiovascular Disease) Study. Public Health Nutr. 2005, 8 (6): 628-635. 10.1079/PHN2004710.CrossRefPubMed
31.
go back to reference He K, Xu Y, Van Horn L: The puzzle of dietary fat intake and risk of ischemic stroke: a brief review of epidemiologic data. Journal of the American Dietetic Association. 2007, 107 (2): 287-295. 10.1016/j.jada.2006.11.010.CrossRefPubMed He K, Xu Y, Van Horn L: The puzzle of dietary fat intake and risk of ischemic stroke: a brief review of epidemiologic data. Journal of the American Dietetic Association. 2007, 107 (2): 287-295. 10.1016/j.jada.2006.11.010.CrossRefPubMed
32.
go back to reference He K, Merchant A, Rimm EB, Rosner BA, Stampfer MJ, Willett WC, Ascherio A: Dietary fat intake and risk of stroke in male US healthcare professionals: 14 year prospective cohort study. Bmj. 2003, 327 (7418): 777-782. 10.1136/bmj.327.7418.777.CrossRefPubMedPubMedCentral He K, Merchant A, Rimm EB, Rosner BA, Stampfer MJ, Willett WC, Ascherio A: Dietary fat intake and risk of stroke in male US healthcare professionals: 14 year prospective cohort study. Bmj. 2003, 327 (7418): 777-782. 10.1136/bmj.327.7418.777.CrossRefPubMedPubMedCentral
33.
go back to reference Gillman MW, Cupples LA, Millen BE, Ellison RC, Wolf PA: Inverse association of dietary fat with development of ischemic stroke in men. Jama. 1997, 278 (24): 2145-2150. 10.1001/jama.278.24.2145.CrossRefPubMed Gillman MW, Cupples LA, Millen BE, Ellison RC, Wolf PA: Inverse association of dietary fat with development of ischemic stroke in men. Jama. 1997, 278 (24): 2145-2150. 10.1001/jama.278.24.2145.CrossRefPubMed
34.
go back to reference Massey LK: Dairy food consumption, blood pressure and stroke. J Nutr. 2001, 131 (7): 1875-1878.PubMed Massey LK: Dairy food consumption, blood pressure and stroke. J Nutr. 2001, 131 (7): 1875-1878.PubMed
35.
go back to reference Iso H, Stampfer MJ, Manson JE, Rexrode K, Hennekens CH, Colditz GA, Speizer FE, Willett WC: Prospective study of calcium, potassium, and magnesium intake and risk of stroke in women. Stroke. 1999, 30 (9): 1772-1779.CrossRefPubMed Iso H, Stampfer MJ, Manson JE, Rexrode K, Hennekens CH, Colditz GA, Speizer FE, Willett WC: Prospective study of calcium, potassium, and magnesium intake and risk of stroke in women. Stroke. 1999, 30 (9): 1772-1779.CrossRefPubMed
36.
go back to reference Abbott RD, Curb JD, Rodriguez BL, Sharp DS, Burchfiel CM, Yano K: Effect of dietary calcium and milk consumption on risk of thromboembolic stroke in older middle-aged men. The Honolulu Heart Program. Stroke. 1996, 27 (5): 813-818.CrossRefPubMed Abbott RD, Curb JD, Rodriguez BL, Sharp DS, Burchfiel CM, Yano K: Effect of dietary calcium and milk consumption on risk of thromboembolic stroke in older middle-aged men. The Honolulu Heart Program. Stroke. 1996, 27 (5): 813-818.CrossRefPubMed
37.
go back to reference Snijder MB, van der Heijden AA, van Dam RM, Stehouwer CD, Hiddink GJ, Nijpels G, Heine RJ, Bouter LM, Dekker JM: Is higher dairy consumption associated with lower body weight and fewer metabolic disturbances? The Hoorn Study. Am J Clin Nutr. 2007, 85 (4): 989-995.PubMed Snijder MB, van der Heijden AA, van Dam RM, Stehouwer CD, Hiddink GJ, Nijpels G, Heine RJ, Bouter LM, Dekker JM: Is higher dairy consumption associated with lower body weight and fewer metabolic disturbances? The Hoorn Study. Am J Clin Nutr. 2007, 85 (4): 989-995.PubMed
38.
go back to reference Larsson S, Männistö S, Vitrtanen M, Kontto J, Albanes D, Virtamo J: Dairy Foods and Stroke. Epidemiology. 2009, 20 (2): 000-000. Larsson S, Männistö S, Vitrtanen M, Kontto J, Albanes D, Virtamo J: Dairy Foods and Stroke. Epidemiology. 2009, 20 (2): 000-000.
39.
go back to reference Ness A, Davey Smith G, Hart C: Milk, coronary heart disease and mortality. Journal of epidemiology and community health. 2001, 379-382. 10.1136/jech.55.6.379. 55 Ness A, Davey Smith G, Hart C: Milk, coronary heart disease and mortality. Journal of epidemiology and community health. 2001, 379-382. 10.1136/jech.55.6.379. 55
Metadata
Title
Stroke and plasma markers of milk fat intake – a prospective nested case-control study
Authors
Eva Warensjö
Annika Smedman
Birgitta Stegmayr
Göran Hallmans
Lars Weinehall
Bengt Vessby
Ingegerd Johansson
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Nutrition Journal / Issue 1/2009
Electronic ISSN: 1475-2891
DOI
https://doi.org/10.1186/1475-2891-8-21

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