Animal Protein, Animal Fat, and Cholesterol Intakes and Risk of Cerebral Infarction Mortality in the Adult Health Study

Abstract

Background and Purpose-A traditional diet that is poor in animal products is thought to explain the high rate of stroke in Asian populations. The purpose of the present study was to examine the effect of a diet rich in animal protein, animal fat, and cholesterol on the risk of cerebral infarction mortality in a Japanese population. Methods-A prospective study of 3731 Japanese men and women aged 35 to 89 years was conducted from 1984 to 2001.Nutrient intake was estimated at baseline from the responses to a 24-hour diary. During the follow-up period, cases of cerebral infarction deaths (as entered on death certificates) were monitored. Results-During the follow-up period, 60 deaths were attributed to cerebral infarction. A high intake of animal fat and cholesterol was significantly associated with a reduced risk of cerebral infarction death. The risk was reduced by 62% (CI, 82% to 18%) for those in the third tertile of animal fat intake, compared with those in the first tertile, with a significant linear dose-response relationship (Pϭ0.0073). The risk of death from infarction was reduced by 63% (CI, 82% to 22%) in the high cholesterol consumption group, compared with the low consumption group. A significant linear dose-response relationship was observed. Animal protein was not significantly associated with infarction mortality after adjustment for animal fat and cholesterol. Conclusions-This study suggests that in Japan, where animal product intake is lower than in Western countries, a high consumption of animal fat and cholesterol was associated with a reduced risk of cerebral infarction death.

Saturated Fat Intake and Cardiovascular Disease in Japanese Population

“…In Fig. 1 in the present paper, we plotted the proportion of saturated fat relative to the total energy intake instead of the absolute amount based on the published literature 12, [14][15][16][18][19][20][21][22] . Consequently, there appears to be a threshold for saturated fat intake of around 7.5% to 10% of the total energy for the inverse relationship between saturated fat intake and the risk of stroke, especially with respect to intraparenchymal hemorrhage, consistent with that observed for the absolute amount of energy (15 to 20 g/day assuming a total energy intake of 1,800 kcal) 16) .…”

“…However, considering that the range of saturated fat intake is significantly different between Western countries and Asia, it is inappropriate to directly apply the results of these meta-analyses to Japan, as they include many Western studies. Therefore, we focused on six cohort studies of Japanese population [12][13][14][15][16][17] . A summary of these studies is presented in Table 1.…”

“…In the Shibata Study 13) and Life Span Study (LSS) 14) , albeit statistically non-significant, an inverse the Circulatory Risk in Communities Study, CIRCS) 7) and a cohort study in the United States (Multiple Risk Factor Intervention Trial, MRFIT) 4) , which independently showed an inverse association between a low total cholesterol level and the risk of intraparenchymal hemorrhage. As a result of these reports, the National Heart, Lung and Blood Institute (NHLBI) held an international conference on low blood cholesterol in 1990 to review and discuss existing data on the U-shaped relationship between the total cholesterol level and cardiovascular disease collected from cohort studies worldwide 8) .…”

“…In the Japan Collaborative Cohort (JACC) Study, a strong inverse association was noted between saturated fat intake and mortality from both ischemic stroke and intraparenchymal hemorrhage 15) . In the Japan Public Health Center-based Prospective Study (JPHC Study), a large community-based cohort of 81,931 Japanese men and women, we found an inverse association between saturated fat intake and the risk of incident intraparenchymal hemorrhage and ischemic stroke; the hazard ratio [95% confidence , ages 34-59, women only, US; HPFS: Health Professional Follow-up Study 19,20) , ages 40-75, men only, US; CIRCS: Circulatory Risk in Communities Study 12) , ages 40-69, men:women 48:52, Japan; JPHC; Japan Public Health Center-based Prospective Study 16) , ages 45-74, men:women 46:54, Japan; JACC; Japan Collaborative Cohort Study 15) , ages 40-79, men:women 39:61, Japan; LSS: Life Span Study 14) , ages 35-89, men:women 38:62, Japan; ATBC: Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study 22) , ages 50-69, male smokers only, Finland; SHS: Strong Heart Study 21) , ages 47-79, men:women 36:64, US. The JACC and LSS were mortality studies, the other studies were incidence studies.…”

Traditional Eating Habits and Level of Homocysteine in the Acute First-Ever Ischaemic Stroke

“…Moderately elevated of all circulating plasma total homocysteine (tHcy) concentrations in the blood (hyperhomocysteinemia) [6] and intake meal with highfat content [7,8] as increasing dietary habits [9], both are cardiovascular risk factors highly influenced by diet [3], that may be determined endothelial vascular dysfunction [10][11][12], as well development of atherosclerosis for decades [13,14] until accelerated and the onset of its first clinical manifestations [15][16][17][18][19].…”