Daily Habit of Water Intake in Patients with Cerebral Infarction before its Onset; Comparison with a Healthy Population: A Cross-Sectional Study

Abstract

Background: While water intake is frequently recommended to prevent cerebral infarction (CI), only few studies have been published on this topic. Objectives: This study retrospectively estimated the daily non-alcohol drink (NAD) intake in CI patients before CI onset and compared it with NAD in healthy subjects. Methods: We performed a cross-sectional study on CI patients in 3 hospitals and healthy subjects in the Kobe Orthopedic and Biomedical Epidemiologic (KOBE) study. Data from 1,287 subjects (274 CI patients and 1,013 healthy subjects) were used for the analyses. By dividing the CI patients into “increased”, “unchanged”, and “decreased” groups according to their current NAD intake, we compared the NAD intake between these 3 groups and healthy subjects by analyses of covariance and the post hoc test, adjusting for sex, age, surveyed month, body mass index, alcohol drinking history, and smoking history. Under the assumption that the NAD intake in the “unchanged” group was equal to the NAD intake before CI onset, the OR of less NAD intake for CI adjusting for the relevant variables in the “unchanged” group and the healthy subjects was calculated; the cut-off point was chosen using Youden’s index. Results: The mean age (mean ± SD) of the participants was 62.8 ± 9.3 years. One hundred and fifty-one patients (36 women) were included in the “increased” group; 105 (30 women), in the “unchanged” group; 18 (2 women), in the “decreased” group; and 1,013 (706 women), in the “healthy” group. The mean NAD intake was 1,702.5 ± 670.2 mL in the “increased” group, 1,494.2 ± 611.2 mL in the “unchanged” group, 1,268.0 ± 596.1 mL in the “decreased” group, and 1,720.6 ± 686.0 mL in the “healthy” group. After adjusting for the relevant variables, a significant difference in NAD intake between the groups was observed (F = 6.1, p < 0.001), and a post hoc test demonstrated significant differences (p < 0.05) in NAD intake between the “healthy” and “unchanged” groups, and between the “increased” and “unchanged” groups. The OR of less NAD intake (<1,570 mL/day, chosen using Youden’s index) for CI was 2.48 (95% CI 1.52–4.07). Conclusion: This study showed that daily NAD intake before CI onset in CI patients was less than that in healthy persons, indicating that sufficient intake of NAD may be protective for CI.

Being Conscious of Water Intake Positively Associated with Sufficient Non-Alcohol Drink Intake Regardless of Seasons and Reasons in Healthy Japanese; the KOBE Study: A Cross Sectional Study

“…Accordingly, the occurrence of ischemic stroke has been reported to rise with decreasing temperature [18] and its incidence does not vary significantly with season [19,20]. Moreover, we also demonstrated a positive association between a lesser NAD intake habit and CI after adjusting for the effect of the seasonal change [3]. These findings strongly indicated maintaining sufficient water intake for prevention of CI due to dehydration not only in summer but also throughout the year is important.…”

“…In contrast to most developed countries, the event risks of cerebrovascular diseases are high and it remains one of top-ranked causes of death and disability in Japan [1,2]. Recent studies demonstrated that patients with cerebral infarction (CI) took less water before the onset than healthy subjects [3], and higher water intake reduced mortality due to ischemic stroke [4,5,6,7,8]. The potential association between water intake and CI is generally explained via the following pathophysiological mechanism; 1) insufficient hydration is one of the most important factors causing dehydration and 2) dehydration is considered to be associated with the development of cerebral ischemic events [7,9,10], probably because of vascular collapse [11], increased blood viscosity [12], and spasm [13].…”