Abstract
Objectives
Low adherence to a Mediterranean diet (MeDi) is associated with increased incidence,
mortality, and severity of acute ischemic strokes (AIS). Nevertheless, the explanatory
factors associated with such results are unclear. Our aim was to investigate stroke
risk factors associated with adherence to a MeDi in a prospective cohort of AIS patients.
Materials and Methods
Patients admitted from February 2017 to February 2020 were included in this study.
Adherence was measured using the 14-point Mediterranean Diet Adherence Screener (MEDAS).
Demographic and clinical characteristics were compared with adherence with a univariate
analysis. A binomial regression was used to investigate the independent association
of premorbid factors and MeDi components with adherence.
Results
There were 413 patients. Mean age was 68.6 (17.4), 176 (42.6%) women. Median MEDAS
score was 6 (IQR 4–7) points. 253 patients (61.2%) had a low adherence (MEDAS ≤ 6).
In the univariate analysis, a low MEDAS was associated with lower education, diabetes,
sedentary lifestyle, greater body mass index (BMI), lower alcohol consumption, and
higher LDLc. In the regression analysis, younger age, lower education, functional
disability, hypertension, sedentary lifestyle, and higher BMI were associated with
lower MEDAS scores. Six MeDi components had particularly low patient adherence: seafood,
legumes, olive oil, nuts, wine, and fruit.
Discussion
These data indicate low adherence to MeDi in younger patients who are less educated
and have existing cardiovascular risk factors, in particular hypertension, sedentary
lifestyle, and higher BMI. Some components of the diet had a particularly low adherence.
Conclusions
Tailoring diet prevention interventions to these specific populations, focusing on
components with known less adherence, could improve adherence to a MeDi and the opportunity
for secondary stroke prevention.
Key Words
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Article info
Publication history
Published online: October 21, 2021
Accepted:
September 30,
2021
Received in revised form:
September 26,
2021
Received:
March 17,
2021
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106154
Copyright
© 2021 Elsevier Inc. All rights reserved.
