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American Journal of Epidemiology Advance Access originally published online on February 12, 2008
American Journal of Epidemiology 2008 167(8):954-961; doi:10.1093/aje/kwm395
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American Journal of Epidemiology © The Author 2008. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Folate, Vitamin B6, Vitamin B12, and Methionine Intakes and Risk of Stroke Subtypes in Male Smokers

Susanna C. Larsson1, Satu Männistö2, Mikko J. Virtanen2, Jukka Kontto2, Demetrius Albanes3 and Jarmo Virtamo2

1 National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
2 Department of Health Promotion and Chronic Disease Prevention, National Public Health Institute, Helsinki, Finland
3 National Cancer Institute, National Institutes of Health, Bethesda, MD

Correspondence to Dr. Susanna C. Larsson, Division of Nutritional Epidemiology, National Institute of Environmental Medicine, Karolinska Institutet, P.O. Box 210, SE-17177 Stockholm, Sweden (e-mail: susanna.larsson{at}ki.se).

Received for publication September 8, 2007. Accepted for publication December 13, 2007.

The associations of dietary folate, vitamin B6, vitamin B12, and methionine intakes with risk of stroke subtypes were examined among 26,556 male Finnish smokers, aged 50–69 years, enrolled in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Dietary intake was assessed at baseline by using a validated food frequency questionnaire. During a mean follow-up of 13.6 years, from 1985 through 2004, 2,702 cerebral infarctions, 383 intracerebral hemorrhages, and 196 subarachnoid hemorrhages were identified from national registers. In analyses adjusting for age and cardiovascular risk factors, a high folate intake was associated with a statistically significant lower risk of cerebral infarction but not intracerebral or subarachnoid hemorrhages. The multivariate relative risk of cerebral infarction was 0.80 (95% confidence interval: 0.70, 0.91; ptrend = 0.001) for men in the highest versus lowest quintile of folate intake. Vitamin B6, vitamin B12, and methionine intakes were not significantly associated with any subtype of stroke. These findings in men suggest that a high dietary folate intake may reduce the risk of cerebral infarction.

cerebral infarction; diet; folic acid; methionine; stroke; vitamin B 6; vitamin B 12


Abbreviations: CI, confidence interval; HDL, high density lipoprotein; ICD, International Classification of Diseases


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