You have full access to this open access article. Previously reported associations of protein-rich foods with stroke subtypes have prompted interest in the assessment of individual amino acids. We examined the associations of dietary amino acids with risks of ischaemic and haemorrhagic stroke in the EPIC study. We analysed data from , participants from seven European countries.
Dietary intakes of 19 individual amino acids were assessed using validated country-specific dietary questionnaires, calibrated using additional h dietary recalls. After a median follow-up of The association persisted after mutual adjustment for all other amino acids, systolic and diastolic blood pressure.
The inverse associations of isoleucine, leucine, valine, phenylalanine, threonine, tryptophan, glutamic acid, serine and tyrosine with ischaemic stroke were each attenuated with adjustment for proline intake. For haemorrhagic stroke, no statistically significant associations were observed in the continuous analyses after correcting for multiple testing. Higher proline intake may be associated with a lower risk of ischaemic stroke, independent of other dietary amino acids and blood pressure.
While stroke is the second leading cause of death worldwide, the incidence of stroke varies substantially between countries reflecting differences in risk factors including variations in dietary intakes [ 1 ]. Differences in dietary protein have been suggested to be important, but previous studies of the associations of dietary protein intake with the risk of stroke have reported conflicting results, possibly reflecting heterogeneity by pathological stroke types and dietary sources of protein [ 2 , 3 ].
The different sources of dietary protein reflect a different profile of individual dietary amino acids. For example, meat and meat products are the main source of the essential amino acids and glycine, while grain products are the main source of dietary cysteine [ 4 ].
