Susanna C Larsson

Publications (122) View all

• Article: Dietary calcium intake and risk of stroke: a dose-response meta-analysis.

  Susanna C Larsson, Nicola Orsini, Alicja Wolk
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  ABSTRACT: BACKGROUND: The findings from epidemiologic studies of calcium intake and risk of stroke have been conflicting. OBJECTIVE: The objective was to conduct a dose-response meta-analysis of prospective studies to assess the association between dietary calcium intake and stroke risk. DESIGN: Relevant studies were identified by searching PubMed and EMBASE databases until 11 December 2012 and by reviewing the reference lists of relevant articles. Observational prospective studies that reported RRs and 95% CIs for the association of calcium intake with stroke incidence or mortality were eligible. Study-specific RRs were combined by using a random-effects model. RESULTS: Eleven prospective studies, including 9095 cases of stroke, were included in the meta-analysis. Evidence of a nonlinear association between dietary calcium intake and risk of stroke was found. In a stratified analysis, calcium intake was inversely associated with risk of stroke in populations with a low to moderate average calcium intake (<700 mg/d; RR for a 300-mg/d increase in calcium intake: 0.82; 95% CI: 0.76, 0.88) but was weakly positively associated with risk in populations with a high calcium intake (≥700 mg/d; corresponding RR: 1.03; 95% CI: 1.01, 1.06). An inverse association between calcium intake and risk of stroke was observed only in Asian populations (n = 4; RR for a 300-mg/d increase in calcium intake: 0.78; 95% CI: 0.71, 0.87). CONCLUSION: These findings suggest that dietary calcium intake may be inversely associated with stroke in populations with low to moderate calcium intakes and in Asian populations.
  American Journal of Clinical Nutrition 04/2013; · 6.67 Impact Factor
• Article: Heme Iron Intake and Risk of Stroke: A Prospective Study of Men.

  Joanna Kaluza, Alicja Wolk, Susanna C Larsson
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  ABSTRACT: BACKGROUND AND PURPOSE: Intake of iron, especially heme iron, has been associated with several diseases. However, epidemiological studies of heme iron and nonheme iron intake in relation to risk of stroke are lacking. The aim of this study was to examine the associations between heme iron and nonheme iron intake and stroke incidence in men. METHODS: The population-based prospective Cohort of Swedish Men included 38 859 men, aged 45 to 79 years, who had no history of stroke, coronary heart disease, or cancer at baseline. Hazard ratios and 95% confidence intervals (95% CIs) were calculated using Cox proportional hazards regression models. RESULTS: During an 11.7 years follow-up, 3097 incident cases of stroke, including 2482 cerebral infarctions and 450 intracerebral hemorrhages, were registered. The hazard ratios of total stroke and cerebral infarction for the highest compared with the lowest quintiles of heme iron intake were 1.16 (95% CI, 1.03-1.31; P trend=0.037) and 1.15 (95% CI, 1.00-1.31; P trend=0.089), respectively. The incidence rates of total stroke per 10 000 person-years were 72.6 in the lowest quintile and 84.4 in the highest. The association was confined to men with body mass index <25 kg/m(2), the hazard ratios were 1.40 (95% CI, 1.17-1.68; P trend<0.001) for total stroke and 1.38 (95% CI, 1.13-1.70; P trend=0.001) for cerebral infarction; no association was observed among overweight and obese men. There was no association between nonheme iron intake and risk of total stroke and stroke types. CONCLUSIONS: Findings from this prospective study indicate that a high heme iron intake, particularly in normal weight individuals, may increase the risk of stroke.
  Stroke 01/2013; · 5.73 Impact Factor
• Article: Black tea consumption and risk of stroke in women and men.

  Susanna C Larsson, Jarmo Virtamo, Alicja Wolk
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  ABSTRACT: PURPOSE: Our aim was examine the association between black tea consumption and risk of total stroke and stroke types in a prospective study. METHODS: A total of 74,961 Swedish women and men who were free of cardiovascular disease and cancer at baseline in 1997 were followed up through December 2008. Tea consumption was assessed with a questionnaire at baseline. Stroke cases were ascertained from the Swedish Hospital Discharge Registry. RESULTS: During a mean follow-up of 10.2 years, we ascertained 4089 cases of first stroke, including 3159 cerebral infarctions, 435 intracerebral hemorrhages, 148 subarachnoid hemorrhages, and 347 unspecified strokes. After adjustment for other risk factors, high tea consumption was associated with a significantly lower risk of total stroke; however, there was no dose-response relation (P for trend = .36). Compared with no tea consumption, the multivariable relative risk for four or more cups per day (median, 5) was 0.79 (95% confidence interval [CI], 0.62-0.998). The corresponding relative risks were 0.80 (95% CI, 0.61-1.04) for cerebral infarction and 0.68 (95% CI, 0.35-1.30) for hemorrhagic stroke. CONCLUSIONS: These findings suggest that daily consumption of four or more cups of black tea is inversely associated with risk of stroke.
  Annals of epidemiology 01/2013; · 2.95 Impact Factor
• Article: Total and specific fruit and vegetable consumption and risk of stroke: A prospective study.

  Susanna C Larsson, Jarmo Virtamo, Alicja Wolk
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  ABSTRACT: BACKGROUND: Fruit and vegetables is a heterogeneous food group with different content of dietary fiber, vitamins, minerals, carotenoids, and bioactive phytochemicals. Our objective was to examine the relation between specific consumption of fruit and vegetable subgroups and stroke risk in a cohort of Swedish women and men. METHODS AND RESULTS: We prospectively followed 74,961 participants (34,670 women and 40,291 men) who had completed a food frequency questionnaire in the autumn of 1997 and were free from stroke, coronary heart disease, and cancer at baseline. Diagnoses of stroke in the cohort during follow-up were ascertained from the Swedish Hospital Discharge Registry. A total of 4089 stroke cases, including 3159 cerebral infarctions, 435 intracerebral hemorrhages, 148 subarachnoid hemorrhages, and 347 unspecified strokes, were ascertained during 10.2 years of follow-up. The multivariable relative risk (RR) of total stroke for the highest vs. lowest category of total fruit and vegetable consumption was 0.87 (95% confidence interval [CI] 0.78-0.97; P for trend = 0.01). The association was confined to individuals without hypertension (corresponding RR, 0.81; 95% CI, 0.71-0.93; P for trend = 0.01). Among individual fruits and vegetable subgroups, inverse associations with total stroke were observed for apples/pears (RR, 0.89; 95% CI, 0.80-0.98; P for trend = 0.02) and green leafy vegetables (RR, 0.92; 95% CI, 0.81-1.04; P for trend = 0.03). CONCLUSION: This study shows an inverse association of fruit and vegetable consumption with stroke risk. Particularly consumption of apples and pears and green leafy vegetables was inversely associated with stroke.
  Atherosclerosis 12/2012; · 3.79 Impact Factor
• Article: Association between Dairy Food Consumption and Risk of Myocardial Infarction in Women Differs by Type of Dairy Food.

  Emma Patterson, Susanna C Larsson, Alicja Wolk, Agneta Akesson
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  ABSTRACT: The relation between dairy foods, particularly specific foods, and risk of cardiovascular disease (CVD) remains unclear. We examined the association between total, as well as specific, dairy food intakes and incidence of myocardial infarction (MI) in a prospective population-based cohort. We followed 33,636 women (aged 48-83 y), free from CVD, cancer, and diabetes at baseline (1997), in the Swedish Mammography Cohort. Consumption of milk, cultured milk/yogurt, cheese, cream, crème fraiche, and butter was obtained from a validated self-administered FFQ at baseline. We used Cox proportional hazards regression models to estimate HRs and 95% CIs, adjusted for relevant CVD risk factors. MI incidence was ascertained from national registries. Over 11.6 y of follow-up, we ascertained 1392 cases of MI. When the highest quintile was compared with the lowest quintile, total dairy food intake was inversely associated with MI risk [multivariable adjusted HR: 0.77 (95% CI: 0.63, 0.95)]. Among specific dairy food products, total cheese was inversely associated [HR: 0.74 (95% CI: 0.60, 0.91)] and butter used on bread but not on cooking was positively associated [HR: 1.34 (95% CI: 1.02, 1.75)] with MI risk. Other specific dairy food products were not significantly associated with MI risk. No differences were observed between consumption of specific low-fat and high-fat dairy foods, expressed as either absolute intakes or intakes relative to the total, and MI risk. Failure to consider dairy foods as a heterogeneous group in future studies could hamper important insights of relevance for the development of dietary guidelines.
  Journal of Nutrition 11/2012; · 3.92 Impact Factor