Abstract DP057: Specific Food Groups Associated With Reduced Risk Of Stroke And Cognitive Impairment

Introduction: While previous studies have shown that certain dietary patterns can reduce the risk of stroke and dementia, these diets have numerous components, making adherence challenging. We aimed to determine which food groups are most important for stroke and dementia prevention to ultimately develop simple and effective diet scores. Methods: We studied participants from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, a prospective cohort study enrolling Black and White adults aged ≥45 years in the United States from 2003-2007. We consolidated food items from a baseline food frequency questionnaire (FFQ) into 38 distinct food groups, including components of the Mediterranean, MIND, and ultra-processed food diets. Multivariable Cox proportional hazards models were used to determine the relationship between each food group (per 1-standard deviation increase) and the risk of stroke and cognitive impairment, adjusting for total calories and demographic, lifestyle, and clinical covariates. Results: Among 8,514 stroke-free participants, higher intake of whole grains (HR=0.86, 95% CI=0.78-0.95, p=0.002), fruits (HR=0.90, 95% CI=0.81-0.995, p=0.04), and coffee (HR=0.86, 95% CI=0.78-0.95, p=0.004) were associated with decreased stroke risk. Conversely, red meat (HR=1.13, 95% CI=1.01-1.26, p=0.03), fast food (HR=1.18, 95% CI=1.08-1.28, p=0.0002), ultra-processed meat (HR=1.14, 95% CI=1.03-1.26, p=0.01) and packaged savory snacks (HR=1.12, 95% CI=1.02-1.23, p=0.01) were associated with increased risk of stroke. In the cognitive impairment analysis (n=5,848 participants with no baseline cognitive impairment and follow-up assessments), higher intake of leafy greens (HR=0.82, 95% CI=0.71-0.93, p=0.003), berries (HR=0.76, 95% CI=0.64-0.91, p=0.002), and coffee (HR=0.82, 95% CI=0.72-0.92, p=0.001) were associated with decreased risk of cognitive impairment. Conversely, increased intake of beans (HR=1.14, 95% CI=1.04-1.25, p=0.004), fast food (HR=1.14, 95% CI=1.003-1.29, p=0.045), and ready-to-eat dishes (HR=1.13, 95% CI=1.01-1.27, p=0.03), such as pizza, were associated with increased risk. Conclusion: Risk of stroke and cognitive impairment were associated with specific food groups, with whole grains, leafy greens, berries, and coffee linked to decreased risk, and fried foods, red and ultra-processed meat, packaged savory snacks, and ready-to-eat dishes linked to increased risk. This highlights targets for simplified dietary guidance.