Relation of dietary glycemic load with ischemic and hemorrhagic stroke: a cohort study in Greece and a meta-analysis

Marta Rossi, Federica Turati, Pagona Lagiou, Dimitrios Trichopoulos, Carlo La Vecchia, Antonia Trichopoulou

Research output: Contribution to journalArticlepeer-review


Purpose: High glycemic load (GL) has been associated with excess stroke risk. Data suggest a different role of diet in the etiology of ischemic and hemorrhagic stroke. Methods: We analyzed data from 19,824 participants of the Greek cohort of the population-based European Prospective Investigation into Cancer and nutrition (EPIC), who were free of cardiovascular diseases, cancer, and diabetes at baseline and had not developed diabetes. Diet was assessed at enrollment through a validated, interviewer-administered semi-quantitative food frequency questionnaire. The average daily GL was derived using standard tables. We also conducted a meta-analysis on GL and stroke (overall, ischemic and hemorrhagic), using random-effects models. Results: In the Greek EPIC cohort, 304 incident stroke cases were identified (67 ischemic, 49 hemorrhagic). Using Cox proportional hazards regression models adjusted for potential confounders, the hazard ratios for the highest versus the lowest GL tertiles were 1.07 [95 % confidence interval (CI) 0.74–1.54] for overall stroke, 1.55 (95 % CI 0.72–3.36) for ischemic and 0.48 (95 % CI 0.18–1.25) for hemorrhagic stroke (p-heterogeneity

Original languageEnglish
Pages (from-to)215-222
Number of pages8
JournalEuropean Journal of Nutrition
Issue number2
Publication statusPublished - 2014


  • Cohort study
  • Diet
  • Glycemic load
  • Meta-analysis
  • Stroke

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Medicine(all)


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