Nutritional Risk Factors among Stroke Survivors in Gaza Governorates: A case-control study

Mohammed Omar Al-Kahlout
محمد عمر الكحلوت
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Al-Quds University
Background Stroke globally is the second leading cause of death for people above the age of 60 years, and the fifth leading cause in people aged 20 to 59 years old; and this is also the situation in Palestine. There are many risk factors know to be linked and related to stroke. Nutritional pattern is one of them. The past fifty year there has been remarkable changes in the nutritional habits. This study aimed to assess nutritional risk factors for development of stroke among stroke survivors and their adult control. Methods This study, a case-control, consisted of 450 participants aged ≥45 years, (150 cases with first stroke and 300 controls with no history of stroke). Twice the numbers of control matched for age, gender, and place of residency. Cases selected from all large governmental hospital, while control selected from 7 Primary health care centers. who were studied between March 2015 to November 2015 in Gaza Strip. For data collection, a self-designed questionnaire was used to interview the participants. Results We have directly interviewed 450 participants, of them 150 complain from first stroke (126 patient with ischemic stroke "84%"; 24 patients with hemorrhagic stroke "16 %") and 300 controls. Significant common risk factors for all strokes were: history of HTN (OR 2.22, 95% CI 1.44-3.47); DM (OR 2.25, 95% CI 1.51-3.36); Cardiac disorder (OR 1.67, 95% CI 1.09-2.55); obesity (OR 1.611, 95% C.I. 1.058–2.445). Among nutritional factors those increased stroke risks were: consumption of Rice (Z=2.222, P-value=0.026), Red meat (Z=2.748, P-value= 0.006), Eggs (Z=2.045, P-value= 0.041), Fried foods (Z=1.939, P-value=0.039), Salts, spices and pickles (Z=2.054, P-value=0.040). According to the type of stroke: HTN (Z=2.80, P-value =0.005); age ≤ 50 years (χ2= 34.30, P-value =0.001) were associated with hemorrhagic stroke; and DM (Z=3.21, P-value =0.001); age ≥ 60 years and Current smoking (χ2= 9.936, P-value=0.002) were associated with hemorrhagic stroke. Other factor that can decrease stroke risk were: high physical activity (OR 0.631, 95% CI 0.400–0.967); increase consumption of non-leafy vegetables (Z=2.664, Pvalue= 0.008); coffee (Z= 2.096, P-value= 0.036); and ketchup or tomato sauce (Z=2.586, Pvalue= 0.010). Recommends Proper nutritional counseling and nutritional recommendation should be integrated in the care of patients who are at risk of developing stroke especially obese patients with hypertension or diabetes in hospital and PHCC to increase and promote the patient's awareness about the stroke risk factors and encourage the intake of a healthy diet.