Association Between Dietary-related Risk Factors and Ischemic Stroke Using Reduced Rank Regression: The Multi-Ethnic Study of Atherosclerosis (MESA), USA.

Objectives
Some studies shed light on the association between dietary patterns and stroke, though, none of them applied reduced rank regression (RRR). Therefore, we sought to extract dietary patterns using RRR, and showed how well the extracted scores by RRR predict stroke in comparison to those scores produced by partial least squares (PLS) and principal components regression (PCR).

Methods
Diet data at baseline with four response variables including body mass index (BMI), fibrinogen, IL-6, low-density lipoprotein (LDL) cholesterol were used to extract dietary patterns. Analyses were based on 5468 men and women aged 45-84 y who had no clinical cardiovascular diseases (CVD) from Multi-Ethnic Study of Atherosclerosis (MESA). Dietary patterns were created by three methods RRR, PLS, and PCR.

Results
The RRR1 was positively associated with stroke incidence in both models (for model 1 hazard ratio (HR): 7.49; 95% CI: 1.66, 33.69 P for trend = 0.01 and for model 2 HR: 6.83; 95% CI: 1.51, 30.87 for quintile 5 compared with the reference category P for trend = 0.02). The RRR1, PLS1, and PCR1 were high in fats and oils, poultry, tomatoes, fried potato and processed meat. Additionally, RRR1 and PLS1 were high in dark-yellow and cruciferous vegetables which negatively were correlated with the first dietary pattern.

Conclusion
Mainly according to the RRR, we identified that a dietary pattern high in fats and oil, poultry, non-diet soda, processed meat, tomatoes, legumes, chicken, tuna and egg salad, fried potato and low in dark-yellow and cruciferous vegetables may increase the incidence of stroke.