ABSTRACT
OBJECTIVE: An analysis was conducted to explore the relationship between dietary fibre intake and stroke risk. METHODS: PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and WanFang and Weipu databases were systematically searched to obtain peer-reviewed literature on the relationship between dietary fibre and stroke risk. The search time was as of 1 April 2023. Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the included studies. The pooled hazard ratio (HR) and 95% confidence interval (CI) were calculated using Stata 16.0. The Q test and I2 statistics were used to evaluate the heterogeneity and sensitivity analysis to explore potential bias. Meta-regression analysis was conducted to explore the relationship between total dietary intake quality and stroke risk. RESULTS: Sixteen high-quality studies, involving 855,671 subjects, met the inclusion criteria and were involved in the final meta-analysis. The results showed that higher total dietary fibre (HR: 0.81; 95% CI: 0.75-0.88), fruit fibre (HR: 0.88; 95% CI: 0.82-0.93), vegetable fibre (HR: 0.85; 95% CI: 0.81-0.89), soluble fibre (HR: 0.82; 95% CI: 0.72-0.93) and insoluble fibre (HR: 0.77; 95% CI: 0.66-0.89) had a positive effect on reducing the risk of stroke. However, cereal fibre (HR: 0.90; 95% CI: 0.81-1.00) was not statistically significant in reducing the risk of stroke. For different stroke types, higher total dietary fibre was associated with ischemic stroke (HR: 0.83; 95% CI: 0.79-0.88) and had a similar positive effect but was not found in haemorrhagic stroke (HR: 0.91; 95% CI: 0.80-1.03). Stroke risk decreased with increased total dietary fibre intake (ß=-0.006189, P=0.001). No potential bias from the individual study was found from sensitivity analysis. CONCLUSION: Increasing dietary fibre intake had a positive effect on reducing the risk of stroke. Different dietary fibres have various effects on stroke.