DキWデ;ヴ┞ aキHヴW キミデ;ニW ;ミS ヴキゲニ ラa キゲIエ;WマキI ;ミS エ;Wマラヴヴエ;ェキI ゲデヴラニW キミ デエW UK WラマWミげゲ Cラエラヴデ Sデ┌S┞ Running title: Dietary fibre and risk of stroke

1 Background: Stroke risk is modifiable through many risk factors, one being healthy dietary habits. 2 Fibre intake was associated with reduced stroke risk in recent meta-analyses however data were 3 contributed by relatively few studies and few examined different stroke types. 4 Methods: 27 373 disease-free women were followed for 14.4 years. Diet was assessed with a 2175 item food frequency questionnaire and stroke cases were identified using English Hospital Episode 6 Statistics and mortality records. Survival analysis was applied to assess risk of total, ischaemic or 7 haemorrhagic stroke in relation to fibre intake. 8 Results: 135 haemorrhagic and 184 ischaemic stroke cases were identified in addition to 138 cases 9 where the stroke type was unknown or not recorded. Greater intake of total fibre, higher fibre 10 density and greater soluble fibre, insoluble fibre and fibre from cereals were associated with 11 significantly lower risk for total stroke. For total stroke, the hazard ratio per 6g/day total fibre intake 12 was 0.89 (95% confidence intervals: 0.81 to 0.99). 13 Different findings were observed for haemorrhagic and ischaemic stroke in healthy weight or 14 overweight women. tTotal fibre, insoluble and cereal fibre were inversely associated with 15 haemorrhagic stroke risk in overweight/obese participants and in healthy weight women, greater 16 cereal fibre was associated with lower ischaemic stroke risk. In non-hypertensive women, higher 17 fibre density was associated with lower ischemic stroke risk. 18 Conclusion: Greater total fibre and fibre from cereals are associated with lower stroke risk and 19 associations were more consistent with ischaemic stroke. The different observations by stroke type, 20 BMI group or hypertensive status indicates potentially different mechanisms. These may be clarified 21 through randomised controlled trials. 22