***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Fruit and vegetables is a heterogeneous food group with different content of dietary fiber , vitamins , minerals , carotenoids , and bioactive phytochemicals . Our objective was to examine the relation between specific consumption of fruit and vegetable subgroups and stroke risk in a cohort of Swedish women and men . METHODS AND RESULTS We prospect ively followed 74,961 participants ( 34,670 women and 40,291 men ) who had completed a food frequency question naire in the autumn of 1997 and were free from stroke , coronary heart disease , and cancer at baseline . Diagnoses of stroke in the cohort during follow-up were ascertained from the Swedish Hospital Discharge Registry . A total of 4089 stroke cases , including 3159 cerebral infa rct ions , 435 intracerebral hemorrhages , 148 subarachnoid hemorrhages , and 347 unspecified strokes , were ascertained during 10.2 years of follow-up . The multivariable relative risk ( RR ) of total stroke for the highest vs. lowest category of total fruit and vegetable consumption was 0.87 ( 95 % confidence interval [ CI ] 0.78 - 0.97 ; P for trend = 0.01 ) . The association was confined to individuals without hypertension ( corresponding RR , 0.81 ; 95 % CI , 0.71 - 0.93 ; P for trend = 0.01 ) . Among individual fruits and vegetable subgroups , inverse associations with total stroke were observed for apples/pears ( RR , 0.89 ; 95 % CI , 0.80 - 0.98 ; P for trend = 0.02 ) and green leafy vegetables ( RR , 0.92 ; 95 % CI , 0.81 - 1.04 ; P for trend = 0.03 ) . CONCLUSION This study shows an inverse association of fruit and vegetable consumption with stroke risk . Particularly consumption of apples and pears and green leafy vegetables was inversely associated with stroke Background There is some evidence that the association of fish and marine fatty acids with stroke risk differs between men and women . We investigated the gender-specific associations of habitual intake of the marine fatty acids eicosapentaenoic acid ( EPA ) plus docosahexaenoic acid ( DHA ) and fish on incident stroke in a population -based study in the Netherl and s. Methods We prospect ively followed 20,069 men and women , aged 20–65 years , without cardiovascular diseases at baseline . Habitual diet was assessed with a vali date d 178-item food frequency question naire . Incidence of stroke was assessed through linkage with mortality and morbidity registers . Cox proportional hazards models were used to estimate multivariable-adjusted hazard ratios ( HR ) and 95 % confidence intervals ( 95%CI ) . Results During 8–13 years of follow-up , 221 strokes occurred . In women , an inverse dose-response relation ( P-trend = 0.02 ) was observed between  EPA-DHA intake and incident stroke , with an HR of 0.49 ( 95 % CI : 0.27–0.91 ) in the top quartile of EPA-DHA ( median 225 mg/d ) as compared to the bottom quartile ( median 36 mg/d ) . In men , the HR ( 95%CI ) for the top quartile of  EPA-DHA  intake was 0.87 ( 0.51–1.48 ) ( P-trend = 0.36 ) . Similar results were observed for fish consumption and stroke incidence . Conclusion A  higher EPA-DHA and fish intake is related to a lower stroke risk in women , while for men an inverse association could not be demonstrated CONTEXT Although increased intake of grain products has been recommended to prevent cardiovascular disease ( CVD ) , prospect i ve data examining the relation of whole grain intake to risk of ischemic stroke are sparse , especially among women . OBJECTIVE To examine the hypothesis that higher whole grain intake reduces the  risk of ischemic stroke in women . DESIGN , SETTING , AND PARTICIPANTS A prospect i ve cohort of 75,521 US women aged 38 to 63 years without previous diagnosis of diabetes mellitus , coronary heart disease , stroke , or other CVDs in 1984 , who completed detailed food frequency question naires ( FFQs ) in 1984 , 1986 , 1990 , and 1994 , and were followed up for 12 years as part of the Nurses ' Health Study . MAIN OUTCOME MEASURE Incidence of ischemic stroke , confirmed by medical records , by quintile of whole grain intake according to FFQ responses . RESULTS During 861,900 person-years of follow-up , 352 confirmed incident cases of ischemic stroke occurred . We observed an inverse association between whole grain intake and ischemic stroke risk . The age-adjusted relative risks ( RRs ) from the lowest to highest quintiles of whole grain intake were 1.00 ( referent ) , 0.68 ( 95 % confidence interval [ CI ] , 0.49 - 0.94 ) , 0.69 ( 95 % CI , 0.51 - 0.95 ) , 0.49 ( 95 % CI , 0.35 - 0.69 ) , and 0.57 ( 95 % CI , 0.42 - 0.78 ; P = .003 for trend ) . Adjustment for smoking modestly attenuated this association ( RR comparing extreme quintiles , 0.64 ; 95 % CI , 0.47 - 0.89 ) . This inverse association remained essentially unchanged with further adjustment for known CVD risk factors , including saturated fat and transfatty acid intake ( multivariate-adjusted RR comparing extreme quintiles , 0.69 ; 95 % CI , 0.50 - 0.98 ) . The inverse relation between whole grain intake and risk of ischemic stroke was also consistently observed among subgroups of women who never smoked , did not drink alcohol , did not exercise regularly , or who did not use postmenopausal hormones . No significant association was observed between total grain intake and risk of ischemic stroke . CONCLUSIONS In this cohort , higher intake of whole grain foods was associated with a  lower risk of ischemic stroke among women , independent of known CVD risk factors . These prospect i ve data support the notion that higher intake of whole grains may reduce the risk of ischemic stroke BACKGROUND The evidence supporting recommendations to limit intake of cholesterol rich foods is inconclusive . We aim ed to examine the association between egg consumption and carotid atherosclerosis phenotypes , and the association with clinical vascular events in a prospect i ve , urban , multi-ethnic population . METHODS AND RESULTS The Northern Manhattan Study is a population based cohort to determine stroke incidence , risk factors and prognosis . A sub-cohort of 1429 NOMAS participants with both carotid ultrasounds and comprehensive dietary information was evaluated ( mean ± SD age of participants 65.80 ± 8.80 , 40 % male , 18 % white , 20 % black , 60 % Hispanic ) . The association between egg consumption and carotid intima media thickness ( cIMT ) was assessed with linear regression . Logistic and quantile regression was used to examine the association between egg consumption and carotid plaque presence , thickness , and area . The relation between egg consumption and clinical vascular events ( N = 2669 ) was examined with Cox models . The mean total cIMT was 0.91 ± 0.08 mm and 58 % had carotid plaque present . Increasing egg consumption was inversely associated with cIMT , plaque presence , thickness , and area , in models adjusted for demographics , vascular risk factors and diet . For every additional egg consumed per week , the risk of plaque decreased by 11 % ( 95 % CI 3%-18 % ) . No association was detected between egg consumption and risk of clinical vascular outcomes , over a mean follow up of 11 years and after adjustment for covariates . CONCLUSIONS Frequency of egg consumption in the low to moderate range was inversely related to several markers of carotid atherosclerosis . No association with clinical vascular events , including stroke , was detected . Our findings do not support current vascular health guidelines suggesting the extreme limitation or avoidance of egg consumption due to its cholesterol content BACKGROUND Data on the relation of plasma and dietary omega-3 ( n-3 ) fatty acids ( FAs ) with heart failure ( HF ) risk have been inconsistent . OBJECTIVE We evaluated the relation of n-3 FAs with HF in US male physicians . DESIGN We used nested case-control ( n = 1572 ) and prospect i ve cohort study design s ( n = 19,097 ) .  Plasma phospholipid n-3 FAs were measured by using gas chromatography , and food-frequency question naires were used to assess dietary n-3 FAs and fish intake .  Incident HF was ascertained via annual follow-up question naires and vali date d in a sub sample . RESULTS The mean age was 58.7 y at blood collection . In a multivariable model , plasma α-linolenic acid ( ALA ) was associated with a lower risk of HF in a nonlinear fashion ( P-quadratic trend = 0.02 ) , and the lowest OR was observed in quintile 4 ( 0.66 ; 95 % CI : 0.47 , 0.94 ) . Plasma EPA and DHA were not associated with HF , whereas plasma docosapentaenoic acid ( DPA ) showed a nonlinear inverse relation with HF for quintile 2 ( OR : 0.55 ; 95 % CI : 0.39 , 0.79 ) . Dietary marine n-3 FAs showed a trend toward a lower risk of HF in quintile 4 ( HR : 0.81 ; 95 % CI : 0.64 , 1.02 ) and a nonlinear pattern across quintiles . Fish intake was associated with a lower risk of HF , with RRs of ~0.70 for all categories of fish consumption greater than one serving per month . CONCLUSIONS Our data are consistent with an inverse and nonlinear relation of plasma phospholipid ALA and DPA , but not EPA or DHA , with HF risk . Fish consumption greater than once per month was associated with a lower HF risk Background — Sugar-sweetened beverage consumption is associated with weight gain and risk of type 2 diabetes mellitus .  Few studies have tested for a relationship with coronary heart disease ( CHD ) or intermediate biomarkers . The role of artificially sweetened beverages is also unclear . Methods and Results — We performed an analysis of the Health Professionals Follow-Up Study , a prospect i ve cohort study including 42 883 men . Associations of cumulatively averaged sugar-sweetened ( eg , sodas ) and artificially sweetened ( eg , diet sodas ) beverage intake with incident fatal and nonfatal CHD ( myocardial infa rct ion ) were examined with proportional hazard models . There were 3683 CHD cases over 22 years of follow-up . Participants in the top quartile of sugar-sweetened beverage intake had a 20 % higher relative risk of CHD than those in the bottom quartile ( relative risk=1.20 ; 95 % confidence interval , 1.09–1.33 ; P for trend < 0.01 ) after adjustment for age , smoking , physical activity , alcohol , multivitamins , family history , diet quality , energy intake , body mass index , pre-enrollment weight change , and dieting . Artificially sweetened beverage consumption was not significantly associated with CHD ( multivariate relative risk=1.02 ; 95 % confidence interval , 0.93–1.12 ; P for trend=0.28 ) . Adjustment for self-reported high cholesterol , high triglycerides , high blood pressure , and diagnosed type 2 diabetes mellitus slightly attenuated these associations . Intake of sugar-sweetened but not artificially sweetened beverages was significantly associated with increased plasma triglycerides , C-reactive protein , interleukin-6 , and tumor necrosis factor receptors 1 and 2 and decreased high-density lipoprotein , lipoprotein(a ) , and leptin ( P<0.02 ) . Conclusions — Consumption of sugar-sweetened beverages was associated with increased risk of CHD and some adverse changes in lipids , inflammatory factors , and leptin . Artificially sweetened beverage intake was not associated with CHD risk or biomarkers The authors aim ed to evaluate the association of the traditional Mediterranean diet and major food groups with incidence of and mortality from cerebrovascular disease ( CBVD ) in a Mediterranean population . The study population was a cohort of 23,601 participants from the Greek segment of the EPIC Study ( European Prospect i ve Investigation into Cancer and Nutrition ) who were free of cardiovascular diseases and cancer at baseline ( 1994 - 1999 ) .  Diet was assessed by means of a vali date d food frequency question naire . A 10-point scale integrating key Mediterranean diet characteristics was used to assess the participants ' degree of adherence to this diet . During a median follow-up period of 10.6 years ( 1994 - 2009 
    Output:
    
There were clear indications for non-linear dose-response relationships between whole grains , fruits , nuts , dairy , and red meat and CHD .
Conclusion : An optimal intake of whole grains , vegetables , fruits , nuts , legumes , dairy , fish , red and processed meat , eggs and SSB showed an important lower risk of CHD , stroke , and HF