The relationship between flavonols intake and stroke in the elderly: a cross-sectional study from NHANES (2007-2010 and 2017-2018)
Abstract
BACKGROUND: Stroke is a common fatal and disabling disease in the elderly. We investigated the correlation and potential benefits of dietary intake of flavonoid compounds and their subclasses in elderly stroke patients.
METHODS: This study analyzed data from the National Health and Nutrition Examination Survey (NHANES) for the cycles 2007-2010 and 2017-2018. Dietary flavonoids intake was calculated based on food frequency questionnaires (FFQ) through a 24-hour dietary recall. To explore the relationship between flavonoids intake and their subclasses with stroke prevalence, we employed multivariable logistic regression models, adjusting for relevant covariates. Restricted cubic splines (RCS) and generalized additive models (GAMs) were applied to explore potential nonlinear relationships between flavonols subclasses and stroke prevalence. Multivariable logistic regression models were conducted both for the overall population and stratified by flavonols subclasses intake. Additionally, we utilized Bayesian kernel machine regression (BKMR) to evaluate the overall effect of flavonols intake levels on stroke status, accounting for potential interaction and correlation between subclasses. Given the high correlation among flavonols subclasses, we incorporated a hierarchical variable selection approach using a Markov Chain Monte Carlo (MCMC) algorithm. Finally, we analyzed the XGBoost model by applying SHAP (SHapley Additive exPlanations) values to assess the specific contribution of…
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