The Burden of Ischemic Stroke due to Diet Low in Polyunsaturated Fatty Acids in Global, 1990-2021

Comprehensive global and regional assessments of polyunsaturated fatty acid (PUFA)-related ischemic stroke (IS) burden, including age-sex stratification and temporal trends, remain limited.

Utilizing the Global Burden of Disease (GBD) 2021 database, this study analyzed IS burden attributed to low PUFA diets across 204 countries and territories (1990-2021). Estimated annual percentage changes (EAPCs) for disability-adjusted life years (DALYs) were used to evaluate spatiotemporal trends.

Globally, age-standardized DALY rates declined significantly (EAPC: -1.64, 95% CI: -1.75 to -1.54), yet absolute DALY cases rose 1.45-fold. Gender disparities were evident, with steeper declines in females (EAPC: -1.96) than males (EAPC: -1.35). Western sub-Saharan Africa (0.39) and Afghanistan (0.64) had the highest burden, while high-income North America (0.03) and Taiwan, China (0.02) had the lowest. Sub-Saharan Africa (EAPC: -0.21) showed minimal improvement. The significant increase in Lesotho (EAPC: 2.51) contrasting with high-income Asia Pacific (EAPC: -4.35) and South Korea (EAPC: -6.92). The age-specific trend shows that the DALY rate increases with age, reaching its peak in the 75-79 age group. The annual growth rate of DALY for young adults is higher, while the downward trend is more significant for the older person.

Despite global progress in age-standardized rates, rising absolute DALYs highlight persistent challenges from demographic shifts and metabolic risks. Region-specific policies targeting dietary PUFA intake, fortified foods, and gender-sensitive interventions are critical to mitigating IS burden.