Xianwei Zeng and collagues suggest our analysis of the INTERSTROKE study1 overestimated the population attributable for ten risk factors of stroke due to the selection of variables included. Although we did not include a variable for metabolic syndrome, we did include the key domains for metabolic syndrome, namely obesity, diabetes, hypertension, and apolipoproteins. Our analysis also included a measure of dietary quality, namely modified alternative healthy index (mAHEI). Variables for health education and hormones were not included, because these were not measured, although certain hormones could be measured in future analyses if deemed scientifically important.
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