Diet and 20-Year Mortality from Coronary Heart Disease

Abstract

In a prospective epidemiologic study of 1001 middle-aged men, we examined the relation between dietary information collected approximately 20 years ago and subsequent mortality from coronary heart disease. The men were initially enrolled in three cohorts: one of men born and living in Ireland, another of those born in Ireland who had emigrated to Boston, and the third of those born in the Boston area of Irish immigrants. There were no differences in mortality from coronary heart disease among the three cohorts. In within-population analyses, those who died of coronary heart disease had higher Keys (P = 0.06) and modified Hegsted (P = 0.02) dietary scores than did those who did not (a high score indicates a high intake of saturated fatty acids and cholesterol and a relatively low intake of polyunsaturated fatty acids). These associations were significant (P = 0.03 for the Keys and P = 0.04 for the modified Hegsted scores) after adjustment for other risk factors for coronary heart disease. Fiber intake (P = 0.04) and a vegetable-foods score, which rose with increased intake of fiber, vegetable protein, and starch (P = 0.02), were lower among those who died from coronary heart disease, though not significantly so after adjustment for other risk factors. A higher Keys score carried an increased risk of coronary heart disease (relative risk, 1.60), and a higher fiber intake carried a decreased risk (relative risk, 0.57). Overall, these results tend to support the hypothesis that diet is related, albeit weakly, to the development of coronary heart disease.

Fiber intake and risk of nonfatal acute myocardial infarction

“…This study confirms in a Southern European population the inverse association found in studies from Northern Europe and the USA (Bolton-Smith et al, 1992; Burr & Sweetnam, 1982;Fehily et al, 1993;Humble et al, 1993;Khaw & BarrettConnor, 1987;Kromhout et al, 1982;Kushi et al, 1985;Morris et al, 1977;Pietinen et al, 1996;Rimm et al, 1996;Wolk et al, 1999). Only a few studies, however, adjusted for energy intake and presented data separately for different types and sources of fiber.…”

“…Several, mostly prospective, epidemiological studies, (Bolton-Smith et al, 1992;Burr & Sweetnam, 1982;Fehily et al, 1993;Humble et al, 1993;Khaw & Barrett-Connor, 1987;Kromhout et al, 1982;Kushi et al, 1985;Morris et al, 1977;Pietinen et al, 1996;Rimm et al, 1996;Wolk et al, 1999) have investigated the relation between fiber intake and risk of acute myocardial infarction (AMI) or cardiovascular disease in general. Most have found significant inverse associations, although only a few have presented estimates adjusted for energy intake and separately for different types and sources of fiber (Kushi et al, 1999).…”

“…Most have found significant inverse associations, although only a few have presented estimates adjusted for energy intake and separately for different types and sources of fiber (Kushi et al, 1999). These studies were conducted in the USA (Humble et al, 1993;Khaw & BarrettConnor, 1987;Kushi et al, 1985;Rimm et al, 1996;Wolk et al, 1999), the UK (Bolton-Smith et al, 1992;Burr & Sweetnam, 1982;Fehily et al, 1993;Kushi et al, 1985;Morris et al, 1977) or Northern Europe (Kromhout et al, 1982;Pietinen et al, 1996), and no data are available, to our knowledge, from Mediterranean countries, where the composition of the diet is qualitatively different, and smoking patterns and other relevant lifestyle habits and environmental exposures also differ.…”

Socio-demographic predictors of self-rated health in the Republic of Ireland: findings from the National Survey on Lifestyle, Attitudes and Nutrition, SLAN

“…Ireland also has a huge migrant related diaspora, the health status of which, has, paradoxically, been better studied in some instances than those who remained at home. (Burvil, McCall, Woodings, & Stenhouse, 1983;Wild & McKeigue, 1997;Harrison, Carrhill, & Sutton, 1993;Kushi, Lew, Stare, & Ellison, 1985;Abbotts, Williams, Ford, Hunt, & West, 1999;Harding & Balarajan, 1996, 2001). …”

Moderate increase in dietary sucrose does not influence fasting or postprandial serum lipids regardless of the presence of apolipoprotein E2 allele in healthy subjects

“…In regard of cardiovascular disease risk, many short-term studies have suggested a dose-dependent hypertriglyceridemic effect for dietary carbohydrates and sucrose (Parks and Hellerstein, 2000). However, longer observational studies have not provided evidence of increased risk of coronary heart disease (CHD) (Kushi et al, 1985;Liu et al, 2000). On the other hand, in a recent study weight gain and risk of type II diabetes were related to consumption of sugar-sweetened beverages in women (Schulze et al, 2004).…”