Dietary nutrients of relative importance associated with coronary artery disease: Public health implication from random forest analysis

Abstract

Dietary nutrients have significant effects on the risk of cardiovascular diseases. However, the results were not uniform across different countries. The study aims to determine the relative importance of dietary nutrients associated with coronary artery disease (CAD) among the Nepalese population. A hospital-based matched case-control study was carried out at Shahid Gangalal National Heart Center in Nepal. In the present study, patients with more than seventy percent stenosis in any main coronary artery branch in angiography were defined as cases, while those presenting normal coronary angiography or negative for stressed exercise test were considered controls. Dietary intakes of 612 respondents over the past 12 months were evaluated using a semi-quantitative customized food frequency questionnaire. In conditional regression model, the daily average dietary intake of β-carotene (OR: 0.54; 95%CI: 0.34, 0.87), and vitamin C (OR: 0.96; 95%CI: 0.93, 0.99) were inversely, whereas dietary carbohydrate (OR: 1.16; 95%CI: 1.1, 1.24), total fat/oil (OR: 1.47; 95%CI: 1.27, 1.69), saturated fatty acid (SFA) (OR: 1.2; 95%CI: 1.11, 1.3), cholesterol (OR: 1.01; 95%CI: 1.001, 1.014), and iron intakes (OR: 1.11; 95%CI: 1.03, 1.19) were positively linked with CAD. Moreover, in random forest analysis, the daily average dietary intakes of SFA, vitamin A, total fat/oil, β-carotene, and cholesterol were among the top five nutrients (out of 12 nutrients variables) of relative importance associated with CAD. The nutrients of relative importance imply a reasonable preventive measure in public health nutrients specific intervention to prevent CAD in a resource-poor country like Nepal. The findings are at best suggestive of a possible relationship between these nutrients and the development of CAD, but prospective cohort studies and randomized control trials will need to be performed in the Nepalese population.

Saturated Fatty Acid Chain Length and Risk of Cardiovascular Disease: A Systematic Review

“…Substitution results were also variable when SFA was substituted with CHO because the type of CHO consumed was not consistent between the studies [ 30 , 31 , 32 , 33 ]. Many studies found a higher intake of refined CHO with a lower fat intake to be more harmful than a higher fat intake consisting of unsaturated fat sources [ 19 , 38 , 41 ]. This may be related to the impact CHO have on blood lipid levels [ 19 ].…”

Asupan Dan Frekuensi Konsumsi Serat, Vitamin B3, dan Pufa Berhubungan dengan Profil Lipid dan Penyakit Jantung Koroner

“…Pada penelitian Kameyama et al, (2020), rerata asupan serat harian responden dislipidemia dengan terapi obat lebih tinggi dibandingkan responden tanpa terapi obat. Pada penelitian Basnet et al, (2020) dan Moghadam et al, (2017), rerata asupan serat kelompok kasus PJK lebih rendah dibandingkan kelompok PJK kontrol atau non PJK. Sedangkan pada penelitian Mahalle et al, (2016) asupan serat responden menurun seiring dengan meningkatnya keparahan penyakit jantung koroner.…”

“…Rerata asupan vitamin B3 responden berkisar antara 8,4 gram hingga 13,8 gram. Pada penelitian Basnet et al, (2020) Kameyama et al, (2020), rerata asupan PUFA responden dislipidemia dengan terapi obat lebih tinggi dibandingkan responden tanpa terapi obat. Penelitian Basnet et al, (2020), menyebutkan rerata asupan PUFA pada kelompok kasus PJK kasus lebih tinggi dibandingkan dengan kelompok kontrol.…”

“…Pada penelitian Basnet et al, (2020) Kameyama et al, (2020), rerata asupan PUFA responden dislipidemia dengan terapi obat lebih tinggi dibandingkan responden tanpa terapi obat. Penelitian Basnet et al, (2020), menyebutkan rerata asupan PUFA pada kelompok kasus PJK kasus lebih tinggi dibandingkan dengan kelompok kontrol. Sedangkan pada penelitian Moghadam et al, (2017), rerata asupan PUFA responden PJK lebih rendah dibandingkan dengan responden non PJK.…”

“…Hasil tersebut sejalan dengan penelitian Putri & Wirjatmadi, (2016) dimana riwayat asupan serat berhubungan signifikan dengan PJK (p−value=0,004). Dua jurnal hasil studi literatur (Basnet et. al., 2020dan Moghadam et.al., 2017 menunjukkan perbedaan yang signifikan antara asupan serat responden PJK kasus dan kontrol, dimana rata−rata asupan serat pada responden PJK kasus lebih rendah.…”