Prospective study of major dietary patterns and risk of coronary heart disease in men

BACKGROUND: Previous studies on diet and coronary heart disease (CHD) focused primarily on individual nutrients or foods. OBJECTIVE: We examined whether overall dietary patterns derived from a food-frequency questionnaire (FFQ) predict risk of CHD in men. DESIGN: This was a prospective cohort study of 44875 men aged 40-75 y without diagnosed cardiovascular disease or cancer at baseline in 1986. RESULTS: During 8 y of follow-up, we documented 1089 cases of CHD (nonfatal myocardial infarction and fatal CHD). Using factor analysis, we identified 2 major dietary patterns using dietary data collected through a 131-item FFQ. The first factor, which we labeled the "prudent pattern," was characterized by higher intake of vegetables, fruit, legumes, whole grains, fish, and poultry, whereas the second factor, the "Western pattern," was characterized by higher intake of red meat, processed meat, refined grains, sweets and dessert, French fries, and high-fat dairy products. After adjustment for age and CHD risk factors, the relative risks from the lowest to highest quintiles of the prudent pattern score were 1.0, 0. 87, 0.79, 0.75, and 0.70 (95% CI: 0.56, 0.86; P: for trend = 0.0009). In contrast, the relative risks across increasing quintiles of the Western pattern score were 1.0, 1.21, 1.36, 1.40, and 1.64 (95% CI: 1.24, 2.17; P: for trend < 0.0001). These associations persisted in subgroup analyses according to cigarette smoking, body mass index, and parental history of myocardial infarction. CONCLUSIONS: These data suggest that major dietary patterns derived from the FFQ predict risk of CHD, independent of other lifestyle variables.     

Diet, urate, and Parkinson's disease risk in men

The authors examined whether a diet that increases plasma urate level is also related to reduced risk of Parkinson's disease (PD). The study population comprised 47,406 men in the Health Professionals Follow-up Study. The potential effect of diet on plasma urate level was estimated by regressing plasma urate on intakes of selected foods and nutrients in a subsample of 1,387 men. Coefficients of this regression model were then used to calculate a dietary urate index for all cohort participants. Multivariate relative risks of PD were estimated by means of Cox proportional hazards models. After 14 years of follow-up (1986-2000), the authors documented 248 incident cases of PD. A higher dietary urate index was associated with a lower risk of PD (top quintile vs. bottom: relative risk = 0.47, p-trend = 0.0008), after adjustment for age, smoking, caffeine intake, and other potential confounders. This association remained strong and significant after further adjustment for each component of the index individually (p-trend < 0.02 for each). These data support urate as a potentially protective factor in PD and suggest that dietary changes expected to increase plasma urate level may contribute to lower risk of PD. These potential benefits, however, should be weighed against expected adverse effects on risk of gout and other chronic diseases.     

Unique dietary patterns and chronic disease risk profiles of adult men: the Framingham nutrition studies

OBJECTIVE: To identify the dietary patterns of adult men and examine their relationships with nutrient intake and chronic disease risk over long-term follow-up. DESIGN/SUBJECTS: Baseline 145-item food frequency questionnaires from 1,666 Framingham Offspring-Spouse cohort men were used to identify comprehensive dietary patterns. Independent 3-day dietary records at baseline and 8 years later provided estimates of subjects' nutrient intake by dietary pattern. Chronic disease risk factor status was compared at baseline and 16-year follow-up across all male dietary patterns. STATISTICAL ANALYSES: Cluster analysis was applied to food frequency data to identify non-overlapping male dietary patterns. Analysis of covariance and logistic regression were used to compare nutrient intake, summary nutritional risk scores, and chronic disease risk status at baseline and follow-up by male dietary pattern. RESULTS: Five distinct and comprehensive dietary patterns of Framingham Offspring-Spouse men were identified and ordered according to overall nutritional risk: Transition to Heart Healthy, Higher Starch, Average Male, Lower Variety, and Empty Calories. Nutritional risk was high and varied by dietary pattern; key nutrient contrasts were stable over 8-year follow-up. Chronic disease risk also varied by dietary pattern and specific subgroup differences persisted over 16 years, notably rates of overweight/obesity and smoking. CONCLUSIONS: Quantitative cluster analysis applied to food frequency questionnaire data identified five distinct, comprehensive, and stable dietary patterns of adult Framingham Offspring-Spouse cohort men. The close associations between the dietary patterns, nutritional risk, and chronic disease profiles of men emphasize the importance of targeted preventive nutrition interventions to promote health in the male population.     

Adherence to the Dietary Guidelines for Americans and risk of major chronic disease in men

BACKGROUND: The Dietary Guidelines for Americans and the food guide pyramid aim to reduce the risk of major chronic disease in the United States, but data supporting their overall effectiveness are sparse. The healthy eating index (HEI) measures the concordance of dietary patterns with these guidelines. OBJECTIVE: We tested whether a high HEI score (range: 0-100; 100 is best) calculated from a validated food-frequency questionnaire (HEI-f) could predict lower risk of major chronic disease in men. DESIGN: A cohort of US male health professionals without major disease completed detailed questionnaires on food intake and other risk factors for heart disease and cancer in 1986 and repeatedly during the 8-y follow-up. Major chronic disease outcome was defined as incident major cardiovascular disease (stroke or myocardial infarction, n = 1092), cancer (n = 1661), or other non-trauma-related deaths (n = 366). RESULTS: The HEI-f was weakly inversely associated with risk of major chronic disease [comparing highest with lowest quintile of the HEI-f, relative risk (RR) = 0.89; 95% CI: 0.79, 1.00; P: < 0.001 for trend]. The HEI-f was associated with moderately lower risk of cardiovascular disease (RR = 0.72; 95% CI: 0.60, 0.88; P: < 0.001) but was not associated with lower cancer risk. CONCLUSIONS: The HEI-f was only weakly associated with risk of major chronic disease, suggesting that improvements to the HEI may be warranted. Further research on the HEI could have implications for refinements to the Dietary Guidelines for Americans and the food guide pyramid.     

Adherence to the Dietary Guidelines for Americans and risk of major chronic disease in women

BACKGROUND: Little is known about the overall health effects of adherence to the Dietary Guidelines for Americans. The healthy eating index (HEI), developed at the US Department of Agriculture, measures how well Americans' diets conform to these guidelines. OBJECTIVE: We tested whether the HEI (scores range from 0 to 100; 100 is best) calculated from food-frequency questionnaires (HEI-f) would predict risk of major chronic disease in women. DESIGN: A total of 67272 US female nurses who were free of major disease completed detailed questionnaires on diet and chronic disease risk factors in 1984 and repeatedly over 12 y. Major chronic disease was defined as fatal or nonfatal cardiovascular disease (myocardial infarction or stroke, n = 1365), fatal or nonfatal cancer (n = 5216), or other nontraumatic deaths (n = 496), whichever came first. We also examined cardiovascular disease and cancer as separate outcomes. RESULTS: After adjustment for smoking and other risk factors, the HEI-f score was not associated with risk of overall major chronic disease in women [relative risk (RR) = 0.97; 95% CI: 0.89, 1.06 comparing the highest with the lowest quintile of HEI-f score]. Being in the highest HEI-f quintile was associated with a 14% reduction in cardiovascular disease risk (RR = 0.86; 95% CI: 0.72, 1. 03) and was not associated with lower cancer risk (RR = 1.02; 95% CI: 0.93, 1.12). CONCLUSION: These data suggest that adherence to the 1995 Dietary Guidelines for Americans, as measured by the HEI-f, will have limited benefit in preventing major chronic disease in women.     

Joint association of alcohol and folate intake with risk of major chronic disease in women

Alcohol interferes with folate metabolism and has opposing effects on the risks of cardiovascular disease and cancer. The authors examined the joint association of alcohol and folate intake with risk of major chronic disease, defined as fatal or nonfatal cardiovascular disease or cancer, or other nontraumatic death. This study included 83,929 women aged 34-59 years with no previous history of cardiovascular disease or cancer who provided dietary data in 1980. During 16 years of follow-up, the authors documented 10,666 new cases of major chronic disease. Overall, heavy drinkers (>30 g/day) with a lower total folate intake (<180 micro g/day) had the highest risk; in comparison with abstainers with a folate intake of 400-599 micro g/day, the multivariate relative risk was 1.36 (95% confidence interval: 1.10, 1.70). However, the increased risk of major chronic disease associated with heavy drinking was largely diminished among women with a higher folate intake (p for interaction = 0.02). The positive association between heavy alcohol/low folate intake and risk of major chronic disease was most apparent among women younger than age 60 years. Adequate folate intake may be important in the primary prevention of overall major chronic disease in women, especially among younger women consuming more than two alcoholic drinks per day.     

Long-term dietary fiber intake and risk of chronic obstructive pulmonary disease: a prospective cohort study of women

European Journal of Nutrition - Until now, only two prospective cohort studies have investigated dietary fiber intake in relation to risk of chronic obstructive pulmonary disease (COPD), but...     

Prospective study of major dietary patterns and colorectal cancer risk in women.

A number of prospective cohort studies have examined the relations of individual dietary variables to risk of colorectal cancer. Few studies have addressed the broader eating patterns that reflect many dietary exposures working together. Using data from a prospective study of 61,463 women, with an average follow-up period of 9.6 years (between 1987 and 1998) and 460 incident cases of colorectal cancer, the authors conducted a factor analysis to identify and examine major dietary patterns in relation to colorectal cancer risk. Using proportional hazards regression to estimate relative risks, the authors found no clear association between a "Western," "healthy," or "drinker" dietary pattern and colorectal cancer risk. However, the data suggested that consuming low amounts of foods that constitute a "healthy" dietary pattern may be associated with increased risks of colon and rectal cancers. An inverse association with the "healthy" dietary pattern was found among women under age 50 years, although the number of cancers in this age group was limited and interpretation of this finding should be cautious. In this age group, relative risks for women in increasing quintiles of the "healthy" dietary pattern, compared with the lowest quintile, were 0.74 (95% confidence interval (CI): 0.41, 1.31), 0.69 (95% CI: 0.39, 1.24), 0.59 (95% CI: 0.32, 1.07), and 0.45 (95% CI: 0.23, 0.88) (p for trend = 0.03). The role of overall eating patterns in predicting colorectal cancer risk requires further investigation.     

Time-to-pregnancy and risk of cardiovascular disease among men and women

European Journal of Epidemiology - A few studies indicate that women with prolonged time-to-pregnancy (TTP) have an increased risk of cardiovascular disease (CVD). This has not been studied in men....     

Diet and the risk of pancreatic cancer in men

To examine the relation between diet and pancreatic cancer, we conducted a population-based case-control study in western Washington. Cases (n = 148) were married men, aged 20-74 years, who were diagnosed with pancreatic cancer from July 1982 to June 1986. Controls (n = 188), identified by random digit dialing, were frequency matched to the cases by 5-year age groups. Wives responded as surrogates for both cases and controls. Wives were interviewed by telephone, and they completed a mailed, self-administered food frequency questionnaire. Results indicated that pancreatic cancer risk increased with increasing protein intake. The increased risk for heavy consumers of protein was largely confined to individuals aged 65 years and above. In that group, the odds ratio for those in the highest quartile of protein intake, relative to the lowest, was 6.0 (95% confidence interval 1.7-20.6). No association was found between pancreatic cancer risk and the intake of total fat, saturated fat, cholesterol, omega-3 fatty acids, or vitamins A and C. There was an unexpected inverse association between calcium intake and pancreatic cancer risk in these data. These findings are discussed in relation to possible etiologic mechanisms that they suggest.     

The prevalence of chronic diseases and major disease risk factors at different ages among 150 000 men and women living in Mexico City: cross-sectional analyses of a prospective study

Background  

While most of the global burden from chronic diseases, and especially vascular diseases, is now borne by low and middle-income countries, few large-scale epidemiological studies of chronic diseases in such countries have been performed.     

Diet, alcohol and coronary heart disease in men

It is well known that there is a significant positive correlation between consumption of saturated fat and cholesterol and international mortality from coronary heart disease (CHD). It is less well appreciated that there is a strong negative correlation between alcohol consumption and CHD, as might be expected from the effect of alcohol on high density lipoprotein levels. Neither of the simple correlations, however, account for CHD in many countries. We examined dietary and alcohol consumption data from 18 countries. The simple correlations with CHD are as follows: saturated fat, r = 0.71; polyunsaturated fat, r = -0.34; total alcohol consumption, r = -0.58. A multiple-regression equation incorporating the dietary and alcohol data, however, yields an r of 0.92.     

Bone mineral density and risk of cardiovascular disease in men and women: the HUNT study

European Journal of Epidemiology - The association between bone mineral density (BMD) and cardiovascular disease (CVD) is not fully understood. We evaluated BMD as a risk factor for cardiovascular...     

Demographic and psychosocial characteristics of middle-aged women and men who use dietary supplements: Results from the Malmo Diet and Cancer Study

In the Western world, huge amounts of money are being spenton dietary supplements, although this usage may be useless andpossibly harmful. Factors that influence supplement consumptionhave not been well defined. This paper aims to describe relationsbetween supplement usage and various sociodemographic and psychosocialfactors. The study cohort consisted of 6,545 men and women,aged 45–65 years, who during 1991 and 1992 participatedin the Malmö Diet and Cancer Study, a large-scale prospectivecohort study. Data on supplement consumption were recorded during7 consecutive days. Each participant also completed a questionnaire,covering education, work history, alcohol, smoking, perceivedhealth and psychosocial factors such as social network, socialsupport, job strain, etc. Total body fat was also measured.The prevalence of supplement consumption was 43% among womenand 29% among men. The most important sododemographic factorswere education, ethnicity and age. Female users tended to beslim, have worse perceived health and to drink more alcoholthan other women, none of which applied to male users. No differencesin smoking habits between users and non-users were noted. Noneof the psychosodal factors appeared to influence supplementconsumption. Those who used vitamins and/or minerals only weremore similar to non-users than those who used all kinds of dietarysupplements. There was a substantial variation in consumptionprevalence with season. The prevalence of supplement consumptionis influenced by a number of demographic factors and also byseason. To claim that supplement users are health-consciousis an over-simplification. The psychosocial factors behind supplementusage call for further analyses.