Meat consumption and fatal ischemic heart disease

In 1960 the meat-consumption habits of 25,153 California Seventh-Day Adventists were assessed by questionnaire. Between 1960 and 1980 ischemic heart disease deaths were identified. Meat consumption was positively associated with fatal ischemic heart disease in both men and women. This association was apparently not due to confounding by eggs, dairy products, obesity, marital status, or cigarette smoking. The positive association between meat consumption and fatal ischemic heart disease was stronger in men than in women and, overall, strongest in young men. For 45- to 64-year-old men, there was approximately a threefold difference in risk between men who ate meat daily and those who did not eat meat. This is the first study to clearly show a dose-response relationship between meat consumption and ischemic heart disease risk.     

Coronary heart disease mortality and alcohol consumption in Framingham

The relationship between ethanol consumption and coronary heart disease was examined in the original Framingham Heart Study cohort (1948) with a 24-year follow-up from exam 2 (2,106 males and 2,639 females). Ethanol consumption shows a strong U-shaped relationship with coronary heart disease mortality for male nonsmokers and heavy smokers both in the raw age-adjusted data and in the Cox regression analyses, where ethanol consumption is modeled quadratically. No ethanol effects were found for female nonsmokers. The age-adjusted data suggest a U-shape curve for female smokers, although this was not confirmed by the Cox analysis. Separate analyses relating alcohol consumption to mortality from all causes showed similar effects except that the reduction in mortality for males was much less. For male coronary heart disease mortality, ethanol consumption was subdivided into beer, wine, and spirits consumption. These beverages were also modeled quadratically in the Cox analyses, and all showed strong U-shaped curves for both nonsmokers and heavy smokers. In nonsmokers, beer and wine show greater reductions in coronary heart disease mortality than spirits.     

The relationship of alcohol consumption to atherosclerotic heart disease

A review of the literature indicated that moderate alcohol consumers appear to have a lower rate of heart disease and a lower mortality than nondrinkers or heavy drinkers. A geographic analysis of 20 countries in 1972 suggested that moderate alcohol consumption appeared to be negatively related to rates of heart disease mortality. A temporal analysis within the United States indicated that changes in alcohol consumption, particularly beer, were highly negatively related to changes in heart disease mortality for 1950 to 1975. The review, in addition to the geographic and temporal analyses, suggests a U-shaped relationship between alcohol consumption and heart disease. Possible reasons for the negative relationship between moderate alcohol consumption and heart disease were discussed, including relationships to high-density lipoprotein cholesterol, changes in food patterns, and stress.     

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.     

Fruit and vegetable consumption,ethnicity and risk of fatal ischemic heart disease

Objective: Mortality rates from ischemic heart disease vary among ethnic groups. Dietary intake of fruits and vegetables has been associated with a lower risk of ischemic heart disease, but ethnic-specific data are limited. Design: Prospective cohort study. Setting: Hawaii and Los Angeles County, between 1993 and 1996. Participants: These analyses included 164,617 adults age 45 to 75, representing five ethnic groups who were enrolled in the Multiethnic Cohort Study. Dietary data were collected at baseline using a validated food frequency questionnaire and fatal ischemic heart disease cases were identified up to December 31, 2001. Associations between fruit and vegetable consumption and fatal ischemic heart disease were examined using multivariate Cox proportional hazard models. Results: The associations between fruit and vegetable intake and fatal ischemic heart disease were similar among the five ethnic groups. When data for the ethnic groups were combined, higher vegetable intake was associated with a protective effect against ischemic heart disease in men with all intake levels above 3.4 servings per day (over 6.6 servings per day: hazard ratio, 0.73; 95% confidence interval, 0.58–0.92). Inconsistent results were observed for women, where the protective association was observed only at mid-level vegetable intake levels, but not among women with the highest level of vegetable intake. There was no evidence of an association for fruit intake. Conclusions: Associations between fruit and vegetable intake and fatal IHD do not appear to vary among ethnic groups. Additional research is needed to clarify associations for fruit versus vegetable intake and impact on cardiovascular outcomes.     

A quantitative analysis of fish consumption and coronary heart disease mortality

Although a rich source of n-3 polyunsaturated fatty acids (PUFAs) that may confer multiple health benefits, some fish contain methyl mercury (MeHg), which may harm the developing fetus. U.S. government recommendations for women of childbearing age are to modify consumption of high-MeHg fish to reduce MeHg exposure, while recommendations encourage fish consumption among the general population because of the nutritional benefits. The Harvard Center for Risk Analysis convened an expert panel (see acknowledgements) to quantify the net impact of resulting hypothetical changes in fish consumption across the population. This paper estimates the impact of fish consumption on coronary heart disease (CHD) mortality and nonfatal myocardial infarction (MI). Other papers quantify stroke risk and the impacts of both prenatal MeHg exposure and maternal intake of n-3 PUFAs on cognitive development. This analysis identified articles in a recent qualitative review appropriate for the development of a dose-response relationship. Studies had to satisfy quality criteria, quantify fish intake, and report the precision of the relative risk estimates. Relative risk results were averaged, weighted proportionately by precision. CHD risks associated with MeHg exposure were reviewed qualitatively because the available literature was judged inadequate for quantitative analysis. Eight studies were identified (29 exposure groups). Our analysis estimated that consuming small quantities of fish is associated with a 17% reduction in CHD mortality risk, with each additional serving per week associated with a further reduction in this risk of 3.9%. Small quantities of fish consumption were associated with risk reductions in nonfatal MI risk by 27%, but additional fish consumption conferred no incremental benefits.     

Independent effect and population impact of obesity on fatal coronary heart disease in adults

BACKGROUND: It is unclear whether the coronary heart disease (CHD) mortality risk associated with obesity is mediated only through traditional CHD risk factors. This analysis evaluated the independent CHD mortality risk due to obesity and determined its population attributable risk (PAR). METHODS: Using the NHANES I Epidemiologic Follow-up Study (1971-1992, n = 10,582), a diabetes-body mass index (BMI) variable was constructed. The hazard ratios (HR) for fatal CHD in the diabetes-BMI categories (adjusting for age, sex, race, exercise, education level, smoking, hypertension, cholesterol, and alcohol use) were determined and the PARs subsequently estimated. RESULTS: Compared to lean non-diabetics, the HR (95% CI) for fatal CHD is 0.8 (0.7, 1.1) in overweight non-diabetics, 1.4 (1.3, 2.0) in obese non-diabetics, 2.2 (1.2, 4.0) in lean diabetics, 2.3 (1.4, 3.9) in overweight diabetics, and 3.3 (1.9, 8.9) in obese diabetics. The PAR% is -6.8 (-15.7, 1.8) in overweight non-diabetics, 6.1 (1.7, 11.1) in obese non-diabetics, 2.0 (0.3, 4.0) in lean diabetics, 2.2 (0.6, 4.3) in overweight diabetics, and 2.2 (0.8, 3.8) in obese diabetics. CONCLUSIONS: Obesity is an independent risk factor for CHD mortality even after controlling for traditional CHD risk factors. The PAR for CHD death in obese non-diabetics is significant. Obesity should be aggressively treated in those without traditional CHD risk factors.     

A review of the relationship between coffee consumption and coronary heart disease

A review of the literature dealing with the relationship between coffee consumption and coronary heart disease revealed that most of the studies did not find coffee consumption to be a risk factor. However, many studies are plagued with methodological difficulties which operate to minimize the probability of identifying coffee consumption as a risk factor. A significant percentage of the studies do not rule out coffee consumption as a significant risk factor in coronary heart disease.Larry Christensen, Ph.D. is Professor, Department of Psychology, Texas A&M University, College Station, TX; Thomas Murray, B.S. is a graduate student, Department of Psychology, University of Mary Hardin Baylor, Belton, TX.     

Alcohol consumption: protection against coronary heart disease and risks to health

In a prospective cardiovascular study of 1341 Trinidadian men aged 35-69 years undertaken between 1977 and 1986, the baseline prevalence rates of cardiac and arterial disease and diabetes mellitus were increased in the 118 (8.8%) who had been but were no longer regular drinkers. This finding suggested that awareness of these disorders was a discouragement to drinking alcohol. When this group and all with coronary heart disease (CHD) or diabetes at entry were excluded, a significant inverse trend was found between alcohol consumption in the week before recruitment and risk of CHD across the subsequent average follow-up of 7.5 years. Men who had taken 5-14 drinks had about half the CHD risk of those who had had no alcohol, even after allowance for age, ethnicity, smoking, blood pressure and serum cholesterol concentration. The overall morbidity and mortality experience in this community indicated a protective effect of alcohol against CHD, but adverse health consequences from multiple causes in drinkers who were alcohol dependent.     

冠心病基因检测与冠心病的关联性

目的观察冠心病基因检测与冠心病是否有关联性,以及关联程度如何。方法选取120例住院患者,其中60例为冠心病人,60例为非冠心病人。年龄40—65岁。冠心病为观察A组,非冠心病为对照B组,记录性别、年龄、冠心病家族史、高血压史、糖尿病史,并均抽血行冠心病基因检测。A组选1人和B组选1人按年龄相近、性别相同配对,共形成60对。开始进行1：1条件Logistic回归分析。结果冠心病家族史、高血压史、糖尿病史、以及冠心病基因检测与冠心病均有关联性。其中冠心病基因检测与冠心病的关联程度低于其他3个因素。结论冠心病基因检测与冠心病有关联性。     

Water, other fluids, and fatal coronary heart disease: the Adventist Health Study

Whole blood viscosity, plasma viscosity, hematocrit, and fibrinogen are considered independent risk factors for coronary heart disease and can be elevated by dehydration. The associations between fatal coronary heart disease and intake of water and fluids other than water were examined among the 8,280 male and 12,017 female participants aged 38-100 years who were without heart disease, stroke, or diabetes at baseline in 1976 in the Adventist Health Study, a prospective cohort study. A total of 246 fatal coronary heart disease events occurred during the 6-year follow-up. High daily intakes of water (five or more glasses) compared with low (two or fewer glasses) were associated with a relative risk in men of 0.46 (95% confidence interval (CI): 0.28, 0.75; p trend = 0.001) and, in women, of 0.59 (95% CI: 0.36, 0.97). A high versus low intake of fluids other than water was associated with a relative risk of 2.47 (95% CI: 1.04, 5.88) in women and of 1.46 (95% CI: 0.7, 3.03) in men. All associations remained virtually unchanged in multivariate analysis adjusting for age, smoking, hypertension, body mass index, education, and (in women only) hormone replacement therapy. Fluid intake as a putative coronary heart disease risk factor may deserve further consideration in other populations or using other study designs.