Plant foods, dietary fibre and risk of ischaemic heart disease in the European prospective investigation into cancer and nutrition (EPIC) cohort

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  • Aurora Perez-Cornago, University of Oxford, Oxford, Storbritannien
  • Francesca L Crowe, University of Oxford, Oxford, University of Birmingham, Storbritannien
  • Paul N Appleby, University of Oxford, Oxford, Storbritannien
  • Kathryn E Bradbury
  • ,
  • Angela M Wood, University of Cambridge, Storbritannien
  • Marianne Uhre Jakobsen, Danmarks Tekniske Universitet
  • ,
  • Laura Johnson, University of Bristol, UK, Storbritannien
  • Carlotta Sacerdote, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Italien
  • Marinka Steur, University of Cambridge, Storbritannien
  • Elisabete Weiderpass, IARC, Frankrig
  • Anne Mette L Würtz
  • Tilman Kühn, German Cancer Research Center (DKFZ), Tyskland
  • Verena Katzke, German Cancer Research Center (DKFZ), Tyskland
  • Antonia Trichopoulou, Hellenic Health Foundation, Athens, Greece., Grækenland
  • Anna Karakatsani, “ATTIKON” University Hospital, Hellenic Health Foundation, Athens, Greece., Grækenland
  • Carlo La Vecchia, Hellenic Health Foundation, Athens, Greece., Universita degli Studi di Milano, Grækenland
  • Giovanna Masala, Institute for Cancer Research, Italien
  • Rosario Tumino, Cancer Registry and Histopathology Department, Civic M.P.Arezzo Hospital, Ragusa, Italy, Ragusa, Italy., Italien
  • Salvatore Panico, EPIC Centre of Naples. Dipartimento di Medicina Clinica e Chirurgia Federico II University, Naples, Italy., Italien
  • Ivonne Sluijs, Utrecht University, Utrecht, Holland
  • Guri Skeie, UiT The Arctic University of Norway, University of Leeds, Norge
  • Liher Imaz, Department of Health of the Basque Country, Spanien
  • Dafina Petrova, Andalusian School of Public Health (EASP), Granada, Universidad de Granada, CIBER Epidemiología y Salud Pública (CIBERESP), Spain., Spanien
  • J Ramón Quirós, Public Health Directorate, Asturias, Spain., Spanien
  • Sandra Milena Colorado Yohar, University of Antioquia, CIBER Epidemiología y Salud Pública (CIBERESP), Spain., Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain., Spanien
  • Paula Jakszyn, Medical Oncology, Catalan Institute of Oncology, IDIBELL., Facultad de Ciencias de la salud, Universidad Ramon LLul, Barcelona, Spanien
  • Olle Melander, Lund University, Malmö, Skåne University Hospital Malmö, Sverige
  • Emily Sonestedt, Lund University, Malmö, Sverige
  • Jonas Andersson, University of Umeå, Umeå, Sweden., Sverige
  • Maria Wennberg, University of Umeå, Umeå, Sweden., Sverige
  • Dagfinn Aune, Imperial Coll London, Imperial College London, Imperial Clin Trials Unit, Bjørknes University College, Oslo, Norway., Oslo University Hospital, Storbritannien
  • Elio Riboli, Imperial Coll London, Imperial College London, Imperial Clin Trials Unit, Storbritannien
  • Matthias B Schulze, German Institute of Human Nutrition Potsdam-Rehbruecke, Potsdam, Germany., University of Potsdam, Tyskland
  • Emanuele di Angelantonio, University of Cambridge, Storbritannien
  • Nicholas J Wareham, University of Cambridge, Storbritannien
  • John Danesh, University of Cambridge, Wellcome Sanger Institute, Storbritannien
  • Nita G Forouhi, University of Cambridge, Storbritannien
  • Adam S Butterworth, University of Cambridge, Storbritannien
  • Timothy J Key, University of Oxford, Oxford, Storbritannien

BACKGROUND: Epidemiological evidence indicates that diets rich in plant foods are associated with a lower risk of ischaemic heart disease (IHD), but there is sparse information on fruit and vegetable subtypes and sources of dietary fibre. This study examined the associations of major plant foods, their subtypes and dietary fibre with risk of IHD in the European Prospective Investigation into Cancer and Nutrition (EPIC).

METHODS: We conducted a prospective analysis of 490 311 men and women without a history of myocardial infarction or stroke at recruitment (12.6 years of follow-up, n cases = 8504), in 10 European countries. Dietary intake was assessed using validated questionnaires, calibrated with 24-h recalls. Multivariable Cox regressions were used to estimate hazard ratios (HR) of IHD.

RESULTS: There was a lower risk of IHD with a higher intake of fruit and vegetables combined [HR per 200 g/day higher intake 0.94, 95% confidence interval (CI): 0.90-0.99, P-trend = 0.009], and with total fruits (per 100 g/day 0.97, 0.95-1.00, P-trend = 0.021). There was no evidence for a reduced risk for fruit subtypes, except for bananas. Risk was lower with higher intakes of nuts and seeds (per 10 g/day 0.90, 0.82-0.98, P-trend = 0.020), total fibre (per 10 g/day 0.91, 0.85-0.98, P-trend = 0.015), fruit and vegetable fibre (per 4 g/day 0.95, 0.91-0.99, P-trend = 0.022) and fruit fibre (per 2 g/day 0.97, 0.95-1.00, P-trend = 0.045). No associations were observed between vegetables, vegetables subtypes, legumes, cereals and IHD risk.

CONCLUSIONS: In this large prospective study, we found some small inverse associations between plant foods and IHD risk, with fruit and vegetables combined being the most strongly inversely associated with risk. Whether these small associations are causal remains unclear.

OriginalsprogEngelsk
Artikelnummerdyaa155
TidsskriftInternational Journal of Epidemiology
Vol/bind50
Nummer1
Sider (fra-til)212-222
Antal sider11
ISSN0300-5771
DOI
StatusUdgivet - feb. 2021

Bibliografisk note

© The Author(s) 2020. Published by Oxford University Press on behalf of the International Epidemiological Association.

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