TY - JOUR
T1 - Plant foods, dietary fibre and risk of ischaemic heart disease in the European prospective investigation into cancer and nutrition (EPIC) cohort
AU - Perez-Cornago, Aurora
AU - Crowe, Francesca L
AU - Appleby, Paul N
AU - Bradbury, Kathryn E
AU - Wood, Angela M
AU - Jakobsen, Marianne Uhre
AU - Johnson, Laura
AU - Sacerdote, Carlotta
AU - Steur, Marinka
AU - Weiderpass, Elisabete
AU - Würtz, Anne Mette L
AU - Kühn, Tilman
AU - Katzke, Verena
AU - Trichopoulou, Antonia
AU - Karakatsani, Anna
AU - La Vecchia, Carlo
AU - Masala, Giovanna
AU - Tumino, Rosario
AU - Panico, Salvatore
AU - Sluijs, Ivonne
AU - Skeie, Guri
AU - Imaz, Liher
AU - Petrova, Dafina
AU - Quirós, J Ramón
AU - Yohar, Sandra Milena Colorado
AU - Jakszyn, Paula
AU - Melander, Olle
AU - Sonestedt, Emily
AU - Andersson, Jonas
AU - Wennberg, Maria
AU - Aune, Dagfinn
AU - Riboli, Elio
AU - Schulze, Matthias B
AU - di Angelantonio, Emanuele
AU - Wareham, Nicholas J
AU - Danesh, John
AU - Forouhi, Nita G
AU - Butterworth, Adam S
AU - Key, Timothy J
N1 - © The Author(s) 2020. Published by Oxford University Press on behalf of the International Epidemiological Association.
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
U2 - 10.1093/ije/dyaa155
DO - 10.1093/ije/dyaa155
M3 - Article
C2 - 33245137
SN - 1464-3685
VL - 50
SP - 212
EP - 222
JO - International Journal of Epidemiology
JF - International Journal of Epidemiology
IS - 1
ER -
