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Diet and incident ischaemic heart disease: the Caerphilly Study

Published online by Cambridge University Press:  09 March 2007

A. M. Fehily ,
J. W. G. Yarnell ,
P. M. Sweetnam  and
P. C. Elwood
A. M. Fehily
Affiliation:
Medical Research Council Epidemiology Unit, Llandough Hospital, Penarth, South Glamorgan CF6 IXX
J. W. G. Yarnell
Affiliation:
Medical Research Council Epidemiology Unit, Llandough Hospital, Penarth, South Glamorgan CF6 IXX
P. M. Sweetnam
Affiliation:
Medical Research Council Epidemiology Unit, Llandough Hospital, Penarth, South Glamorgan CF6 IXX
P. C. Elwood
Affiliation:
Medical Research Council Epidemiology Unit, Llandough Hospital, Penarth, South Glamorgan CF6 IXX
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Abstract

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The Caerphilly Prospective Ischaemic Heart Disease (IHD) Study is based on a sample of 2512 men aged 45–59 years when first seen. Nutrient intakes, estimated using a self-administered semi-quantitative food frequency questionnaire, are available for 2423 men (96%). Amongst these, 148 major IHD events occurred during the first 5 years of follow-up. Associations were examined between these events and baseline diet. Incident IHD (new events) was negatively associated with total energy intake: men who went on to experience an IHD event had consumed 560 kJ (134 kcal)/d (6%) less at baseline than men who experienced no event (P = 0.01). The relative odds of an IHD event was 1.5 among men in the lowest fifth of energy intake, compared with 1.3,1.2,0.9 and 1.0 respectively for the other four fifths (P < 0.05). The difference in energy intake was reflected in lower intakes of every nutrient examined. When expressed as a percentage of total energy, mean intakes of men who experienced an IHD event were virtually identical to those of men who did not. There was some evidence suggesting a positive association between total fat intake and IHD risk, but the trend was not consistent and not statistically significant. There was no association for animal fat. Alcohol consumption was negatively associated with subsequent IHD, but only in men who already had evidence of IHD at baseline (P < 0.05). Dietary fibre, particularly from fruit and vegetables, was 7% lower in men who had an incident IHD event (P < 0.05), but the difference was not independent of total energy. There was a trend of increasing IHD risk with decreasing vitamin C intake, the relative odds of an IHD event being 1.6 among men in the lowest one-fifth of the vitamin C distribution, but this was not statistically significant.

Keywords

Energy intakeFat intakeDietary fibreIschaemic heart diseaseVitamin C
Type
Nutritional Studies of Populations
Information
British Journal of Nutrition , Volume 69 , Issue 2 , March 1993 , pp. 303 - 314
Copyright
Copyright © The Nutrition Society 1993

References

REFERENCES

Bainton, D., Baker, I. A., Sweetnam, P. M., Yarnell, J. W. G. & Elwood, P. C. (1988). Prevalence of ischaemic heart disease: The Caerphilly and Speedwell surveys. British Heart Journal 59, 201–206.CrossRefGoogle ScholarPubMed
Bolton-Smith, C., Casey, C. E., Gey, K. F., Smith, W. C. S. & Tunstall-Pedoe, H. (1991). Antioxidant vitamin intakes assessed using a food-frequency questionnaire: correlation with biochemical status in smokers and non- smokers. British Journal of Nutrition 65, 337–346.CrossRefGoogle ScholarPubMed
Burr, M. L., Fehily, A. M., Gilbert, J. F., Rogers, S., Holliday, R. M., Sweetnam, P. M., Elwood, P. C. & Deadman, N. M. (1989). Effects of changes in fat, fish and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet 2, 757–761.CrossRefGoogle ScholarPubMed
Caerphilly and Speedwell Collaborative Group (1984). The Caerphilly and Speedwell Collaborative Heart Disease Studies. Journal of Epidemiology and Community Health 38, 259–262.CrossRefGoogle Scholar
Cullen, K., Stenhouse, N. S. & Wearne, K. L. (1982). Alcohol and mortality in the Busselton study. International Journal of Epidemiology 11, 67–70.CrossRefGoogle ScholarPubMed
Dyer, A., Stamler, J., Paul, O., Berkson, D. M., Shekelle, R. B., Lepper, M. H., McKean, H., Lindberg, H. A., Garside, D. & Tokich, T. (1981). Alcohol, cardiovascular risk factors and mortality: the Chicago experience. Circulation 64, Suppl. 111, 20, 27.Google ScholarPubMed
Fehily, A. M., Yarnell, J. W. G. & Butland, B. K. (1987). Diet and ischaemic heart disease in the Caerphilly study. Human Nutrition: Applied Nutrition 41A, 319–326.Google Scholar
Garcia-Palmieri, M. R., Sorlie, P., Tillotson, J., Costas, R., Cordero, E. & Rodriguez, M. (1980). Relationship of dietary intake to subsequent coronary heart disease incidence: the Puerto Rico Heart Health Programme. American Journal of Clinical Nutrition 33, 1818–1827.CrossRefGoogle Scholar
Gey, K. F., Brubacher, B. B. & Stahelin, H. B. (1987). Plasma levels of antioxidant vitamins in relation to ischaemic heart disease and cancer. American Journal of Clinical Nutrition 45, 1368–1387.CrossRefGoogle ScholarPubMed
Gordon, T., Kagan, A., Garcia-Palmieri, M., Kannel, W. B., Zukel, W. J., Tillotson, J., Sorlie, P. & Hjortland, M. (1981). Diet and its relation to coronary heart disease and death in three populations. Circulation 63, 500–515.CrossRefGoogle ScholarPubMed
Hegsted, D. M., McGandy, R. B., Myers, M. L. & Stare, F. J. (1965). Quantitative effects of dietary Fdt on serum cholesterol in man. American Journal of Clinical Nutrition 17, 281–295.CrossRefGoogle Scholar
Jain, M. G., Harrison, L., Howe, G. R. & Miller, A. B. (1982). Evaluation of a self-administered dietary questionnaire for use in a cohort study. American Journal of Clinical Nutrition 36, 931–935.CrossRefGoogle ScholarPubMed
Jain, M., Howe, G. R., Johnson, K. C. & Miller, A. B. (1980). Evaluation of a diet history questionnaire for epidemiological studies. American Journal of Epidemiology 111, 212––219.CrossRefGoogle Scholar
Kagan, A., Yano, K., Rhoads, G. G. & McGee, D. L. (1981). Alcohol and cardiovascular disease: the Hawaiian experience. Circulation 64, Suppl. 111, 27–31.Google ScholarPubMed
Keys, A., Anderson, J. T. & Grande, F. (1965). Serum cholesterol response to changes in the diet. 1-5. Metabolism 14, 747–787.CrossRefGoogle ScholarPubMed
Khaw, K. T. & Barrett-Connor, E. (1987). Dietary fibre and reduced ischaemic heart disease mortality rates in men and women: a 12-year prospective study. American Journal of Epidemiology 126, 1093–1102.CrossRefGoogle ScholarPubMed
Klatsky, A. L., Armstrong, M. A. & Friedman, G. D. (1990). Risk of cardiovascular mortality in alcohol drinkers, ex-drinkers and non-drinkers. American Journal of Cardiology 66, 1237–1242.CrossRefGoogle Scholar
Kozarevic, D., Demirovic, J., Gordon, T., Kaelber, C. T., McGee, D. & Zukel, W. J. (1982). Drinking habits and coronary heart disease. The Yugoslavia cardiovascular disease study. American Journal of Epidemiology 116, 748–758.CrossRefGoogle ScholarPubMed
Kromhout, D. & Coulander, C. L. (1984). Diet, prevalence and 10-year mortality from coronary heart disease in 871 middle-aged men. The Zutphen study. American Journal of Epidemiology 119, 733–741.CrossRefGoogle ScholarPubMed
Kushi, L. H., Lew, R. A., Stare, F. J., Ellison, C. R., El Lozy, M., Bourke, G., Daly, L., Graham, I., Hickey, N., Mulcahy, R. & Keveney, J. (1985). Diet and 20-year mortality from coronary heart disease: the Ireland-Boston diet-heart study. New England Journal of Medicine 312, 811–818.CrossRefGoogle ScholarPubMed
McGee, D. L., Reed, D. M., Yano, K., Kagan, A. & Tillotson, J. (1984). Ten-year incidence of coronary heart disease in the Honolulu Heart Programme: relationship to nutrient intake. American Journal of Epidemiology 119, 667–676.CrossRefGoogle ScholarPubMed
Marniot, M. G., Rose, G., Shipley, M. J. & Thomas, B. J. (1981). Alcohol and mortality: a U-shaped curve. Lancet i, 580, 583.CrossRefGoogle Scholar
Marr, J. W. & Morris, J. N. (1981). Dietary intake and the risk of coronary heart disease in Japanese men living in Hawaii. American Journal of Clinical Nutrition 34, 1156–1157.CrossRefGoogle ScholarPubMed
Morris, J. N., Marr, J. W. & Clayton, D. G. (1977). Diet and heart: a postscript. British Medical Journal 2, 1307–1314.CrossRefGoogle Scholar
O'Donnell, M. G., Nelson, M., Wise, P. H. & Walker, D. M. (1991). A computerized diet questionnaire for use in diet and health education. I. Development and validation. British Journal of Nutrition 66, 3–15.CrossRefGoogle ScholarPubMed
Paul, A. A. & Southgate, D. A. T. (1978). McCance and Widdowson's The Composition of Foods, 4th ed. London: H.M. Stationery Office.Google Scholar
Paul, O., Lepper, M. H., Phelan, W. H., Dupertuis, G. W., MacMillan, A., McKean, H. & Park, H. (1963). A longitudinal survey of coronary heart disease. Circulation 28, 20–31CrossRefGoogle ScholarPubMed
Posner, B. M., Cobb, J. L., Bekdnger, A. J., Cupples, L. A., D'gostino, R. B. & Stokes, J. (1991). Dietary lipid predictors of coronary heart disease in men. The Framingham Study. Archives of Internal Medicine 151, 1181–1187.CrossRefGoogle ScholarPubMed
Ramirez, J. & Flowers, N. C. (1980). Leucocyte ascorbic acid and its relationship to coronary heart disease in man. American Journal of Clinical Nutrition 33, 2079–2087.CrossRefGoogle ScholarPubMed
Riemersma, R. A., Wood, D. A., MacIntyre, C. C. A., Elton, R. A., Gey, K. F. & Oliver, M. F. (1991). Risk of angina pectoris and plasma concentrations of vitamins A, C and E and carotene. Lancet 337, 1–5.CrossRefGoogle Scholar
Rose, G. (1985). Sick individuals and sick populations. International Journal of Epidemiology 14, 32–38.CrossRefGoogle ScholarPubMed
Rose, G. & Blackburn, H. (1968). Cardiovascular Survey Methods. WHO Monograph Series no. 56. Geneva: WHO.Google Scholar
Shaper, A. G., Coch, D. G., Walker, M. & MacFarlane, P. W. (1984). Prevalence of ischaemic heart disease in middle-aged British men. British Heart Journal 51, 595–605.CrossRefGoogle ScholarPubMed
Shaper, A. G., Wannamethee, G. & Walker, M. (1988). Alcohol and mortality in British men: explaining the U- shaped curve. Lancet ii, 1267–1273.CrossRefGoogle Scholar
Shekelle, R. B., MacMillan Shryock, A., Paul, O., Lepper, M., Stamler, J., Liu, S. & Rayner, W. J. (1981). Diet, serum cholesterol and death from coronary heart disease. The Western Electric Study. New England Journal of Medicine 304, 65–70.CrossRefGoogle ScholarPubMed
Silman, A. J. & Marr, J. W. (1985). Is low energy intake a risk factor for ischaemic heart disease? British Heart Journal 53, 624–630.CrossRefGoogle ScholarPubMed
Willett, W. C., Simpson, L., Stampfer, M. J., Rosner, B., Bain, C., Witschi, J., Hennekens, C. H. & Speizer, F. E. (1985). Reproducibility and validity of a semiquantitative food frequency questionnaire. American Journal of Epidemiology 122, 51–65.CrossRefGoogle ScholarPubMed
Yarnell, J. W. G., Fehily, A. M., Milbank, J. E., Sweetnam, P. M. & Walker, C. L. (1983). A short dietary questionnaire for use in an epidemiological survey: comparison with weighed dietary records. Human Nutrition: Applied Nufrition 37A, 103–112.Google Scholar