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Plant foods, dietary fibre and risk of ischaemic heart disease in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

  • 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,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, Ptrend = 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.show moreshow less

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Author details:Aurora Perez-CornagoORCiD, Francesca L. Crowe, Paul N. Appleby, Kathryn E. BradburyORCiD, Angela M. WoodORCiD, Marianne Uhre JakobsenORCiD, Laura JohnsonORCiD, Carlotta Sacerdote, Marinka Steur, Elisabete WeiderpassORCiD, Anne Mette L. Wurtz, Tilman Kuhn, Verena Katzke, Antonia Trichopoulou, Anna Karakatsani, Carlo La Vecchia, Giovanna MasalaORCiD, Rosario Tumino, Salvatore Panico, Ivonne Sluijs, Guri SkeieORCiD, Liher Imaz, Dafina Petrova, J. Ramon Quiros, Sandra Milena Colorado Yohar, Paula JakszynORCiD, Olle MelanderORCiD, Emily Sonestedt, Jonas Andersson, Maria Wennberg, Dagfinn AuneORCiD, Elio RiboliORCiDGND, Matthias B. SchulzeORCiDGND, Emanuele di AngelantonioORCiD, Nicholas J. WarehamORCiD, John Danesh, Nita G. Forouhi, Adam S. Butterworth, Timothy J. Key
URN:urn:nbn:de:kobv:517-opus4-560340
DOI:https://doi.org/10.25932/publishup-56034
ISSN:1866-8372
Pubmed ID:https://pubmed.ncbi.nlm.nih.gov/33245137
Title of parent work (German):Zweitveröffentlichungen der Universität Potsdam : Mathematisch-Naturwissenschaftliche Reihe
Publication series (Volume number):Zweitveröffentlichungen der Universität Potsdam : Mathematisch-Naturwissenschaftliche Reihe (1367)
Publication type:Postprint
Language:English
Date of first publication:2021/11/27
Publication year:2021
Publishing institution:Universität Potsdam
Release date:2024/03/22
Tag:coronary heart disease; fruit; legumes; nuts; seeds; vegetables
Issue:1
Number of pages:13
Source:International Journal of Epidemiology, Volume 50, Issue 1, February 2021, Pages 212–222, https://doi.org/10.1093/ije/dyaa155
Funding institution:UK Medical Research CouncilUK Research & Innovation (UKRI)Medical Research Council UK (MRC) [MR/M012190/1, G0800270, MR/L003120/1, 1000143, MC_UU_12015/1, MC_UU_12015/5, MC_UU_12015/520]; Cancer Research UKCancer Research UK [C8221/A19170, 570/A16491, 14136, C570/A16491]; Wellcome Trust (Our Planet Our Health, Livestock Environment and People) [205212/Z/16/Z]; Cancer Research UK Population Research Fellowship [C60192/A28516]; World Cancer Research Fund (WCRF UK), as part of the Word Cancer Research Fund International grant programme [2019/1953]; European UnionEuropean Commission [HEALTH-F2-2012-279233]; European Research CouncilEuropean Research Council (ERC)European Commission [268834]; British Heart FoundationBritish Heart Foundation [SP/09/002, RG/08/014, RG13/13/30194]; UK National Institute of Health ResearchNational Institute for Health Research (NIHR); EU FP6 programmeEuropean Commission [LSHM_CT_2006_037197]; European Commission (DGSANCO)European CommissionEuropean Commission Joint Research Centre; International Agency for Research on Cancer; Danish Cancer Society (Denmark)Danish Cancer Society; Ligue Contre le Cancer (France); Institut Gustave Roussy (France); Mutuelle Generale de l'Education Nationale (France); Institut National de la Sante et de la Recherche Medicale (INSERM) (France)Institut National de la Sante et de la Recherche Medicale (Inserm); German Cancer Aid (Germany)Deutsche Krebshilfe; German Cancer Research Center (DKFZ) (Germany); Federal Ministry of Education and Research (BMBF) (Germany)Federal Ministry of Education & Research (BMBF); Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy (Italy)Fondazione AIRC per la ricerca sul cancro; National Research Council (Italy)Consiglio Nazionale delle Ricerche (CNR); Dutch Ministry of Public Health, Welfare and Sports (VWS); Netherlands Cancer Registry (NKR); LK Research Funds; Dutch Prevention Funds; Dutch ZON (Zorg Onderzoek Nederland)Netherlands Organization for Scientific Research (NWO); World Cancer Research Fund (WCRF)World Cancer Research Fund International (WCRF); Health Research Fund (FIS) (Spain)Instituto de Salud Carlos III [PI13/00061, PI13/01162]; Regional Government of Andalucia (Spain)Junta de Andalucia; Regional Government of Asturias (Spain); Regional Government of Basque Country (Spain); Regional Government of Murcia (Spain) [6236]; Regional Government of Navarra (Spain); ISCIII RETIC (Spain)Instituto de Salud Carlos III [RD06/0020]; Swedish Cancer Society (Sweden)Swedish Cancer Society; Swedish Research Council (Sweden)Swedish Research Council; County Council of Skane (Sweden); County Council of Vasterbotten (Sweden); NIHR Biomedical Research Centre Cambridge: Nutrition, Diet, and Lifestyle Research Theme [IS-BRC-1215-20014]; British Heart Foundation ChairBritish Heart Foundation; NIHR Senior Investigator Award; Girdlers' New Zealand Health Research Council Fellowship; National Institute for Health ResearchNational Institute for Health Research (NIHR); BHF-Turing Cardiovascular Data Science Award; ECInnovative Medicines Initiative (BigData@Heart); Alpro Foundation [15-08-2016]; Core MRC Unit support through the Nutritional Epidemiology Programme [MC_UU_12015/5]; MRCUK Research & Innovation (UKRI)Medical Research Council UK (MRC) [MC_UU_00006/3, MR/M012190/1, MC_UU_12015/5, MR/L003120/1, MC_UU_12015/1, MR/N003284/1, MC_UU_00006/1, G0500300, G0800270] Funding Source: UKRI
Organizational units:Mathematisch-Naturwissenschaftliche Fakultät / Institut für Ernährungswissenschaft
DDC classification:5 Naturwissenschaften und Mathematik / 54 Chemie / 540 Chemie und zugeordnete Wissenschaften
Peer review:Referiert
Publishing method:Open Access / Green Open-Access
License (German):License LogoCC-BY - Namensnennung 4.0 International
External remark:Bibliographieeintrag der Originalveröffentlichung/Quelle
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