The association of the Mediterranean diet with heart failure risk in a Dutch population
Strengers, Julia G; den Ruijter, Hester M; Boer, Jolanda M A; Asselbergs, Folkert W; Verschuren, W M Monique; van der Schouw, Yvonne T; Sluijs, Ivonne
(2021) NMCD : Nutrition metabolism and cardiovascular diseases, volume 31, issue 1, pp. 60 - 66
(Article)
Abstract
Background and aims: It is still unclear whether a healthy diet can prevent heart failure (HF). Therefore, this study aimed to investigate the association between adherence to a Mediterranean-style diet, reflected by modified Mediterranean Diet Scores (mMDS), and the incidence of HF in men and women. Methods and results: This
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observational study comprised 9316 men and 27,645 women from the EPIC-NL cohort free from cardiovascular disease at baseline. Dietary intakes were assessed using a validated food frequency questionnaire. mMDS was calculated using a 9-point scale based on consumption of vegetables, legumes, fruit, nuts, seeds, grains, fish, fat ratio, dairy, meat and alcohol. HF events were ascertained by linkage to nation-wide registries. Multivariable Hazard Ratios (HR) and 95% confidence intervals (CI) were estimated by Cox proportional hazards regression models. Over a median follow-up of 15 years (IQR 14–16), 633 HF events occurred: 144 in men (1.5%) and 489 in women (1.8%). The median mMDS was 4 (IQR 3–5). There was significant effect modification by sex (P-value for interaction <0.001), therefore results are stratified for men and women. For men, a higher mMDS associated with lower HF risk (HR: 0.88; 95% CI: 0.79, 0.98 per point increase in mMDS; HR upper category: 0.53; 95% CI: 0.33, 0.86), whereas no association was found in women (HR: 0.98; 95% CI: 0.93, 1.04 per point increase; HR upper category: 1.07; 95% CI: 0.83, 1.36). Conclusion: Adherence to a Mediterranean-style diet may reduce HF risk, particularly in men. The underlying reasons for the differences in findings between men and women need further study.
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Keywords: Diet, Heart failure, Nutrition, Prevention, Cardiology and Cardiovascular Medicine, Nutrition and Dietetics, Medicine (miscellaneous), Endocrinology, Diabetes and Metabolism, Journal Article
ISSN: 0939-4753
Publisher: Elsevier
Note: Funding Information: FWA is supported by UCL Hospitals NIHR Biomedical Research Centre (United Kingdom). Funding Information: The EPIC-NL study was funded by ?European Commission: Public Health and Consumer Protection Directorate 1993?2004; Research Directory-General 2005?; Dutch Ministry of Public Health, Welfare and Sports (WVS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), and World Cancer Research Fund (WCRF) (The Netherlands).FWA is supported by UCL Hospitals NIHR Biomedical Research Centre (United Kingdom). Funding Information: The EPIC-NL study was funded by “ European Commission: Public Health and Consumer Protection Directorate 1993–2004; Research Directory-General 2005”; Dutch Ministry of Public Health, Welfare and Sports (WVS), Netherlands Cancer Registry (NKR), LK Research Funds , Dutch Prevention Funds , Dutch ZON (Zorg Onderzoek Nederland), and World Cancer Research Fund (WCRF) (The Netherlands). Publisher Copyright: © 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University
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