Diet and Lifestyle Factors and Risk of Atherosclerotic Cardiovascular Disease—A Prospective Cohort Study

Atherosclerotic cardiovascular disease (ACVD) is the leading cause of death worldwide. This study aimed to investigate the association between diet and lifestyle factors, beyond traditional risk factors, and the risk of incident ACVD. The Malmö Diet and Cancer study included 30,446 middle-aged indiv...

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Autores principales:	Stefan Acosta, Anna Johansson, Isabel Drake
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	atherosclerosis cardiovascular disease epidemiology diet quality fish fiber Nutrition. Foods and food supply TX341-641
Acceso en línea:	https://doaj.org/article/3909bd46ee3c4cbcbff98285a25f3df2
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spelling	oai:doaj.org-article:3909bd46ee3c4cbcbff98285a25f3df22021-11-25T18:34:25ZDiet and Lifestyle Factors and Risk of Atherosclerotic Cardiovascular Disease—A Prospective Cohort Study10.3390/nu131138222072-6643https://doaj.org/article/3909bd46ee3c4cbcbff98285a25f3df22021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6643/13/11/3822https://doaj.org/toc/2072-6643Atherosclerotic cardiovascular disease (ACVD) is the leading cause of death worldwide. This study aimed to investigate the association between diet and lifestyle factors, beyond traditional risk factors, and the risk of incident ACVD. The Malmö Diet and Cancer study included 30,446 middle-aged individuals. Baseline examinations including a dietary assessment, questionnaire and interviews, were performed between 1991–1996. After excluding individuals with prevalent cardiovascular disease and atrial fibrillation or flutter, 26,990 participants remained. In a previously developed diet quality index, adherence to recommended intake of saturated fat (SFA), polyunsaturated fat (PUFA), fish and shellfish, fiber, vegetables and fruit, and sucrose results in one point per dietary component, with a maximum diet score of six points. Diagnosis of incident ACVD was based on validated diagnoses of coronary artery disease, atherothrombotic ischemic stroke, carotid artery disease or peripheral artery disease. Multivariable Cox regression analysis adjusting for established risk factors was performed to assess hazard ratios (HR) with 95% confidence intervals (CI). After a median follow-up of 21.1 years, 5858 (21.7%) individuals diagnosed with ACVD unrelated to atrial fibrillation or flutter were identified. Higher diet score (HR 0.94/point increase; 95% CI 0.91–0.97; <i>p</i> < 0.001), intake of fish and shellfish (HR 0.95/standard deviation (SD) increment, 95% CI 0.93–0.98), fiber (HR 0.93/SD increment, 95% CI 0.89–0.98) and SFA (HR 0.96/SD increment, 95% CI 0.92–0.99) consumption were associated with decreased risk for incident ACVD. High leisure-time physical activity (HR 0.82, 95% CI 0.74–0.91) was associated with reduced risk and obesity (HR 1.17, 95% CI 1.08–1.27) with increased risk of incident ACVD. The present study strengthens current recommendations of improving diet quality and increasing physical activity in preventing ACVD.Stefan AcostaAnna JohanssonIsabel DrakeMDPI AGarticleatherosclerosiscardiovascular diseaseepidemiologydiet qualityfishfiberNutrition. Foods and food supplyTX341-641ENNutrients, Vol 13, Iss 3822, p 3822 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	atherosclerosis cardiovascular disease epidemiology diet quality fish fiber Nutrition. Foods and food supply TX341-641
spellingShingle	atherosclerosis cardiovascular disease epidemiology diet quality fish fiber Nutrition. Foods and food supply TX341-641 Stefan Acosta Anna Johansson Isabel Drake Diet and Lifestyle Factors and Risk of Atherosclerotic Cardiovascular Disease—A Prospective Cohort Study
description	Atherosclerotic cardiovascular disease (ACVD) is the leading cause of death worldwide. This study aimed to investigate the association between diet and lifestyle factors, beyond traditional risk factors, and the risk of incident ACVD. The Malmö Diet and Cancer study included 30,446 middle-aged individuals. Baseline examinations including a dietary assessment, questionnaire and interviews, were performed between 1991–1996. After excluding individuals with prevalent cardiovascular disease and atrial fibrillation or flutter, 26,990 participants remained. In a previously developed diet quality index, adherence to recommended intake of saturated fat (SFA), polyunsaturated fat (PUFA), fish and shellfish, fiber, vegetables and fruit, and sucrose results in one point per dietary component, with a maximum diet score of six points. Diagnosis of incident ACVD was based on validated diagnoses of coronary artery disease, atherothrombotic ischemic stroke, carotid artery disease or peripheral artery disease. Multivariable Cox regression analysis adjusting for established risk factors was performed to assess hazard ratios (HR) with 95% confidence intervals (CI). After a median follow-up of 21.1 years, 5858 (21.7%) individuals diagnosed with ACVD unrelated to atrial fibrillation or flutter were identified. Higher diet score (HR 0.94/point increase; 95% CI 0.91–0.97; <i>p</i> < 0.001), intake of fish and shellfish (HR 0.95/standard deviation (SD) increment, 95% CI 0.93–0.98), fiber (HR 0.93/SD increment, 95% CI 0.89–0.98) and SFA (HR 0.96/SD increment, 95% CI 0.92–0.99) consumption were associated with decreased risk for incident ACVD. High leisure-time physical activity (HR 0.82, 95% CI 0.74–0.91) was associated with reduced risk and obesity (HR 1.17, 95% CI 1.08–1.27) with increased risk of incident ACVD. The present study strengthens current recommendations of improving diet quality and increasing physical activity in preventing ACVD.
format	article
author	Stefan Acosta Anna Johansson Isabel Drake
author_facet	Stefan Acosta Anna Johansson Isabel Drake
author_sort	Stefan Acosta
title	Diet and Lifestyle Factors and Risk of Atherosclerotic Cardiovascular Disease—A Prospective Cohort Study
title_short	Diet and Lifestyle Factors and Risk of Atherosclerotic Cardiovascular Disease—A Prospective Cohort Study
title_full	Diet and Lifestyle Factors and Risk of Atherosclerotic Cardiovascular Disease—A Prospective Cohort Study
title_fullStr	Diet and Lifestyle Factors and Risk of Atherosclerotic Cardiovascular Disease—A Prospective Cohort Study
title_full_unstemmed	Diet and Lifestyle Factors and Risk of Atherosclerotic Cardiovascular Disease—A Prospective Cohort Study
title_sort	diet and lifestyle factors and risk of atherosclerotic cardiovascular disease—a prospective cohort study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/3909bd46ee3c4cbcbff98285a25f3df2
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Diet and Lifestyle Factors and Risk of Atherosclerotic Cardiovascular Disease—A Prospective Cohort Study

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