Plant foods, dietary fibre and risk of ischaemic heart disease in the EPIC cohort

Aurora Perez-Cornago; Francesca Crowe; Paul N. Appleby; Kathryn E  Bradbury; Angela M  Wood; Marianne Uhre  Jakobsen; Laura  Johnson; Carlotta Sacerdote; Marinka  Steur; Elisabete Weiderpass; Anne Mette L  Würtz; Tilman  Kühn; Verena  Katzke; Antonia  Trichopoulou; Anna  Karakatsani; Carlo La Vecchia; Giovanna  Masala; Rosario Tumino; Salvatore Panico; Ivonne  Sluijs; Guri  Skeie; Liher  Imaz; Dafina  Petrova; J.  Ramón Quirós; Sandra Milena  Colorado Yohar; Paula  Jakszyn; Olle Melander; Emily  Sonestedt; Jonas  Andersson; Maria  Wennberg; Dagfinn  Aune; Elio Riboli; Matthias B.  Schulze; Emanuele Di Angelantonio; Nicholas J  Wareham; John Danesh; Nita G Forouhi; Adam S. Butterworth; Timothy J Key

doi:10.1093/ije/dyaa155

Plant foods, dietary fibre and risk of ischaemic heart disease in the EPIC cohort

Aurora Perez-Cornago, Francesca Crowe, Paul N. Appleby, Kathryn E Bradbury, Angela M Wood, Marianne Uhre Jakobsen, Laura Johnson, Carlotta Sacerdote, Marinka Steur, Elisabete Weiderpass, Anne Mette L Würtz, Tilman Kühn, Verena Katzke, Antonia Trichopoulou, Anna Karakatsani, Carlo La Vecchia, Giovanna Masala, Rosario Tumino, Salvatore Panico, Ivonne SluijsGuri Skeie, Liher Imaz, Dafina Petrova, J. Ramón Quirós, Sandra Milena Colorado Yohar, Paula Jakszyn, Olle Melander, Emily Sonestedt, Jonas Andersson, Maria Wennberg, Dagfinn Aune, Elio Riboli, Matthias B. Schulze, Emanuele Di Angelantonio, Nicholas J Wareham, John Danesh, Nita G Forouhi, Adam S. Butterworth, Timothy J Key

Applied Health Research

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Abstract

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 EPIC.

Methods: We conducted a prospective analysis of 490,311 men and women in ten European countries without a history of myocardial infarction or stroke at recruitment (12.6 years of follow-up, n cases=8504). Dietary intake was assessed using validated questionnaires, calibrated with 24-hour 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% CI:0.90-0.99, P-trend=0.009), and total fruits (per 100g/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 10g/day 0.90, 0.82-0.98, P-trend=0.020), total fibre (per 10g/day 0.95, 0.85-0.98, P-trend=0.015), fruit and vegetable fibre (per 4g/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.

Original language	English
Article number	dyaa155
Number of pages	11
Journal	International Journal of Epidemiology
Early online date	27 Nov 2020
DOIs	https://doi.org/10.1093/ije/dyaa155
Publication status	E-pub ahead of print - 27 Nov 2020

Bibliographical note

Not yet published 16/11/20.

Keywords

fruit
vegetables
legumes
nuts
seeds
coronary heart disease

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Perez-Cornago, A., Crowe, F., Appleby, P. N., Bradbury, K. E., Wood, A. M., Jakobsen, M. U., Johnson, L., Sacerdote, C., Steur, M., Weiderpass, E., Würtz, A. M. L., Kühn, T., Katzke, V., Trichopoulou, A., Karakatsani, A., La Vecchia, C., Masala, G., Tumino, R., Panico, S., ... Key, T. J. (2020). Plant foods, dietary fibre and risk of ischaemic heart disease in the EPIC cohort. International Journal of Epidemiology, Article dyaa155. Advance online publication. https://doi.org/10.1093/ije/dyaa155

@article{46ce72f6d1994ca8834c331a18a88a0f,

title = "Plant foods, dietary fibre and risk of ischaemic heart disease in the EPIC cohort",

abstract = "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 EPIC.Methods: We conducted a prospective analysis of 490,311 men and women in ten European countries without a history of myocardial infarction or stroke at recruitment (12.6 years of follow-up, n cases=8504). Dietary intake was assessed using validated questionnaires, calibrated with 24-hour 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% CI:0.90-0.99, P-trend=0.009), and total fruits (per 100g/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 10g/day 0.90, 0.82-0.98, P-trend=0.020), total fibre (per 10g/day 0.95, 0.85-0.98, P-trend=0.015), fruit and vegetable fibre (per 4g/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.",

keywords = "fruit, vegetables, legumes, nuts, seeds, coronary heart disease",

author = "Aurora Perez-Cornago and Francesca Crowe and Appleby, {Paul N.} and Bradbury, {Kathryn E} and Wood, {Angela M} and Jakobsen, {Marianne Uhre} and Laura Johnson and Carlotta Sacerdote and Marinka Steur and Elisabete Weiderpass and W{\"u}rtz, {Anne Mette L} and Tilman K{\"u}hn and Verena Katzke and Antonia Trichopoulou and Anna Karakatsani and {La Vecchia}, Carlo and Giovanna Masala and Rosario Tumino and Salvatore Panico and Ivonne Sluijs and Guri Skeie and Liher Imaz and Dafina Petrova and {Ram{\'o}n Quir{\'o}s}, J. and {Colorado Yohar}, {Sandra Milena} and Paula Jakszyn and Olle Melander and Emily Sonestedt and Jonas Andersson and Maria Wennberg and Dagfinn Aune and Elio Riboli and Schulze, {Matthias B.} and {Di Angelantonio}, Emanuele and Wareham, {Nicholas J} and John Danesh and Forouhi, {Nita G} and Butterworth, {Adam S.} and Key, {Timothy J}",

note = "Not yet published 16/11/20.",

year = "2020",

month = nov,

day = "27",

doi = "10.1093/ije/dyaa155",

language = "English",

journal = "International Journal of Epidemiology",

issn = "0300-5771",

publisher = "Oxford University Press",

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Perez-Cornago, A, Crowe, F, Appleby, PN, Bradbury, KE, Wood, AM, Jakobsen, MU, Johnson, L, Sacerdote, C, Steur, M, Weiderpass, E, Würtz, AML, Kühn, T, Katzke, V, Trichopoulou, A, Karakatsani, A, La Vecchia, C, Masala, G, Tumino, R, Panico, S, Sluijs, I, Skeie, G, Imaz, L, Petrova, D, Ramón Quirós, J, Colorado Yohar, SM, Jakszyn, P, Melander, O, Sonestedt, E, Andersson, J, Wennberg, M, Aune, D, Riboli, E, Schulze, MB, Di Angelantonio, E, Wareham, NJ, Danesh, J, Forouhi, NG, Butterworth, AS & Key, TJ 2020, 'Plant foods, dietary fibre and risk of ischaemic heart disease in the EPIC cohort', International Journal of Epidemiology. https://doi.org/10.1093/ije/dyaa155

TY - JOUR

T1 - Plant foods, dietary fibre and risk of ischaemic heart disease in the EPIC cohort

AU - Perez-Cornago, Aurora

AU - Crowe, Francesca

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 - Ramón Quirós, J.

AU - Colorado Yohar, Sandra Milena

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 - Not yet published 16/11/20.

PY - 2020/11/27

Y1 - 2020/11/27

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 EPIC.Methods: We conducted a prospective analysis of 490,311 men and women in ten European countries without a history of myocardial infarction or stroke at recruitment (12.6 years of follow-up, n cases=8504). Dietary intake was assessed using validated questionnaires, calibrated with 24-hour 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% CI:0.90-0.99, P-trend=0.009), and total fruits (per 100g/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 10g/day 0.90, 0.82-0.98, P-trend=0.020), total fibre (per 10g/day 0.95, 0.85-0.98, P-trend=0.015), fruit and vegetable fibre (per 4g/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 EPIC.Methods: We conducted a prospective analysis of 490,311 men and women in ten European countries without a history of myocardial infarction or stroke at recruitment (12.6 years of follow-up, n cases=8504). Dietary intake was assessed using validated questionnaires, calibrated with 24-hour 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% CI:0.90-0.99, P-trend=0.009), and total fruits (per 100g/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 10g/day 0.90, 0.82-0.98, P-trend=0.020), total fibre (per 10g/day 0.95, 0.85-0.98, P-trend=0.015), fruit and vegetable fibre (per 4g/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.

KW - fruit

KW - vegetables

KW - legumes

KW - nuts

KW - seeds

KW - coronary heart disease

UR - http://ije.oxfordjournals.org/

U2 - 10.1093/ije/dyaa155

DO - 10.1093/ije/dyaa155

M3 - Article

SN - 0300-5771

JO - International Journal of Epidemiology

JF - International Journal of Epidemiology

M1 - dyaa155

ER -

Plant foods, dietary fibre and risk of ischaemic heart disease in the EPIC cohort

Abstract

Bibliographical note

Keywords

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Cite this