Changes in Nut Consumption and Subsequent Cardiovascular Disease Risk Among US Men and Women: 3 Large Prospective Cohort Studies

Abstract Objective To evaluate the association between egg intake and cardiovascular disease risk among women and men in the United States, and to conduct a meta-analysis of prospective cohort studies. Design Prospective cohort study, and a systematic review and meta-analysis of prospective cohort studies. Setting Nurses’ Health Study (NHS, 1980-2012), NHS II (1991-2013), Health Professionals’ Follow-Up Study (HPFS, 1986-2012). Participants Cohort analyses included 83 349 women from NHS, 90 214 women from NHS II, and 42 055 men from HPFS who were free of cardiovascular disease, type 2 diabetes, and cancer at baseline. Main outcome measures Incident cardiovascular disease, which included non-fatal myocardial infarction, fatal coronary heart disease, and stroke. Results Over up to 32 years of follow-up (>5.54 million person years), 14 806 participants with incident cardiovascular disease were identified in the three cohorts. Participants with a higher egg intake had a higher body mass index, were less likely to be treated with statins, and consumed more red meats. Most people consumed between one and less than five eggs per week. In the pooled multivariable analysis, consumption of at least one egg per day was not associated with incident cardiovascular disease risk after adjustment for updated lifestyle and dietary factors associated with egg intake (hazard ratio for at least one egg per day v less than one egg per month 0.93, 95% confidence interval 0.82 to 1.05). In the updated meta-analysis of prospective cohort studies (33 risk estimates, 1 720 108 participants, 139 195 cardiovascular disease events), an increase of one egg per day was not associated with cardiovascular disease risk (pooled relative risk 0.98, 95% confidence interval 0.93 to 1.03, I 2 =62.3%). Results were similar for coronary heart disease (21 risk estimates, 1 411 261 participants, 59 713 coronary heart disease events; 0.96, 0.91 to 1.03, I 2 =38.2%), and stroke (22 risk estimates, 1 059 315 participants, 53 617 stroke events; 0.99, 0.91 to 1.07, I 2 =71.5%). In analyses stratified by geographical location (P for interaction=0.07), no association was found between egg consumption and cardiovascular disease risk among US cohorts (1.01, 0.96 to 1.06, I 2 =30.8%) or European cohorts (1.05, 0.92 to 1.19, I 2 =64.7%), but an inverse association was seen in Asian cohorts (0.92, 0.85 to 0.99, I 2 =44.8%). Conclusions Results from the three cohorts and from the updated meta-analysis show that moderate egg consumption (up to one egg per day) is not associated with cardiovascular disease risk overall, and is associated with potentially lower cardiovascular disease risk in Asian populations. Systematic review registration PROSPERO CRD42019129650.

Download Full-text

An overview and update on the epidemiology of flavonoid intake and cardiovascular disease risk

Food & Function ◽

10.1039/d0fo01118e ◽

2020 ◽

Vol 11 (8) ◽

pp. 6777-6806

Author(s):

Benjamin H. Parmenter ◽

Kevin D. Croft ◽

Jonathan M. Hodgson ◽

Frederik Dalgaard ◽

Catherine P. Bondonno ◽

...

Keyword(s):

Cardiovascular Disease ◽

Cohort Studies ◽

Prospective Cohort ◽

Lower Risk ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Prospective Cohort Studies ◽

Flavonoid Intake

Higher intakes of flavonoid-rich foods are associated with a lower risk of cardiovascular disease in prospective cohort studies.

Download Full-text

Definitions, regulations, and new frontiers for dietary fiber and whole grains

Nutrition Reviews ◽

10.1093/nutrit/nuz061 ◽

2020 ◽

Vol 78 (Supplement_1) ◽

pp. 6-12

Author(s):

Renee Korczak ◽

Joanne L Slavin

Keyword(s):

Cardiovascular Disease ◽

Cohort Studies ◽

Dietary Fiber ◽

Prospective Cohort ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

The United States ◽

Whole Grains ◽

Whole Grain ◽

Prospective Cohort Studies

Abstract The aim of this article is to review the definitions and regulations for dietary fiber and whole grains worldwide and to discuss barriers to meeting recommended intake levels. Plant foods, such as whole grains, that are rich in dietary fiber are universally recommended in dietary guidance. Foods rich in dietary fiber are recommended for all, but dietary recommendations for whole grains and dietary fiber depend on definitions and regulations. Official recommendations for dietary fiber in the United States and Canada are denoted by dietary reference intakes (DRIs), which are developed by the Institute of Medicine. An adequate intake (AI) for dietary fiber was based on prospective cohort studies of dietary fiber intake and cardiovascular disease risk that found 14 grams of dietary fiber per 1000 kilocalories protected against cardiovascular disease (CVD). This value was used to set AIs for dietary fiber across the life cycle based on recommended calorie intakes. Actual intakes of dietary fiber are generally about half of the recommended levels. Recommendations for whole grain intake are equally challenging, as definitions for whole grain foods are needed to set recommendations. The 2005 Dietary Guidelines for Americans recommended that half of all grain servings be whole grains, but usual intakes are generally less than 1 serving per day, rather than the recommended 3 servings per day. Scientific support for whole grain recommendations is based on the same prospective cohort studies and links to CVD protection used to inform dietary fiber guidance. Thus, dietary fiber is a recommended nutrient and whole grains are a recommended dietary pattern in dietary guidance in North America and around the world. Challenges for attaining recommended intakes of dietary fiber and whole grains include low-carbohydrate diets, low-gluten diets, and public health recommendations to avoid processed foods.

Download Full-text