Energy-adjusted Dietary Inflammatory Index scores predict long-term cardiovascular disease mortality and other causes of death in an ecological analysis of the Seven Countries Study

2020 ◽  
pp. 204748732090386
Author(s):  
Paolo E Puddu ◽  
Nitin Shivappa ◽  
Alessandro Menotti ◽  
James R Hébert ◽  
Hanna Tolonen ◽  
...  

Using data from the Seven Countries Study of Cardiovascular Diseases, the first study to conduct international comparisons of men in different European, USA, and Japanese cohorts, we examined the effect of diet-associated inflammation on prediction of coronary heart disease-, other major cardiovascular disease- and all-cause mortality after 50-years of follow-up. The energy-adjusted Dietary Inflammatory Index was used to quantify the effect of diet on systemic inflammation. Positive linear correlations were observed between the cohort-average energy-adjusted Dietary Inflammatory Index score and both overall death rates ( R = 0.61, p = 0.0114) and major cardiovascular disease mortality rates ( R = 0.51, p = 0.0337) but not cancer. Correlations for all-cause mortality were higher when the Belgrade outlier cohort was omitted ( R = 0.72, p = 0.0024) or when analyses were adjusted for socioeconomic status ( R = 0.67, p = 0.0065). There was also a significant reverse correlation between energy-adjusted Dietary Inflammatory Index score and age at death ( R = –0.50 to –0.68, p = 0.0480 to 0.0012). Adjusting for systolic blood pressure, cholesterol, and smoking habits did not modify these correlations that were still significant. With control for these covariates a significant correlation emerged for coronary heart disease. Results obtained using a 25-year follow-up to allow unprojected data from all cohorts were similar. Results from this long-term follow-up study are consistent with a recommendation to increase consuming an anti-inflammatory diet characterized by high concentrations of fruits and vegetables and low consumption of simple carbohydrates and fats.

2016 ◽  
Vol 217 ◽  
pp. 64-68 ◽  
Author(s):  
Leandro Fórnias Machado de Rezende ◽  
Catarina Machado Azeredo ◽  
Daniela Silva Canella ◽  
Olinda do Carmo Luiz ◽  
Renata Bertazzi Levy ◽  
...  

Author(s):  
Yangbo Sun ◽  
Buyun Liu ◽  
Linda G. Snetselaar ◽  
Robert B. Wallace ◽  
Aladdin H. Shadyab ◽  
...  

Background Dietary recommendations regarding protein intake have been focused on the amount of protein. However, such recommendations without considering specific protein sources may be simplistic and insufficient. Methods and Results We included 102 521 postmenopausal women enrolled in the Women’s Health Initiative between 1993 and 1998, and followed them through February 2017. During 1 876 205 person‐years of follow‐up, 25 976 deaths occurred. Comparing the highest with the lowest quintile, plant protein intake was inversely associated with all‐cause mortality (hazard ratio [HR], 0.91 [0.86, 0.96]), cardiovascular disease mortality (HR, 0.88 [0.79, 0.97]), and dementia mortality (HR, 0.79 [0.67, 0.94]). Among major protein sources, comparing the highest with the lowest quintile of consumption, processed red meat (HR, 1.06 [1.01, 1.10]) or eggs (HR, 1.14 [1.10, 1.19]) was associated with higher risk of all‐cause mortality. Unprocessed red meat (HR, 1.12 [1.02, 1.23]), eggs (HR, 1.24 [1.14, 1.34]), or dairy products (HR, 1.11 [1.02, 1.22]) was associated with higher risk of cardiovascular disease mortality. Egg consumption was associated with higher risk of cancer mortality (HR, 1.10 [1.02, 1.19]). Processed red meat consumption was associated with higher risk of dementia mortality (HR, 1.20 [1.05, 1.32]), while consumption of poultry (HR, 0.85 [0.75, 0.97]) or eggs (HR, 0.86 [0.75, 0.98]) was associated with lower risk of dementia mortality. In substitution analysis, substituting of animal protein with plant protein was associated with a lower risk of all‐cause mortality, cardiovascular disease mortality, and dementia mortality, and substitution of total red meat, eggs, or dairy products with nuts was associated with a lower risk of all‐cause mortality. Conclusions Different dietary protein sources have varying associations with all‐cause mortality, cardiovascular disease mortality, and dementia mortality. Our findings support the need for consideration of protein sources in future dietary guidelines.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Maria Tellez-Plaza ◽  
Eliseo Guallar ◽  
Barbara Howard ◽  
Jason Umans ◽  
Kevin Francesconi ◽  
...  

Introduction: Cadmium is a widespread toxic metal with potential cardiovascular effects, but establishing cadmium as a cardiovascular risk factor has been limited by the lack of data on its association with incident cardiovascular events. Hypothesis: We tested the hypothesis that urine cadmium concentrations would be associated with cardiovascular disease mortality and incidence. Methods: Prospective cohort study of 3,347 American Indian adults 45-74 years old without prevalent cardiovascular disease from Arizona, Oklahoma and North and South Dakota who participated in the Strong Heart Study (SHS) in 1989-91 and had urine cadmium measures available. Urine cadmium was measured using inductively coupled plasma mass spectrometry. Follow-up extended through December 30 th 2007. Results: We identified 1,028 cardiovascular events, including 372 deaths. After adjustment for known cardiovascular risk factors, the hazard ratios (95% CI) for cardiovascular and coronary heart disease mortality, comparing the 80 th to the 20 th percentiles of urine cadmium concentrations, were 1.43 (1.21, 1.69) and 1.33 (1.09, 1.62), respectively. The corresponding hazard ratios for incident cardiovascular disease, coronary heart disease, stroke, and heart failure were 1.16 (1.04, 1.29), 1.11 (0.98, 1.27), 1.50 (1.01, 2.22) and 1.22 (1.01, 1.47), respectively. The associations were similar in different study subgroups, including never-smokers. The figure shows increasing dose-response relations between urine cadmium concentrations and all cardiovascular disease mortality and incidence endpoints except for incident stroke. Conclusions: Urine cadmium, a biomarker of long-term exposure, was positively and consistently associated with cardiovascular disease mortality and incidence, overall and across subgroups. These findings support that cadmium exposure is a cardiovascular risk factor irrespective of the source of exposure. Efforts to reduce cadmium exposure in the population are needed.


2020 ◽  
pp. 204748731990105
Author(s):  
Sae Young Jae ◽  
Sudhir Kurl ◽  
Kanokwan Bunsawat ◽  
Barry A Franklin ◽  
Jina Choo ◽  
...  

Aims Although both low socioeconomic status (SES) and poor cardiorespiratory fitness (CRF) are associated with increased chronic disease and heightened mortality, it remains unclear whether moderate-to-high levels of CRF are associated with survival benefits in low SES populations. This study evaluated the hypothesis that SES and CRF predict all-cause mortality and cardiovascular disease mortality and that moderate-to-high levels of CRF may attenuate the association between low SES and increased mortality. Methods This study included 2368 men, who were followed in the Kuopio Ischaemic Heart Disease Study cohort. CRF was directly measured by peak oxygen uptake during progressive exercise testing. SES was characterized using self-reported questionnaires. Results During a 25-year median follow-up, 1116 all-cause mortality and 512 cardiovascular disease mortality events occurred. After adjusting for potential confounders, men with low SES were at increased risks for all-cause mortality (hazard ratio 1.49, 95% confidence interval: 1.30–1.71) and cardiovascular disease mortality (hazard ratio1.38, 1.13–1.69). Higher levels of CRF were associated with lower risks of all-cause mortality (hazard ratio 0.54, 0.45–0.64) and cardiovascular disease mortality (hazard ratio 0.53, 0.40–0.69). In joint associations of SES and CRF with mortality, low SES-unfit had significantly higher risks of all-cause mortality (hazard ratio 2.15, 1.78–2.59) and cardiovascular disease mortality (hazard ratio 1.95, 1.48-2.57), but low SES-fit was not associated with a heightened risk of cardiovascular disease mortality (hazard ratio 1.09, 0.80-1.48) as compared with their high SES-fit counterparts. Conclusion Both SES and CRF were independently associated with subsequent mortality; however, moderate-to-high levels of CRF were not associated with an excess risk of cardiovascular disease mortality in men with low SES.


Author(s):  
Abdonas Tamosiunas ◽  
Laura Sapranaviciute-Zabazlajeva ◽  
Dalia Luksiene ◽  
Dalia Virviciute ◽  
Martin Bobak

Background: The purpose of the study is to evaluate the association between cognitive function and risk of all-cause and cardiovascular disease mortality during 10 years of the follow-up. Methods: 7087 participants were assessed in the baseline survey of the Health Alcohol Psychosocial Factors in Eastern Europe (HAPIEE) study in 2006–2008. During 10 years of follow-up, all-cause and CVD mortality risk were evaluated. Results: During 10 years of follow-up, 768 (23%) men and 403 (11%) women died (239 and 107 from CVD). After adjustment for sociodemographic, biological, lifestyle factors, and illnesses, a decrease per 1 standard deviation in different cognitive function scores increased risk for all-cause mortality (by 13%–24% in men, and 17%–33% in women) and CVD mortality (by 19%–32% in men, and 69%–91% in women). Kaplan-Meier survival curves for all-cause and CVD mortality, according to tertiles of cognitive function, revealed that the lowest cognitive function (1st tertile) predicts shorter survival compared to second and third tertiles (p < 0.001). Conclusions: The findings of this follow-up study suggest that older participants with lower cognitive functions have an increased risk for all-cause and CVD mortality compared to older participants with a higher level of cognitive function.


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