Dietary patterns with a high probability of inflammation are significantly associated with a high incidence of cardiovascular disease (CVD). stroke With a new pool analysis of three prospective cohort studies.
The analysis included 210,145 US women and men who were followed up in nurse health surveys I and II and health care professional follow-up for up to 32 years.
After adjusting for the use of anti-inflammatory drugs and CVD risk factors, those whose dietary pattern is ranked in the quintile with the highest likelihood of inflammation have a 38% higher risk of CVD (the quintile with the highest hazard ratio). 1.38) comparing the rank with the lowest quintile, the risk was 46% higher Coronary heart disease (HR, 1.46), and 28% higher risk of stroke (HR, 1.28), all P For trend <.001.
JunLi, MD, PhD, and colleagues at Harvard TH Chan School of Public Health and Harvard Medical School in Boston, Massachusetts Their study In the November 10 issue of Journal of American Universities of Cardiovascular..
The likelihood of dietary inflammation was assessed using a food-based dietary index called the “empirical dietary inflammation pattern” or EDIP.
In an interview, Lee explained: EDIP was developed 4 years ago By many of the same authors involved in the study, including Dr. Walter C. Willett and Dr. Frank B. Fu, MDs of nutrition at Harvard University.
“We have summarized all the foods people eat into 39 defined food groups, these 39 food groups and 3 inflammatory markers (interleukin-6 (IL-6), C-reactive protein (CRP). )) Was examined and a downgraded regression analysis was performed. Tumor necrosis factor alpha receptor 2. Eighteen food groups were found that most predicted these biomarkers, and EDIP was weighted sum of these 18 food groups. Was calculated as. “
People with high intakes of green leafy vegetables (kale, spinach, arugula), dark yellow vegetables (pumpkin, yellow peppers, carrots), whole grains, fruits, tea, coffee and wine have longer-term CVD than those with high intakes. Low-risk lean meat, processed meat, offal meat, refined carbohydrates, and sweet drink intake.
Associations were consistent across cohorts and gender and remained significant in multiple sensitivity analyzes that regulated alcohol consumption, years of smoking packs, lipid-lowering and antihypertensive drug use, sodium intake, and blood pressure. ..
In a secondary analysis, a diet with a high potential for inflammation was also associated with significantly higher biomarker levels indicating systemic, vascular, metabolic inflammation, and decreased lipid profile.
“We wanted to be able to provide guidance on dietary patterns and dietary combinations,” Lee said. “When people are told to eat more polyunsaturated fats instead of saturated and trans fats, most people don’t know which foods have higher or lower nutrients, and many foods. Have different nutrients-some are good and some are bad, so instead of pointing out specific nutrients to avoid, help find foods with a high percentage of healthy nutrients I wanted to. “
The researchers used data positively collected from nurse health studies I and II, which began in 1984, and follow-up studies of healthcare professionals. More than 210,000 participants were included in the analysis after excluding participants who lacked dietary information or who were previously diagnosed with heart disease, stroke, or cancer. Participants completed a survey every four years to check their dietary intake.
Prevention, not treatment
so Editorial commentRamon Estruch, MD, PhD and colleagues at the Hospital Clinic in Barcelona, Spain, suggested that it might be time for better dietary guidelines.
“A better knowledge of the various foods and dietary patterns, primarily the health protection provided by their anti-inflammatory properties, provides the basis for designing healthier dietary patterns to protect against heart disease. It should be, “the editor wrote.
They added extra virgin olive oil, fatty fish and tomatoes to the list of foods with “established anti-inflammatory properties”.
In the comments theheart.org | Medscape Cardiology, Estarch, the results of this new study, Prepared Trials showing a reduced risk of major CV events in high individuals Cardiovascular risk It is assigned to an anti-inflammatory Mediterranean diet pattern supplemented with extra virgin olive oil or nuts compared to that assigned to a low-fat diet.
“The study by Jun Li et al. Helps anti-inflammatory diets prevent cardiovascular events, and more importantly, when subjects increase their consumption of foods most likely to be anti-inflammatory, a healthy diet We are seeing that the pattern can be even healthier, “he says. “The explanation of the mechanism adds plausibility to the results of observational studies,” he added.
Estruch was the Principal Investigator of PREDIME D.This trial was originally published in 2013 and has since Withdrawal and reissue In 2018, some fixes were needed, but the results were virtually unchanged.
Li is supported by grants from the National Institute of Diabetes, Gastroenterology and Kidney Disease and Boston Nutrition obesity Research center. Estruch does not disclose any financial relationships related to the content of this article.
J Am Coll Cardiol. Published online on November 3, 2020. Full text, editorial
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