Department of Hygiene, University of Porto Medical School, Porto, Portugal.
Am J Clin Nutr. 2010 Jul;92(1):211-7. doi: 10.3945/ajcn.2009.29075. Epub 2010 May 19.
The Southern European Atlantic Diet (SEAD) is the traditional diet in northern Portugal and Galicia, a region in northwest Spain.
The objective was to examine the association between adherence to the SEAD and the occurrence of nonfatal acute myocardial infarction (AMI).
This was a population-based case-control study in Porto, Portugal. Cases were patients aged > or =18 y who were hospitalized with an incident AMI (n = 820), and controls were individuals without AMI selected at random from the resident population of the participating hospitals' catchment area (n = 2196). A validated food-frequency questionnaire was administered in face-to-face interviews to assess dietary intake in the previous year. We developed an SEAD adherence index with 9 key components: fresh fish excluding cod, cod, red meat and pork products, dairy products, legumes and vegetables, vegetable soup, potatoes, whole-grain bread, and wine. A score of 1 or 0 was assigned to each food consumed and reflected consumption that was higher or lower, respectively, than the sex-specific median in controls.
After adjustment for the main confounders, a 1-point increment in the SEAD score was associated with a 10% reduced odds of AMI [odds ratio (OR): 0.90; 95% CI: 0.85, 0.96]. In comparison with individuals in the lower quartile of the SEAD index (lowest adherence), those in the upper quartile had a 33% lower likelihood of experiencing an AMI (OR: 0.67; 95% CI: 0.51, 0.88; P for trend = 0.003). An SEAD index calculated by reverse scoring for red meat and pork products and potatoes led to an even stronger inverse association between the SEAD and AMI (OR for the upper compared with the lower quartile of SEAD index: 0.40; 95% CI: 0.30, 0.52; P for trend < 0.001).
Adherence to the SEAD was associated with lower odds of nonfatal AMI. However, some but not all food components of the SEAD may contribute to the very low coronary mortality in northern Portugal and Galicia.
南欧大西洋饮食（SEAD）是葡萄牙北部和西班牙西北部加利西亚地区的传统饮食。
本研究旨在探讨 SEAD 的遵循程度与非致死性急性心肌梗死（AMI）发生之间的关系。
这是葡萄牙波尔图的一项基于人群的病例对照研究。病例为年龄≥18 岁因初次发生 AMI 住院的患者（n=820），对照组为来自参与医院的住院人群的随机选择的未发生 AMI 的个体（n=2196）。通过面对面访谈，采用经过验证的食物频率问卷评估了前一年的饮食摄入情况。我们制定了一个 SEAD 遵循指数，其中包含 9 个关键组成部分：新鲜鱼类（不包括鳕鱼）、鳕鱼、红肉和猪肉产品、乳制品、豆类和蔬菜、蔬菜汤、土豆、全麦面包和葡萄酒。每种食物的摄入量为 1 或 0，分别代表摄入量高于或低于对照组的性别特异性中位数。
在校正主要混杂因素后，SEAD 评分每增加 1 分，AMI 的发生风险降低 10%[比值比（OR）：0.90；95%置信区间（CI）：0.85，0.96]。与 SEAD 指数较低四分位的个体（最低依从性）相比，处于 SEAD 指数较高四分位的个体发生 AMI 的可能性低 33%（OR：0.67；95%CI：0.51，0.88；趋势检验 P=0.003）。对于红肉和猪肉产品以及土豆进行反向评分的 SEAD 指数计算得出，SEAD 与 AMI 之间呈更强的负相关（SEAD 指数最高四分位与最低四分位的比值比：0.40；95%CI：0.30，0.52；趋势检验 P<0.001）。
SEAD 的遵循程度与非致死性 AMI 的发生风险降低相关。然而，SEAD 的某些但不是所有食物成分可能有助于葡萄牙北部和加利西亚的极低冠心病死亡率。
