Center for Emergency, Skåne University Hospital, Malmö, Sweden.
PLoS One. 2013 Aug 5;8(8):e71095. doi: 10.1371/journal.pone.0071095. Print 2013.
To investigate if diet quality is related to incidence of cardiovascular (CV) events.
A diet quality index based on the 2005 Swedish Nutrition Recommendations and the Swedish Dietary Guidelines was created and included six dietary components: saturated fatty acids, polyunsaturated fatty acids, fish and shellfish, dietary fiber, fruit and vegetables, and sucrose. The index ranked 17126 participants (59% women) of the population-based Malmö Diet and Cancer cohort (Sweden) on their dietary intakes. Total index score was categorized as low, medium or high. Cox proportional hazard regression was used to model associations between index score categories and index components with risk of incident CV events, with adjustment for potential confounders. The incidence of first CV events (non-fatal or fatal myocardial infarction or ischemic stroke or death from ischemic heart disease) was monitored from baseline (1991-1996) until December 31, 2008; 703 CV events occurred in women and 1093 in men.
A high diet quality was associated with decreased risk of CV events when compared to a low diet quality. In multivariate analysis, the risk reduction was 32% (hazard ratio = 0.68, 95% confidence interval: 0.49-0.73) in men and 27% (hazard ratio = 0.73, 95% confidence interval: 0.59-0.91) in women. When examined separately and mutually adjusted for each other, the individual components were either not associated with CV risk or marginally decreased risks were seen.
High quality diets in line with current recommendations may reduce the risk of CV events. This study illustrates the importance of considering a combination of dietary factors when evaluating diet-disease associations.
研究饮食质量与心血管（CV）事件发生率的关系。
基于 2005 年瑞典营养建议和瑞典饮食指南创建了一个饮食质量指数，该指数包含六个饮食成分：饱和脂肪酸、多不饱和脂肪酸、鱼类和贝类、膳食纤维、水果和蔬菜以及蔗糖。该指数根据基于人群的马尔默饮食与癌症队列（瑞典）的 17126 名参与者（59%为女性）的饮食摄入量对其进行了排名。总指数得分分为低、中或高。使用 Cox 比例风险回归模型来构建指数得分类别与指数成分与 CV 事件风险之间的关联，同时调整潜在的混杂因素。从基线（1991-1996 年）开始监测首次 CV 事件（非致命或致命心肌梗死或缺血性中风或缺血性心脏病死亡）的发生情况，直至 2008 年 12 月 31 日；女性发生 703 例 CV 事件，男性发生 1093 例。
与低饮食质量相比，高饮食质量与 CV 事件风险降低相关。在多变量分析中，男性的风险降低 32%（风险比=0.68，95%置信区间：0.49-0.73），女性的风险降低 27%（风险比=0.73，95%置信区间：0.59-0.91）。当分别检查并相互调整时，个别成分与 CV 风险无关，或风险略有降低。
符合当前建议的高质量饮食可能降低 CV 事件的风险。本研究说明了在评估饮食与疾病关联时考虑饮食因素组合的重要性。
