Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
J Am Coll Cardiol. 2014 Sep 30;64(13):1299-306. doi: 10.1016/j.jacc.2014.06.1190.
Adherence to a combination of healthy dietary and lifestyle practices may have an impressive impact on the primary prevention of myocardial infarction (MI).
The aim of this study was to examine the benefit of combined low-risk diet and healthy lifestyle practices on the incidence of MI in men.
The population-based, prospective cohort of Swedish men comprised 45- to 79-year-old men who completed a detailed questionnaire on diet and lifestyle at baseline in 1997. In total, 20,721 men with no history of cancer, cardiovascular disease, diabetes, hypertension, or high cholesterol levels were followed through 2009. Low-risk behavior included 5 factors: a healthy diet (top quintile of Recommended Food Score), moderate alcohol consumption (10 to 30 g/day), no smoking, being physically active (walking/bicycling ≥40 min/day and exercising ≥1 h/week), and having no abdominal adiposity (waist circumference <95 cm).
During 11 years of follow-up, we ascertained 1,361 incident cases of MI. The low-risk dietary choice together with moderate alcohol consumption was associated with a relative risk of 0.65 (95% confidence interval [CI]: 0.48 to 0.87) compared with men having 0 of 5 low-risk factors. Men having all 5 low-risk factors compared with those with 0 low-risk factors had a relative risk of 0.14 (95% CI: 0.04 to 0.43). This combination of healthy behaviors, present in 1% of the men, could prevent 79% (95% CI: 34% to 93%) of the MI events on the basis of the study population.
Almost 4 of 5 MIs in men may be preventable with a combined low-risk behavior.
坚持健康的饮食和生活方式可能会对心肌梗死（MI）的一级预防产生显著影响。
本研究旨在探讨低危饮食和健康生活方式相结合对男性 MI 发病率的影响。
本研究采用基于人群的前瞻性队列研究，纳入了年龄在 45 至 79 岁之间的瑞典男性。这些男性在 1997 年基线时完成了一份关于饮食和生活方式的详细问卷。共有 20721 名男性无癌症、心血管疾病、糖尿病、高血压或高胆固醇血症病史，随访至 2009 年。低危行为包括 5 个因素：健康饮食（推荐食品评分的前五分之一）、适量饮酒（10 至 30 克/天）、不吸烟、身体活跃（每天步行/骑自行车≥40 分钟和每周运动≥1 小时）和无腹部肥胖（腰围<95 厘米）。
在 11 年的随访期间，我们确定了 1361 例 MI 事件。与具有 0 个低危因素的男性相比，低危饮食选择加上适量饮酒与相对风险为 0.65（95%置信区间：0.48 至 0.87）相关。与具有 0 个低危因素的男性相比，具有 5 个低危因素的男性的相对风险为 0.14（95%置信区间：0.04 至 0.43）。在研究人群中，这种健康行为的组合（存在于 1%的男性中）可预防 79%（95%置信区间：34%至 93%）的 MI 事件。
近 4/5 的男性 MI 可能可以通过综合的低危行为预防。
