Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Eur J Nutr. 2020 Dec;59(8):3405-3413. doi: 10.1007/s00394-019-02170-7. Epub 2020 Jan 7.
A healthy diet may contribute to the primary prevention of heart failure (HF), but evidence is still inconclusive. We aimed to study the association between adherence to the Dutch dietary guidelines and incidence of HF.
We studied 37,468 participants aged 20-70 years and free of HF at baseline from the EPIC-NL cohort. At baseline (1993-1997), data were collected on demographics, lifestyle, and presence of chronic diseases. Dietary intake was assessed using a 178-item validated food frequency questionnaire. Dietary intake data were used to calculate scores on the Dutch Healthy Diet 2015 Index (DHD15-index) measuring adherence to the Dutch dietary guidelines. The DHD15-index is based on the average daily intake of 14 food groups resulting in a total score ranging between 0 and 140, with higher scores indicating better adherence. HF morbidity and mortality during follow-up were ascertained through linkage with national registries. Cox proportional hazards analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the association between DHD15 adherence and HF risk, adjusting for sociodemographic and lifestyle characteristics.
The average score on the DHD15-index was 71 (SD = 15). During a median follow-up of 15.2 years (IQR 14.1-16.5), 674 HF events occurred. After adjustment for demographic and lifestyle characteristics, higher scores on the DHD15-index were associated with lower risk of HF (HR 0.73; 95% CI 0.58-0.93; P 0.001).
In a large Dutch population of middle-aged adults, higher adherence to the Dutch dietary guidelines was associated with lower risk of HF.
健康的饮食可能有助于心力衰竭（HF）的一级预防，但证据仍不确定。我们旨在研究荷兰饮食指南的依从性与 HF 发生率之间的关系。
我们研究了 EPIC-NL 队列中 37468 名年龄在 20-70 岁且基线时无 HF 的参与者。在基线（1993-1997 年）时，收集了人口统计学、生活方式和慢性疾病存在情况的数据。饮食摄入使用经过验证的 178 项食物频率问卷进行评估。饮食摄入数据用于计算荷兰健康饮食 2015 指数（DHD15-index）的分数，该指数用于衡量对荷兰饮食指南的依从性。DHD15-index 基于 14 种食物组的平均日摄入量，总分为 0 至 140 分，得分越高表示依从性越好。通过与国家登记册的链接确定随访期间 HF 的发病率和死亡率。使用 Cox 比例风险分析来估计 DHD15 依从性与 HF 风险之间的关联的风险比（HR）和 95%置信区间（95%CI），并调整了社会人口统计学和生活方式特征。
DHD15-index 的平均得分为 71（SD=15）。在中位数为 15.2 年（IQR 14.1-16.5）的随访期间，发生了 674 例 HF 事件。在调整了人口统计学和生活方式特征后，DHD15-index 的得分越高，HF 的风险越低（HR 0.73；95%CI 0.58-0.93；P<0.001）。
在荷兰中年成年人的大型人群中，较高的荷兰饮食指南依从性与 HF 风险降低相关。
