Associations between Multiple Food Consumption Frequencies and the Incidence of Cardiovascular Disease in High Cardiac Risk Subjects.

BACKGROUND

Dietary choices are inextricably linked to the incidence of cardiovascular disease (CVD), whereas an optimal dietary pattern to minimize CVD morbidity in high-risk subjects remains challenging.

METHODS

We comprehensively assessed the relationship between food consumption frequencies and CVD in 28,979 high-risk subjects. The outcome was defined as the composite of the incidence of major CVD events, including coronary heart disease and stroke. Risk factors associated with CVD were screened through a shrinkage approach, specifically least absolute shrinkage and selection operator (LASSO) regression. Hazard ratios (HRs) for various dietary consumption frequencies were assessed using multivariable Cox frailty models with random intercepts.

RESULTS

Increased egg and seafood consumption were associated with a lower risk of CVD (daily vs little, HR 1.70, 95% confidence interval, CI: 0.79-3.64, = 0.0073 and HR 1.86, 95% CI: 1.24-2.81, = 0.024, respectively). 6 non-food (age, sex, smoke, location, heart ratio, and systolic blood pressure) and 3 food (fruit, egg, and seafood) related risk factors were included in the nomogram to predict 3 and 5-year incidence of CVD. The concordance indexes of the training and validation cohorts were 0.733 (95% CI: 0.725-0.741) and 0.705 (95% CI: 0.693-0.717), respectively. The nomogram was validated using the calibration and time-dependent receiver operating characteristic curves, demonstrating respectable accuracy and discrimination.

CONCLUSIONS

Guided by the concept of "food as medicine", this nomogram could provide dietary guidance and prognostic prediction for high cardiac risk subjects in CVD prevention.