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A Mediterranean-style diet, its components and the risk of heart failure: a prospective population-based study in a non-Mediterranean country.

Abstract

BACKGROUND/OBJECTIVES

Growing evidence emerged about the role of diet in heart failure (HF) development, but data are sparse and inconclusive. We examined the association between a Mediterranean-style diet, its components and HF risk.

SUBJECTS/METHODS

Analyses were carried out in 24 008 middle-aged participants of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam (Germany), including 209 incident HF cases within 8.2 years. The traditional Greek Mediterranean diet score (tMED) was used to assess dietary adherence. Cox's proportional hazards regression was applied to estimate the relationship between the adherence to the Mediterranean-style diet, its components and HF risk.

RESULTS

After adjustment for age, sex and energy intake, a 2-unit increment in the tMED was associated with 26% lower risk of HF (HR (95% confidence interval (CI)): 0.76 (0.60-0.97)). After multivariable adjustment, this association was slightly attenuated and lost significance [HR (95%CI): 0.82 (0.64-1.05)]. Interestingly, we observed a significant association in multivariable adjusted models when milk products were excluded from the score (HR (95% CI): 0.75 (0.59-0.96)). Three score components were significantly associated with HF risk: alcohol (HR (95%CI): 0.73 (0.55-0.97) for moderate versus low/high intakes), meat: 2.04 (1.17-3.55) and fish: 0.59 (0.36-0.95), both for the highest versus the lowest quintile.

CONCLUSIONS

The tMED was not significantly associated with HF risk, but low meat, high fish and moderate alcohol intake were inversely associated with HF risk in our non-Mediterranean population. Minor dietary changes could be valuable primary prevention measures, particularly the increase of fish consumption while reducing the intake of meat.

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  • Authors+Show Affiliations

    ,

    Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany. DZHK (German Centre for Cardiovascular Research), Partner Site Berlin/Potsdam, Potsdam, Germany.

    ,

    Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany. DZHK (German Centre for Cardiovascular Research), Partner Site Berlin/Potsdam, Potsdam, Germany. Institute of Epidemiology, Christian-Albrechts University Kiel, Kiel, Germany.

    ,

    Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany.

    Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany. DZHK (German Centre for Cardiovascular Research), Partner Site Berlin/Potsdam, Potsdam, Germany. Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany. Department of Food Safety, The Federal Institute for Risk Assessment, Berlin, Germany.

    Source

    MeSH

    Adult
    Animals
    Diet, Mediterranean
    Feeding Behavior
    Female
    Fishes
    Germany
    Heart Failure
    Humans
    Male
    Meat
    Middle Aged
    Prospective Studies
    Risk Factors
    Surveys and Questionnaires

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    27507073

    Citation

    Wirth, J, et al. "A Mediterranean-style Diet, Its Components and the Risk of Heart Failure: a Prospective Population-based Study in a non-Mediterranean Country." European Journal of Clinical Nutrition, vol. 70, no. 9, 2016, pp. 1015-21.
    Wirth J, di Giuseppe R, Boeing H, et al. A Mediterranean-style diet, its components and the risk of heart failure: a prospective population-based study in a non-Mediterranean country. Eur J Clin Nutr. 2016;70(9):1015-21.
    Wirth, J., di Giuseppe, R., Boeing, H., & Weikert, C. (2016). A Mediterranean-style diet, its components and the risk of heart failure: a prospective population-based study in a non-Mediterranean country. European Journal of Clinical Nutrition, 70(9), pp. 1015-21. doi:10.1038/ejcn.2016.140.
    Wirth J, et al. A Mediterranean-style Diet, Its Components and the Risk of Heart Failure: a Prospective Population-based Study in a non-Mediterranean Country. Eur J Clin Nutr. 2016;70(9):1015-21. PubMed PMID: 27507073.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - A Mediterranean-style diet, its components and the risk of heart failure: a prospective population-based study in a non-Mediterranean country. AU - Wirth,J, AU - di Giuseppe,R, AU - Boeing,H, AU - Weikert,C, Y1 - 2016/08/10/ PY - 2016/03/01/received PY - 2016/06/27/revised PY - 2016/06/29/accepted PY - 2016/8/11/entrez PY - 2016/8/11/pubmed PY - 2018/1/27/medline SP - 1015 EP - 21 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 70 IS - 9 N2 - BACKGROUND/OBJECTIVES: Growing evidence emerged about the role of diet in heart failure (HF) development, but data are sparse and inconclusive. We examined the association between a Mediterranean-style diet, its components and HF risk. SUBJECTS/METHODS: Analyses were carried out in 24 008 middle-aged participants of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam (Germany), including 209 incident HF cases within 8.2 years. The traditional Greek Mediterranean diet score (tMED) was used to assess dietary adherence. Cox's proportional hazards regression was applied to estimate the relationship between the adherence to the Mediterranean-style diet, its components and HF risk. RESULTS: After adjustment for age, sex and energy intake, a 2-unit increment in the tMED was associated with 26% lower risk of HF (HR (95% confidence interval (CI)): 0.76 (0.60-0.97)). After multivariable adjustment, this association was slightly attenuated and lost significance [HR (95%CI): 0.82 (0.64-1.05)]. Interestingly, we observed a significant association in multivariable adjusted models when milk products were excluded from the score (HR (95% CI): 0.75 (0.59-0.96)). Three score components were significantly associated with HF risk: alcohol (HR (95%CI): 0.73 (0.55-0.97) for moderate versus low/high intakes), meat: 2.04 (1.17-3.55) and fish: 0.59 (0.36-0.95), both for the highest versus the lowest quintile. CONCLUSIONS: The tMED was not significantly associated with HF risk, but low meat, high fish and moderate alcohol intake were inversely associated with HF risk in our non-Mediterranean population. Minor dietary changes could be valuable primary prevention measures, particularly the increase of fish consumption while reducing the intake of meat. SN - 1476-5640 UR - https://www.unboundmedicine.com/medline/citation/27507073/full_citation L2 - http://dx.doi.org/10.1038/ejcn.2016.140 DB - PRIME DP - Unbound Medicine ER -