Adherence to dietary guidelines and cardiovascular disease risk in the EPIC-NL cohort

E.A. Struijk, A.M. May, N.L.W.J. Wezenbeek, H. Fransen, S.S. Soedamah-Muthu, A. Geelen, J. Boer, Y.T. van der Schouw, H.B. Bueno de Mesquita, J.W.J. Beulens

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Abstract

Background Global and national dietary guidelines have been created to lower chronic disease risk. The aim of this study was to assess whether greater adherence to the WHO guidelines (Healthy Diet Indicator (HDI)); the Dutch guidelines for a healthy diet (Dutch Healthy Diet-index (DHD-index)); and the Dietary Approaches to Stop Hypertension (DASH) diet was associated with a lower risk of cardiovascular disease (CVD), coronary heart disease (CHD) or stroke. Methods A prospective cohort study was conducted among 33,671 healthy Dutch men and women aged 20–70 years recruited into the EPIC-NL study during 1993–1997. We used Cox regression adjusted for relevant confounders to estimate the hazard ratios per standard deviation increase in score and 95% confidence intervals (CI) of the associations between the dietary guidelines and CVD, CHD and stroke risk. Results After an average follow-up of 12.2 years, 2752 CVD cases were documented, including 1630 CHD cases and 527 stroke cases. We found no association between the HDI (0.98, 95% CI 0.94; 1.02) or DHD-index (0.96, 95% CI 0.92; 1.00) and CVD incidence. Similar results were found for these guidelines and CHD or stroke incidence. Higher adherence to the DASH diet was significantly associated with a lower CVD (0.92, 95% CI 0.89; 0.96), CHD (0.91, 95% CI 0.86; 0.95), and stroke (0.90, 95% CI 0.82; 0.99) risk. Conclusion The HDI and the DHD-index were not associated with CVD risk, while the DASH diet was significantly associated with a lower risk of developing CVD, CHD and stroke.
Original languageEnglish
Pages (from-to)354-359
JournalInternational Journal of Cardiology
Volume176
Issue number2
DOIs
Publication statusPublished - 2014

Keywords

  • coronary-heart-disease
  • major chronic disease
  • systematic analysis
  • for-americans
  • global burden
  • style diet
  • 21 regions
  • women
  • men
  • questionnaire

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