Healthy eating and lower mortality risk in a large cohort of cardiac patients who received state-of-the-art drug treatment

F.P.C. Sijtsma, S.S. Soedamah-Muthu, J. de Goede, L.M. Oude Griep, J.M. Geleijnse, D. Kromhout

Research output: Contribution to journalArticleAcademicpeer-review

10 Citations (Scopus)

Abstract

Background: Little is known about dietary scores and mortality
risk in cardiac patients who are well treated with drugs with attendant
relatively low risk of cardiovascular diseases (CVDs).
Objective: We assessed whether healthy eating lowers the risk of
CVD and all-cause mortality in cardiac patients.
Design: We included 4307 patients from the Alpha Omega Trial aged
60–80 y with a clinically diagnosed myocardial infarction and monitored
mortality for 10 y. Diet was assessed at baseline (2002–2006)
with a validated 203-item food-frequency questionnaire. We created 2
dietary scores on the basis of nonoverlapping sets of foods: the Dutch
Healthy Nutrient and Food Score (DHNaFS) and the Dutch Undesirable
Nutrient and Food Score (DUNaFS). The associations of both
dietary scores with CVD and all-cause mortality were assessed by
using multivariable-adjusted Cox regression models.
Results: The median time after myocardial infarction at baseline was
3.7 y (IQR: 1.7–6.3 y). During a median of 6.5 y of follow-up (IQR: 5.3–
7.6 y), 801 patients died; 342 of those died of CVD. One patient was lost
to follow-up. A substantially higher average amount of DHNaFS foods
(w1750 g/d) than DUNaFS foods (w650 g/d) was consumed. Almost
all patients received drug treatment: 86% used statins, 90% used antihypertensive
medication, and 98% used antithrombotic medication. Patients
in the fifth quintile of the DHNaFS had a 30% (HR: 0.70; 95% CI: 0.55,
0.91) lower CVD risk and a 32% (HR: 0.68; 95% CI: 0.47, 0.99) lower
all-cause mortality risk than did patients in the first quintile. The
DUNaFS was unrelated to both CVD and all-cause mortality.
Conclusion: Beyond state-of-the-art drug treatment, healthy eating
was associated with a lower risk of CVD and all-cause mortality in
cardiac patients. This trial was registered at clinicaltrials.gov as
NCT00127452. Am J Clin Nutr doi: 10.3945/ajcn.115.112276.
Original languageEnglish
Pages (from-to)1527-1533
JournalAmerican Journal of Clinical Nutrition
Volume102
Issue number6
DOIs
Publication statusPublished - 2015

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