BackgroundHigher potato intake, especially French fries, was unfavorably associated with cardiometabolic endpoints in population-based studies. Little is known about this in patients with ischemic heart disease (IHD).ObjectiveTotal and boiled potatoes and French fries intake were examined in relation to cardiovascular disease (CVD) mortality, all-cause mortality, and type 2 diabetes mellitus (T2DM) risk in Dutch post-myocardial infarction (MI) patients of the Alpha Omega Cohort.MethodsWe analyzed 3,401 patients (60–80 years, 78% male), free from T2DM at baseline, with an MI ≤ 10 years before enrolment. Diet was assessed at baseline (2002–2006) using a 203-item validated Food Frequency Questionnaire (FFQ) that includes potato preparation methods. Cause-specific mortality was monitored through December 2018, and T2DM incidence (self-reported physician diagnosis and/or prescribed anti-diabetes medication) was monitored during the first 40 months of follow-up. Multivariable Cox models were used to obtain hazard ratios (HRs) for fatal endpoints and incident T2DM in tertiles of potato intake.ResultsPatients had a median total potato intake (mainly boiled) of 111 g/d, 96% consumed >1 serving (200 g) per week. French fries were consumed by 48% of the patients (median of 6 g/d among consumers). During >12 years of follow-up (38,987 person-years), 1,476 deaths occurred of which 641 were from CVD, 394 were from IHD, and 119 were from a stroke. Total and boiled potatoes were not associated with CVD mortality, but a higher risk of all-cause mortality was observed (HR: 1.07; 95% CI: 1.01, 1.14; per 50 g/d). Potato consumption tended to be positively associated with incident T2DM (186 cases; HR: 1.11, 95% CI: 0.94, 1.32; per 50 g/d). Results for French fries were inconsistent for all outcomes.ConclusionIn Dutch post-MI patients, potatoes (mainly boiled) were not associated with CVD mortality but possibly adversely associated with all-cause mortality and T2DM risk. These findings warrant confirmation in other IHD patient cohorts. The Alpha Omega Cohort is registered at ClinicalTrials.gov as NCT03192410.

Introduction: Higher potatoes intake, especially French fries, was unfavorably associated with cardiometabolic endpoints in population-based studies. Little is known about this in coronary heart disease (CHD) patients. Hypothesis: Boiled potatoes and French fries intake might increase the risk of type 2 diabetes (T2D), cardiovascular disease (CVD) mortality and all-cause mortality after myocardial infarction (MI). Methods: We analyzed 3401 Dutch patients (60-80 y, 78% male) from the Alpha Omega Cohort, free from T2D, with an MI ≤ 10 y before enrolment. Diet was assessed at baseline (2002-2006) using a 203-item validated food frequency questionnaire, including potato preparation methods. T2D incidence (self-reported physician diagnosis and/or prescribed anti-diabetes medication) was monitored during the first 40 months of follow-up and cause-specific mortality through December 2018. Multivariable Cox models were used to obtain Hazard Ratios (HRs) for incident T2D and fatal endpoints in potato categories. Results: Patients had a median potato intake (mainly boiled) of 111 g/d (3.8 weekly servings of 200 g), with 6% consuming <1 serving per week. French fries were consumed by 48% of the patients (median: 6 g/d). Total potato intake was non-linearly associated with T2D risk during early follow-up (186 cases). Compared to 0-2 servings, HRs were 1.52 (0.97, 2.39) for 3-4 servings and 1.78 (1.10, 2.89) for ≥5 servings per week. During >12 y of follow-up (38,987 person-years) 1618 deaths occurred, of which 697 from CVD, 431 from CHD and 128 from stroke. HRs for fatal endpoints were non-significant in categories of total and boiled potatoes (Table). For French fries (consumers vs. non-consumers), HRs were 1.23 (0.89, 1.69) for T2D, 1.03 (0.87, 1.22) for fatal CVD and 0.93 (0.83, 1.04) for all-cause mortality. Conclusion: In Dutch post-MI patients, potatoes (mainly boiled) were neutrally associated with CVD and all-cause mortality. An increased risk of T2D was found for French fries, which warrants further study in CHD patient cohorts.