Nutrition is a powerful independent risk factor for coronary heart disease in women—The CORA Study: a population-based case–control study

Abstract

Background: It is still common practice to rely mostly on drug treatment for preventing cardiovascular disease, although a healthy nutrition has been defined that may prevent most premature cardiovascular events. Objectives: This research raises the question of the magnitude of the effect of nutrition on cardiovascular disease independent of that of clinical risk factors, which are the targets of drug therapy. Design: The study of coronary risk factors for atherosclerosis in women compares clinical, biochemical, and lifestyle factors in 200 consecutive pre-and postmenopausal women with incident coronary heart disease (CHD) to those in 255 age-matched population-based controls. Results: Cases reported a higher intake of energy, predominantly through animal fat and protein reflected by a higher consumption of meat and sausage, while controls ate more fruit and vegetables. Multivariate analysis adjusted for clinical risk factors depicted a high intake of meat and sausage and a low consumption of fruit and vegetables as independent risk factors with an odds ratio of 2.5 (95% confidence interval 1.1-5.7) and 0.7 (95% confidence interval 0.5-1.0) for each 100 g per day, respectively. These dietary factors were found to be significantly more pronounced in cases with any clinical risk factor identified in this population as compared to controls with the same risk factors. Conclusions: The CORA-study clearly indicates a major impact of dietary habits on CHD in women independent of, and additive to, that of conventional risk factors. Thus, in clinical practice, the potential of nutrition as part of a healthy lifestyle is commonly greatly underestimated in favour of drug treatment. Sponsorship: German Stifterverband für die Wissenschaft.

Differential Association of Anthropometric Parameters with Coronary Risk in Women – Data of the CORA Study

“…In other studies [21][22][23][24], higher initial weight with continuous weight gain also has been reported for patients with hypertension, glucose intolerance, diabetes, low HDL cholesterol, and the metabolic syndrome. A dietary pattern characterized by a high intake of meat and meat products and a lower intake of fruit and vegetables may be critical [25]. However in the CORA study the pattern of weight gain associated with components of the metabolic syndrome appears to differ from that related to CHD which is characterized by an early weight gain particularly between 30 and 40 years of age.…”

Association between alcohol consumption and carotid intima–media thickness in a healthy population: data of the STRATEGY study (Stress, Atherosclerosis and ECG Study)

“…However, several studies suggest that the benefit of alcohol drinking is largely confined to individuals at increased risk for CVD, to older subjects or to those with a poor nutrition status (Fuchs et al, 1995;Zyriax et al, 2005;Merchant et al, 2008;Bos et al, 2010). In contrast, studies including younger adults suggested that increasing alcohol intake is associated with coronary calcification and vascular damage (Pletcher et al, 2005;van Trijp et al, 2005).…”

Relationship between meat intake and the development of acute coronary syndromes: the CARDIO2000 case–control study

“…Additionally, the risk of acute MI and CHD was directly associated with frequency of meat consumption, as well as with processed meats like ham and salami, in a case-control study of women, after adjustment for major non-dietary covariates (Gramenzi et al, 1990), as well as in the CORA study (Zyriax et al, 2005). Finally, studies that examine the effect of dietary patterns and not food group or nutrient intake alone, on CHD risk, characterize a 'Western' pattern, as a pattern rich in red and processed meats, among other characteristics, and associate it with increased risk of CHD, independent of other lifestyle variables (Hu et al, 2000).…”