Abstract
Environmental factors, and in particular diet, are known to play a key role in the development of Coronary Heart Disease. Many of these factors were unveiled by detailed nutritional epidemiology studies, focusing on the role of a single nutrient or food at a time. Here, we apply an Environment-Wide Association Study approach to Nurses’ Health Study data to explore comprehensively and agnostically the association of 257 nutrients and 117 foods with coronary heart disease risk (acute myocardial infarction and fatal coronary heart disease). After accounting for multiple testing, we identify 16 food items and 37 nutrients that show statistically significant association – while adjusting for potential confounding and control variables such as physical activity, smoking, calorie intake, and medication use – among which 38 associations were validated in Nurses’ Health Study II. Our implementation of Environment-Wide Association Study successfully reproduces prior knowledge of diet-coronary heart disease associations in the epidemiological literature, and helps us detect new associations that were only marginally studied, opening potential avenues for further extensive experimental validation. We also show that Environment-Wide Association Study allows us to identify a bipartite food-nutrient network, highlighting which foods drive the associations of specific nutrients with coronary heart disease risk.
Highlights
In models adjusted for age, lifestyle behaviors, and dietary variables, the highest quintile of carbohydrate intake was not associated with incident CHD (pooled RR = 1.04; 95% CI: 0.96, 1.14; P trend = 0.31)
Total fiber intake was not associated with risk of CHD (pooled RR = 0.94; 95% CI: 0.85, 1.03; P trend = 0.72), while cereal fiber was associated with a lower risk for incident CHD (pooled RR = 0.80; 95% CI: 0.74, 0.87; P trend
In fully adjusted models, the carbohydrate-to-total fiber ratio was not associated with incident CHD (pooled RR = 1.04; 95% CI: 0.96, 1.13; P trend = 0.46)
Summary
We aimed to assess the relation between various measures of carbohydrate quality and incident CHD
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