Abstract P218: Longitudinal Changes in Berry Intake and the Risk of Cardiovascular Disease in Women

Abstract

Background: High intake of polyphenols has been linked to a lower risk of cardiovascular disease (CVD). Berries are high in polyphenols, including anthocyanins, along with other key nutrients. However, few studies have investigated the association between longitudinal changes in berry intake and long-term risk of CVD. The aim of this study was to investigate whether longitudinal changes in berry intake are associated with the risk of major CVD endpoints. Methods: Longitudinal changes in berry intake (sum of blueberries and strawberries) were assessed from two 131-item food-frequency questionnaires (FFQ) completed in 1992-1995 (FFQ1) and 2004 (FFQ2) among 29,598 middle-aged and older women free of CVD from the Women’s Health Study. Women also provided self-reports of a wide range of lifestyle, clinical and dietary factors at both timepoints. For each FFQ, women were categorized into two categories of total berry, blueberry, and strawberry intake: never/rarely and ≥1 time/month. Women were then categorized as having consistent low intake (never/rarely), consistent any intake (≥1 time/month), any increase in intake, and any decrease in intake between FFQ assessments. We used Cox proportional hazards models to calculate age and multivariable-adjusted hazard ratios (HRs) (95% confidence intervals (CI)). We included age, randomization assignments, smoking status, body mass index, physical activity, hormone replacement therapy, family history of myocardial infarction (MI), hypercholesterolemia, hypertension, diabetes, fruit and vegetable intake, saturated fatty acid intake, and omega-3 intake as covariates at the FFQ2 assessment. Results: During a mean follow-up of 9.9 years, we identified 851 cases of incident major CVD (MI, stroke, and CVD death). The intakes of total berries at FFQ1 were 23% (never/rarely) and 77% (≥1 time/month). Corresponding intakes at FFQ2 were 15% and 85%, respectively. In multivariable-adjusted models, consistently having any berry intake (HR: 1.00 (0.78-1.28)), any increase (HR: 0.89 (0.66-1.19)), or any decrease (HR: 0.84 (0.60-1.18)) in total berry intake over 10 years were not significantly associated with the risk of major CVD compared to women with consistently having no intake. A similar lack of association was observed for changes in strawberry intake. Increasing blueberry intake was associated with a lower risk of major CVD (HR: 0.83 (0.69-0.99)), whereas consistently having any blueberry intake (HR: 1.09 (0.91-1.29)) and any decrease in blueberry intake (HR: 0.97 (0.75-1.27)) were not associated with CVD. Conclusions: The results from this prospective study of middle-aged and older women initially free of CVD suggest that increasing blueberry intake over time may lower the risk of subsequent CVD.