Abstract WP194: Impact Of Total Energy Intake On Stroke Mortality Is Greater Than That Of Coronary Heart Disease: A 24-year Follow-up Of Representative Japanese (NIPPON DATA80), 1980-2004

Abstract

INTRODUCTION: Previous studies showed that calorie restriction decreased blood pressure and plasma lipid, and increased longevity. However, impact of total energy intake (EI) on mortality from cardiovascular disease (CVD) including types of CVD has not been studied. We assessed the hypothesis that lower EI was associated with decreased risk of CVD, coronary heart disease (CHD), and stroke mortality. Methods: We studied the association between EI and mortality form all CVD, CHD, and stroke using the National Integrated Project for Prospective Observation of Noncommunicable Disease and Its Trends in the Aged (NIPPON DATA80) database with a 24-year follow-up. We followed a random sample of 8,825 Japanese aged ≥30 years (mean age, 50.0 years at baseline in 1980; 43.3% men) without history of CVD, kidney disease, or diabetes. Those with lack of information about EI or extreme EI (sex-specific intake of highest or lowest 0.5%) were also excluded. EI was calculated from a 3 days weighed food record method. We classified the participants into sex-specific quintiles of EI (the lowest quintile: men<2,025.1 kcal/day, women<1,627.0 kcal/day, the highest quintile: men≥2,776.8 kcal/day, women≥2,219.7 kcal/day). We used Cox proportional-hazards models to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for sex, age, body mass index, smoking, drinking, systolic blood pressure, blood glucose, and total cholesterol. Results: Multivariate HR in the lowest quintile (in reference to the highest quintile) from all CVD was significantly decreased (HR: 0.78, 95%CI: 0.62-0.98). The association was more remarkable for stroke mortality (HR: 0.67, 95%CI: 0.48-0.93) than for CHD mortality (HR: 0.82, 95%CI: 0.49-1.37). After further adjustment of multivariate HRs for sodium/potassium ratio, we observed similar results. Conclusion: A 24-year follow-up of NIPPON DATA80 demonstrated that lower EI was associated with decreased risk of CVD mortality: the association was more remarkable for stroke mortality than for CHD mortality.