Dietary patterns and 5-year incidence of cardiovascular disease: A multivariate analysis of the ATTICA study

Abstract

Background and aims The 5-year incidence of cardiovascular disease (CVD) in relation to dietary habits, among men and women from Greece, was evaluated. Methods and results From May 2001 to December 2002, 1514 men and 1528 women (>18 years) without any clinical evidence of CVD, living in the Attica area, Greece, were enrolled in the ATTICA study. In 2006, a group of experts performed the 5-year follow-up (941 of the 3042 participants were lost). Development of CVD (coronary heart disease, acute coronary syndromes, stroke, or other CVD) during the follow-up period was defined according to WHO ICD-10 criteria. Principal Components Analysis was applied, and 15 dietary patterns were extracted (71% of total information explained) from 26 foods or food groups. The 5-year incidence of CVD was 11.0% in men and 6.1% in women ( p < 0.001); the case fatality rate was 1.6%. Multi-adjusted analysis revealed that the dietary pattern that was mainly characterized by cereals, small fish, hardtack and olive oil intake, was associated with lower CVD risk (HR per 1 unit = 0.72, 95% CI 0.52–1.00); the pattern that was characterized by fruits, vegetables intake and olive oil use in daily cooking was associated with lower CVD risk (HR per 1 unit = 0.80, 95% CI 0.66–0.97); while patterns that were mainly characterized by sweets, red meat, margarine, salty nuts intake, and hard cheese, as well as alcohol intake, were associated with higher CVD risk (HR per 1 unit = 1.26, 95% CI 1.01–1.56, and HR per 1 unit = 1.32, 95% CI 1.05–1.66, respectively). Conclusions Multivariate statistical methods revealed dietary patterns based on empirical epidemiological data which were associated with the development of CVD.