High sweet foods and low life satisfaction can act as risk factors for acute coronary syndrome through synergistic interaction

Abstract

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health & Welfare, Republic of Korea. Background Dietary and psychological factors contribute to development of coronary artery disease (CAD). However, contributing components of these lifestyle factors may vary depending on ethnic and cultural background, and secondary prevention programs dealing with these factors in specific population are not well established. Aims We aimed to analyze dietary and psychological characteristics and independent risk factors in Korean patients with acute coronary syndrome (ACS). Methods Ninety-two patients with ACS (29 acute myocardial infarction, 63 unstable angina) and 69 controls were subject to analysis of lifestyle factors focused on dietary and psychological status. Dietary intake was assessed by a food frequency questionnaire (FFQ) using the KoGES software and Can-Pro 4.0. Psychological depression and perceived stress were measured with the Patient Health Questionnaire 9 (PHQ-9) and the Korean version of Perceived Stress Scale (K-PSS), respectively. In additions, eight domains of life satisfaction was assessed with the Domain Satisfaction Questionnaire (DSQ). Results ACS group had more men (79% vs 61%) and was older (53 yr vs. 49 yr), less physically active, and higher waist circumference and BMI than controls. Dietary analyses showed that ACS group had more intakes of sweets and fish/seafood in both men and women compared to controls. Psychological analyses showed that ACS group had higher depressive symptom (5.4 vs. 4.2, p<0.05) and less total DSQ scores (average satisfaction scores across the 8 life domains: 4.2 vs. 4.7, p<0.001) along with the lower DSQ scores of all 8 individual domains (love relationship, leisure, standard of living, job, health, family life, sex life, and self). There was a modest but significant linear inverse correlation between daily sweet intakes and total DSQ score (r = -0.23, p=0.01). Sweets (OR: 4.57, 95% CI: 1.94-11.40) and total DSQ scores (OR: 0.34, 95% CI: 0.14-0.81) were identified, by multivariate logistic regression analysis, as independent risk factors that synergistically as well as individually contribute to development of ACS. Conclusions High sweet food intake and low life satisfaction can act as independent risk factors for ACS through interactive mechanism. These data also highlight the importance of the role of positive psychological factor in cardiovascular health.