Major dietary patterns and risk of acute myocardial infarction in young, urban Pakistani population.

Mohammad Perwaiz Iqbal

doi:10.12669/pjms.315.7690

Abstract

Objective:To investigate the role of dietary intake in the development of premature acute myocardial infarction (AMI) in a hospital-based Pakistani population in Karachi.Methods:In a case control study, 203 consecutive patients (146 males and 57 females) with their first AMI and age below 45 years were enrolled with informed consent. Similarly, 205 gender and age matched (within 3 years) healthy adults were also included as controls. Dietary intake of both cases and controls was assessed by using a simple 14-item food frequency questionnaire. Using factor analysis, 3 major dietary patterns- prudent dietary pattern, combination dietary pattern and western dietary pattern were identified. Fasting plasma/serum of both cases and controls were analyzed for homocysteine, folate, vitamin B12, blood Pb, ferritin, cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides. ANOVA and conditional logistic regression were used to predict the association of dietary patterns with AMI.Results:Consumption of prudent diet, characterized by high consumption of legumes, vegetables, wheat, chicken and fruits, is protective against the risk of premature AMI. Moderate to high consumption of combination diet, characterized by high intake of eggs, fish, fruits, juices and coffee was associated with decreased risk of AMI. No association was observed between western diet, characterized by high intake of meat, fish and tea with milk and risk of AMI.Conclusions:Consumption of a prudent dietary pattern and a combination dietary pattern is protective against the risk of AMI in a Pakistani population.

Highlights

There is growing evidence that coronary artery disease (CAD) is seen in relatively younger Pakistani population
Some of the food items used in this questionnaire have been previously studied for association with B-vitamins, plasma homocysteine and cardiovascular disease.[11,14]
Factor analysis revealed 3 major dietary patterns. These were labeled as “ prudent dietary pattern”, which was characterized by high consumption of legumes, cooked and uncooked vegetables, wheat, chicken and fruits; “combination dietary pattern” which was characterized by high consumption of eggs, fish, fruits, juices and coffee; and “western dietary pattern”, which was characterized by high intake of meat, fish and tea with milk (Table-I)

Summary

Introduction

There is growing evidence that coronary artery disease (CAD) is seen in relatively younger Pakistani population. 28.3% of patients with acute myocardial infarction (AMI) in 17 coronary care units (CCU) in all 4 provinces of Pakistan were found to be younger than 45 years. Correspondence: March 10, 2015 June 16, 2015 June 20, 2015 of age.[1] In another study in Faisalabad, 35% of AMI patients admitted in CCU of Divisional Headquarter Hospital and Faisalabad Institute of Cardiology were found to be below the age of 45 years.[2] These reports are indicative of early onset of this disease in Pakistan. Since Pakistanis are known to consume high fat diet and low amounts of green leafy vegetables[7,8,9], we embarked on investigating the role of dietary intake and its association with premature AMI in a hospital-based study conducted in Karachi, Pakistan

Methods

Results

Conclusion