TY - JOUR
T1 - Adherence to dietary guidelines and cardiovascular disease risk in the EPIC-NL cohort
AU - Struijk, Ellen A.
AU - May, Anne M.
AU - Wezenbeek, Nick L.W.
AU - Fransen, Heidi P.
AU - Soedamah-Muthu, Sabita S.
AU - Geelen, Anouk
AU - Boer, Jolanda M.A.
AU - Van Der Schouw, Yvonne T.
AU - Bueno-De-Mesquita, H. Bas
AU - Beulens, Joline W.J.
PY - 2014/1/1
Y1 - 2014/1/1
N2 - Background: Global and national dietary guidelines have been created to lower chronic disease risk. The aim of this study was to assess whether greater adherence to the WHO guidelines (Healthy Diet Indicator (HDI)); the Dutch guidelines for a healthy diet (Dutch Healthy Diet-index (DHD-index)); and the Dietary Approaches to Stop Hypertension (DASH) diet was associated with a lower risk of cardiovascular disease (CVD), coronary heart disease (CHD) or stroke. Methods: A prospective cohort study was conducted among 33,671 healthy Dutch men and women aged 20-70 years recruited into the EPIC-NL study during 1993-1997. We used Cox regression adjusted for relevant confounders to estimate the hazard ratios per standard deviation increase in score and 95% confidence intervals (CI) of the associations between the dietary guidelines and CVD, CHD and stroke risk. Results: After an average follow-up of 12.2 years, 2752 CVD cases were documented, including 1630 CHD cases and 527 stroke cases. We found no association between the HDI (0.98, 95% CI 0.94; 1.02) or DHD-index (0.96, 95% CI 0.92; 1.00) and CVD incidence. Similar results were found for these guidelines and CHD or stroke incidence. Higher adherence to the DASH diet was significantly associated with a lower CVD (0.92, 95% CI 0.89; 0.96), CHD (0.91, 95% CI 0.86; 0.95), and stroke (0.90, 95% CI 0.82; 0.99) risk. Conclusion: The HDI and theDHD-indexwere not associated with CVD risk,while the DASH dietwas significantly associated with a lower risk of developing CVD, CHD and stroke.
AB - Background: Global and national dietary guidelines have been created to lower chronic disease risk. The aim of this study was to assess whether greater adherence to the WHO guidelines (Healthy Diet Indicator (HDI)); the Dutch guidelines for a healthy diet (Dutch Healthy Diet-index (DHD-index)); and the Dietary Approaches to Stop Hypertension (DASH) diet was associated with a lower risk of cardiovascular disease (CVD), coronary heart disease (CHD) or stroke. Methods: A prospective cohort study was conducted among 33,671 healthy Dutch men and women aged 20-70 years recruited into the EPIC-NL study during 1993-1997. We used Cox regression adjusted for relevant confounders to estimate the hazard ratios per standard deviation increase in score and 95% confidence intervals (CI) of the associations between the dietary guidelines and CVD, CHD and stroke risk. Results: After an average follow-up of 12.2 years, 2752 CVD cases were documented, including 1630 CHD cases and 527 stroke cases. We found no association between the HDI (0.98, 95% CI 0.94; 1.02) or DHD-index (0.96, 95% CI 0.92; 1.00) and CVD incidence. Similar results were found for these guidelines and CHD or stroke incidence. Higher adherence to the DASH diet was significantly associated with a lower CVD (0.92, 95% CI 0.89; 0.96), CHD (0.91, 95% CI 0.86; 0.95), and stroke (0.90, 95% CI 0.82; 0.99) risk. Conclusion: The HDI and theDHD-indexwere not associated with CVD risk,while the DASH dietwas significantly associated with a lower risk of developing CVD, CHD and stroke.
KW - CVD
KW - DASH diet
KW - DHD-index
KW - Dietary guidelines
KW - EPIC-NL
KW - HDI
UR - http://www.scopus.com/inward/record.url?scp=84922414243&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ijcard.2014.07.017
DO - https://doi.org/10.1016/j.ijcard.2014.07.017
M3 - Article
C2 - 25107447
SN - 0167-5273
VL - 176
SP - 354
EP - 359
JO - International journal of cardiology
JF - International journal of cardiology
IS - 2
ER -