Peter Pribiš

Abstract

Dietary habits are believed to be major determinants of risk of coronary heart disease (CHD). Studies of high and low risk populations have suggested several nutrients to be protective or hazardous against CHD. Most published work since 1984 on diet and CHD in the Adventist Health Study (AHS) population examined either foods or food groups. This study investigated ten nutrients as exposure variables and their relationship to CHD risk. A cohort of 23,616 nonsmoking, non-Hispanic white California Seventh-day Adventists was followed for six years beginning in 1976. Extensive dietary information was collected at baseline, as well as values of traditional coronary risk factors. There were 249 cases of definitive fatal CHD, and 130 definitive non-fatal myocardial infarctions (MI) identified during the follow-up. In the [multivariate] analysis, three different models of control for energy intake were tested: the Standard model, Energy Partition model, and Residual model. The number of significant results across all three models were approximately the same and no one model produced notably more statistically significant results. Men who consumed more vegetable protein, vegetable fat, and fiber experienced substantially fewer non-fatal myocardial infarctions. The same nutrients showed protection against fatal CHD as well, but the results were not as decisive. The relative risk (RR) of non-fatal MI in men for vegetable protein was 0.57 (95% confidence interval [Cl], 0.42 - 0.78), for vegetable fat the RR was 0.52 (95% Cl, 0.36 - 0.75), and for fiber the RR was 0.77 (95% Cl, 0.62 - 0.97). When these nutrients were analyzed as categorical variables, a dose response effect was observed. The results for women were inconclusive.

Dietary vitamin E seems to be protective for men and women for fatal CHD. For men the RR from the lowest to the highest tertile was 1.00, 0.45 and 0.61, respectively (overall χ2 p=0.04); for women 1.00, 0.95 and 0.55, respectively (overall χ2 p=0.08). The results for supplemental vitamin E were questionable. These data do not prove a causal relationship, but provide evidence of an association between a higher intake of vegetable protein, vegetable fat, fiber, and dietary vitamin E, and a lower risk of CHD in men and women.

Department

Nutrition

School

School of Public Health

First Advisor

Joan Sabaté

Second Advisor

Gary E. Fraser

Third Advisor

Georgia Hodgkin

Degree Name

Doctor of Public Health (DrPH)

Degree Level

Ph.D.

Year Degree Awarded

1996

Date (Title Page)

3-1996

Language

English

Library of Congress/MESH Subject Headings

Coronary Disease -- etiology; Risk Factors; Nutrition Assessment; Nutrition Surveys; Diet Food Habits

Type

Dissertation

Page Count

xvi; 186

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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