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Djousse L.,Harvard University | Djousse L.,Massachusetts Veterans Epidemiology and Research Information Center and Geriatric Research | Hopkins P.N.,University of Utah | North K.E.,University of North Carolina at Chapel Hill | And 3 more authors.
Clinical Nutrition | Year: 2011

Background & aims: Epidemiologic studies have suggested beneficial effects of flavonoids on cardiovascular disease. Cocoa and particularly dark chocolate are rich in flavonoids and recent studies have demonstrated blood pressure lowering effects of dark chocolate. However, limited data are available on the association of chocolate consumption and the risk of coronary heart disease (CHD). We sought to examine the association between chocolate consumption and prevalent CHD. Methods: We studied in a cross-sectional design 4970 participants aged 25-93 years who participated in the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study. Chocolate intake was assessed through a semi-quantitative food frequency questionnaire. We used generalized estimating equations to estimate adjusted odds ratios. Results: Compared to subjects who did not report any chocolate intake, odds ratios (95% CI) for CHD were 1.01 (0.76-1.37), 0.74 (0.56-0.98), and 0.43 (0.28-0.67) for subjects consuming 1-3 times/month, 1-4 times/week, and 5+ times/week, respectively (p for trend <0.0001) adjusting for age, sex, family CHD risk group, energy intake, education, non-chocolate candy intake, linolenic acid intake, smoking, alcohol intake, exercise, and fruit and vegetables. Consumption of non-chocolate candy was associated with a 49% higher prevalence of CHD comparing 5+/week vs. 0/week [OR = 1.49 (0.96-2.32)]. Conclusions: These data suggest that consumption of chocolate is inversely related with prevalent CHD in a general United States population. © 2010. Source

Robbins J.M.,Harvard University | Petrone A.B.,Harvard University | Ellison R.C.,Boston University | Hunt S.C.,University of Utah | And 7 more authors.
e-SPEN Journal | Year: 2014

Background and aims: Eggs are a ubiquitous and important source of dietary cholesterol and nutrients, yet their relationship to coronary heart disease (CHD) remains unclear. While some data have suggested a positive association between egg consumption and CHD, especially among diabetic subjects, limited data exist on the influence of egg consumption on subclinical disease. Thus, we sought to examine whether egg consumption is associated with calcified atherosclerotic plaques in the coronary arteries. Methods: In a cross-sectional design, we studied 1848 participants of the NHLBI Family Heart Study without known CHD. Egg consumption was assessed by a semi-quantitative food frequency questionnaire and coronary-artery calcium (CAC) was measured by cardiac CT. We defined prevalent CAC using an Agatston score of at least 100 and fitted generalized estimating equations to calculate prevalence odds ratios of CAC. Results: Mean age was 56.5 years and 41% were male. Median consumption of eggs was 1/week. There was no association between frequency of egg consumption and prevalent CAC. Odds ratios (95% CI) for CAC were 1.0 (reference), 0.95 (0.66-1.38), 0.94 (0.63-1.40), and 0.90 (0.57-1.42) for egg consumption of almost never, 1-3 times per month, once per week, and 2+ times per week, respectively (p for trend 0.66), adjusting for age, sex, BMI, smoking, alcohol, physical activity, income, field center, total calories, and bacon. Additional control for hypertension and diabetes mellitus, or restricting the analysis to subjects with diabetes mellitus or fasting glucose >126mg/dL did not alter the findings. Conclusions: These data do not provide evidence for an association between egg consumption and prevalent CAC in adult men and women. © 2014 European Society for Clinical Nutrition and Metabolism. Source

Robbins J.M.,Harvard University | Robbins J.M.,Massachusetts Veterans Epidemiology and Research Information Center and Geriatric Research | Petrone A.B.,Harvard University | Carr J.J.,Vanderbilt University | And 9 more authors.
American Heart Journal | Year: 2015

Background The American Heart Association (AHA) established recommendations based on 7 ideal health behaviors and factors with the goal of improving cardiovascular health (CVH) and reducing both morbidity and mortality from cardiovascular disease by 20% by 2020. Few studies have investigated their association with subclinical coronary heart disease. We sought to examine whether the 7 AHA CVH metrics were associated with calcified atherosclerotic plaque in the coronary arteries. Methods In a cross-sectional design, we studied 1,731 predominantly white men and women from the National Heart, Lung, and Blood Institute Family Heart Study without prevalent coronary heart disease. Diet was assessed by a semiquantitative food frequency questionnaire. Coronary artery calcium (CAC) was measured by cardiac computed tomography. We defined prevalent CAC using an Agatston score of 100+ and fitted generalized estimating equations to calculate prevalence odds ratios of CAC. Results Mean age was 56.8 years, and 41% were male. The median number of ideal CVH metrics was 3, and no participant met all 7. There was a strong inverse relationship between number of ideal CVH metrics and prevalent CAC. Odds ratios (95% CI) for CAC of 100+ were 1.0 (reference), 0.37 (0.29-0.45), 0.35 (0.26-0.44), and 0.27 (0.20-0.36) among subjects with 0 to 1, 2, 3, and 4+ ideal CVH metrics, respectively (P =.0001), adjusting for sex, age, field center, alcohol, income, education, and energy consumption. Conclusions These data demonstrate a strong and graded inverse relationship between AHA ideal CVH metrics and prevalent CAC in adult men and women. Source

Wilk J.B.,Harvard University | Tsai M.Y.,University of Minnesota | Hanson N.Q.,University of Minnesota | Gaziano J.M.,Harvard University | And 3 more authors.
American Journal of Clinical Nutrition | Year: 2012

Background: Data on the relation of plasma and dietary omega-3 (n-3) fatty acids (FAs) with heart failure (HF) risk have been inconsistent. Objective: We evaluated the relation of n23 FAs with HF in US male physicians. Design: We used nested case-control (n = 1572) and prospective cohort study designs (n = 19,097). Plasma phospholipid n-3 FAs were measured by using gas chromatography, and food-frequency questionnaires were used to assess dietary n-3 FAs and fish intake. Incident HF was ascertained via annual follow-up questionnaires and validated in a subsample. Results: The mean age was 58.7 y at blood collection. In a multivariable model, plasma α-linolenic acid (ALA) was associated with a lower risk of HF in a nonlinear fashion (P-quadratic trend = 0.02), and the lowest OR was observed in quintile 4 (0.66; 95% CI: 0.47, 0.94). Plasma EPA and DHA were not associated with HF, whereas plasma docosapentaenoic acid (DPA) showed a nonlinear inverse relation with HF for quintile 2 (OR: 0.55; 95% CI: 0.39, 0.79). Dietary marine n-3 FAs showed a trend toward a lower risk of HF in quintile 4 (HR: 0.81; 95% CI: 0.64, 1.02) and a nonlinear pattern across quintiles. Fish intake was associated with a lower risk of HF, with RRs of ∼0.70 for all categories of fish consumption greater than one serving per month. Conclusions: Our data are consistent with an inverse and nonlinear relation of plasma phospholipid ALA and DPA, but not EPA or DHA, with HF risk. Fish consumption greater than once per month was associated with a lower HF risk. © 2012 American Society for Nutrition. Source

Robbins J.,Brigham and Womens Hospital | Robbins J.,Massachusetts Veterans Epidemiology and Research Information Center and Geriatric Research | Robbins J.,Harvard University | Djousse L.,Brigham and Womens Hospital | And 2 more authors.
Current Cardiovascular Risk Reports | Year: 2015

Congestive heart failure (HF) remains one of the leading causes of morbidity and mortality in the USA, and its prevalence continues to rise with an aging population. Few nutritional guidelines exist for the prevention of HF, but recent evidence demonstrating beneficial effects of dietary interventions in the prevention and treatment of cardiovascular disease (CVD) offers promise for their role in HF. The current review summarizes pertinent data from both clinical trials and observational studies focused on the potential contribution of individual food items, supplements, and dietary patterns to the primary and secondary prevention of HF. We further highlight gaps in our understanding of the role of diet in HF and future directions to help bridge important areas of need. © 2015, Springer Science+Business Media New York. Source

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