Thromb Haemost 2012; 108(03): 554-560
DOI: 10.1160/TH11-11-0818
Cardiovascular Biology and Cell Signalling
Schattauer GmbH

Heart healthy diet and risk of myocardial infarction and venous thromboembolism

The Tromsø Study
Ida J. Hansen-Krone
1   Hematological Research Group, Department of Clinical Sciences, University of Tromsø, Tromsø, Norway
,
Kristin F. Enga
1   Hematological Research Group, Department of Clinical Sciences, University of Tromsø, Tromsø, Norway
,
Inger Njølstad
2   Department of Community medicine, University Hospital of North Norway, Tromsø, Norway
,
John-Bjarne Hansen
1   Hematological Research Group, Department of Clinical Sciences, University of Tromsø, Tromsø, Norway
3   Division of Internal medicine, University Hospital of North Norway, Tromsø, Norway
,
Sigrid K. Braekkan
1   Hematological Research Group, Department of Clinical Sciences, University of Tromsø, Tromsø, Norway
3   Division of Internal medicine, University Hospital of North Norway, Tromsø, Norway
› Author Affiliations
Further Information

Publication History

Received: 29 November 2011

Accepted after major revision: 19 May 2012

Publication Date:
25 November 2017 (online)

Summary

Prudent dietary patterns are associated with reduced risk of arterial cardiovascular diseases (CVD). Limited data exist on the relation between diet and venous thromboembolism (VTE). The aim of our prospective, population based study was to investigate the association of a heart healthy diet on risk of myocardial infarction (MI) and VTE. Information on dietary habits was available in 18,062 subjects, aged 25–69, who participated in the fourth Tromsø study, 1994–1995. Dietary patterns were assessed by a slightly modified version of the validated SmartDiet score; a 13-item questionnaire producing a diet score based on the intakes of fat, fibre, fruit and vegetables. Incident events of MI (n=518) and VTE (n=172) were recorded to the end of follow-up December 31, 2005 (median follow-up 10.8 years). Cox-regression models were used to calculate hazard ratios (HR). A healthy diet score of >27 points (upper tertile) was associated with 17% reduced risk of MI (HR: 0.83, 95% confidence interval [CI]: 0.66–1.06), and no association with VTE (HR: 1.01; 95%CI: 0.66–1.56), compared to <24 points (lower tertile) in multivariable analysis. High intake of fish, fruit, vegetables and polyunsatured fat had a 23% reduced risk of MI (HR 0.77; 95%CI: 0.60–0.98), but no association with VTE (HR 0.95; 95%CI: 0.64–1.40). A heart healthy diet showed an even more favourable association with MI in obese subjects (HR: 0.62; 95%CI: 0.41–0.95), but not with VTE. Our findings suggest that a heart healthy dietary pattern is associated with moderately reduced risk of MI, but not related to risk of VTE.

 
  • References

  • 1 Heit JA. Venous thromboembolism: disease burden, outcomes and risk factors. J Thromb Haemost 2005; 03: 1611-1617.
  • 2 Silverstein MD, Heit JA, Mohr DN. et al. Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med 1998; 158: 585-593.
  • 3 White RH. The epidemiology of venous thromboembolism. Circulation 2003; 107: I4-8.
  • 4 Bova C, Marchiori A, Noto A. et al. Incidence of arterial cardiovascular events in patients with idiopathic venous thromboembolism. A retrospective cohort study. Thromb Haemost 2006; 96: 132-136.
  • 5 Prandoni P, Bilora F, Marchiori A. et al. An association between atherosclerosis and venous thrombosis. N Engl J Med 2003; 348: 1435-1441.
  • 6 Sorensen HT, Horvath-Puho E, Pedersen L. et al. Venous thromboembolism and subsequent hospitalisation due to acute arterial cardiovascular events: a 20-year cohort study. Lancet 2007; 370: 1773-1779.
  • 7 de Lorgeril M, Renaud S, Mamelle N. et al. Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet 1994; 343: 1454-1459.
  • 8 Trichopoulou A, Costacou T, Bamia C. et al. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 2003; 348: 2599-2608.
  • 9 Jensen RA. Postoperative thrombosis-emboli; their frequency in the period 1940–1948 at the III department of Ulveval Sykehus and the surgical department of Akers Sykehus. Acta Chir Scand 1952; 103: 263-275.
  • 10 Strom A. Examination into the diet of Norwegian families during the war years 1942–45. Acta Med Scan Suppl 1948; 214: 1-47.
  • 11 Steffen LM, Folsom AR, Cushman M. et al. Greater fish, fruit, and vegetable intakes are related to lower incidence of venous thromboembolism: the Longitudinal Investigation of Thromboembolism Etiology. Circulation 2007; 115: 188-195.
  • 12 Lutsey PL, Steffen LM, Virnig BA, Folsom AR. Diet and incident venous thromboembolism: the Iowa Women's Health Study. Am Heart J 2009; 157: 1081-1087.
  • 13 Bhoopat L, Rojnuckarin P, Hiransuthikul N. et al. Low vegetable intake is strongly associated with venous thromboembolism in Thai population. Blood Coagul Fibrinolysis 2010; 21: 758-763.
  • 14 Randall E, Marshall JR, Brasure J. et al. Dietary patterns and colon cancer in western New York. Nutr Cancer 1992; 18: 265-276.
  • 15 Fung TT, Willett WC, Stampfer MJ. et al. Dietary patterns and the risk of coronary heart disease in women. Arch Intern Med 2001; 161: 1857-1862.
  • 16 Hu FB, Rimm EB, Stampfer MJ. et al. Prospective study of major dietary patterns and risk of coronary heart disease in men. Am J Clin Nutr 2000; 72: 912-921.
  • 17 van Dam RM, Grievink L, Ocke MC. et al. Patterns of food consumption and risk factors for cardiovascular disease in the general Dutch population. Am J Clin Nutr 2003; 77: 1156-1163.
  • 18 Svilaas A, Strom EC, Svilaas T. et al. Reproducibility and validity of a short food questionnaire for the assessment of dietary habits. Nutr Metab Cardiovasc Dis 2002; 12: 60-70.
  • 19 Braekkan SK, Mathiesen EB, Njolstad I. et al. Mean platelet volume is a risk factor for venous thromboembolism: the Tromso Study, Tromso, Norway. J Thromb Haemost 2010; 08: 157-162.
  • 20 Hansen-Krone IJ, Braekkan SK, Enga KF. et al. Alcohol consumption, types of alcoholic beverages and risk of venous thromboembolism – The Tromso Study. Thromb Haemost 2011; 106: 272-278.
  • 21 Enga KF, Braekkan SK, Hansen-Krone IJ. et al. Emotional states and future risk of venous thromboembolism: the Tromso Study. Thromb Haemost 2012; 107: 485-493.
  • 22 Niemelä M, Kulathinal S, Joseph B. et al. Follow-up data. The Morgam Project. Available at: http://www.ktl.fi/publications/morgam/qa/followup/followup.htm#CE_diagnosis Accessed: April 17 2012
  • 23 Iqbal R, Anand S, Ounpuu S. et al. Dietary patterns and the risk of acute myocardial infarction in 52 countries: results of the INTERHEART study. Circulation 2008; 118: 1929-1937.
  • 24 Oliveira A, Rodriguez-Artalejo F, Gaio R. et al. Major habitual dietary patterns are associated with acute myocardial infarction and cardiovascular risk markers in a southern European population. J Am Diet Assoc 2011; 111: 241-250.
  • 25 Fitzgerald KC, Chiuve SE, Buring JE. et al. Comparison of associations of adherence to a Dietary Approaches to Stop Hypertension (DASH)-style diet with risks of cardiovascular disease and venous thromboembolism. J Thromb Haemost 2012; 10: 189-198.
  • 26 Chen ST, Maruthur NM, Appel LJ. The effect of dietary patterns on estimated coronary heart disease risk: results from the Dietary Approaches to Stop Hypertension (DASH) trial. Circ Cardiovasc Qual Outcomes 2010; 03: 484-489.
  • 27 Bonaa KH, Bjerve KS, Straume B. et al. Effect of eicosapentaenoic and docosahexaenoic acids on blood pressure in hypertension. A population-based intervention trial from the Tromso study. N Engl J Med 1990; 322: 795-801.
  • 28 Nordoy A, Hatcher LF, Ullmann DL. et al. Individual effects of dietary saturated fatty acids and fish oil on plasma lipids and lipoproteins in normal men. Am J Clin Nutr 1993; 57: 634-639.
  • 29 Nordoy A, Hatcher L, Goodnight S. et al. Effects of dietary fat content, saturated fatty acids, and fish oil on eicosanoid production and hemostatic parameters in normal men. J Lab Clin Med 1994; 123: 914-920.
  • 30 Holy EW, Forestier M, Richter EK. et al. Dietary alpha-linolenic acid inhibits arterial thrombus formation, tissue factor expression, and platelet activation. Arterioscler Thromb Vasc Biol 2011; 31: 1772-1780.
  • 31 Hansen JB, Lyngmo V, Svensson B. et al. Inhibition of exercise-induced shortening of bleeding time by fish oil in familial hypercholesterolemia (type IIa). Arte-rioscler Thromb 1993; 13: 98-104.
  • 32 Mora S, Rifai N, Buring JE. et al. Fasting compared with nonfasting lipids and apolipoproteins for predicting incident cardiovascular events. Circulation 2008; 118: 993-1001.
  • 33 Njolstad I, Arnesen E, Lund-Larsen PG. Smoking, serum lipids, blood pressure, and sex differences in myocardial infarction. A 12-year follow-up of the Finnmark Study. Circulation 1996; 93: 450-456.
  • 34 Poulter N. Coronary heart disease is a multifactorial disease. Am J Hypertens 1999; 12: 92S-95S.
  • 35 Braekkan SK, Hald EM, Mathiesen EB. et al. Competing risk of atherosclerotic risk factors for arterial and venous thrombosis in a general population: the Tromso study. Arterioscler Thromb Vasc Biol 2012; 32: 487-491.
  • 36 Holst AG, Jensen G, Prescott E. Risk factors for venous thromboembolism: results from the Copenhagen City Heart Study. Circulation 2010; 121: 1896-1903.
  • 37 Glynn RJ, Rosner B. Comparison of risk factors for the competing risks of coronary heart disease, stroke, and venous thromboembolism. Am J Epidemiol 2005; 162: 975-982.
  • 38 Hald EM, Braekkan SK, Mathiesen EB. et al. High-sensitivity C-reactive protein is not a risk factor for venous thromboembolism: the Tromso study. Haematologica 2011; 96: 1189-1194.
  • 39 Reich LM, Folsom AR, Key NS. et al. Prospective study of subclinical atherosclerosis as a risk factor for venous thromboembolism. J Thromb Haemost 2006; 04: 1909-1913.
  • 40 van der Hagen PB, Folsom AR, Jenny NS. et al. Subclinical atherosclerosis and the risk of future venous thrombosis in the Cardiovascular Health Study. J Thromb Haemost 2006; 04: 1903-1908.
  • 41 Wessel TR, Arant CB, Olson MB. et al. Relationship of physical fitness vs body mass index with coronary artery disease and cardiovascular events in women. J Am Med Assoc 2004; 292: 1179-1187.
  • 42 Mora S, Cook N, Buring JE. et al. Physical activity and reduced risk of cardiovascular events: potential mediating mechanisms. Circulation 2007; 116: 2110-2118.
  • 43 Borch KH, Hansen-Krone I, Braekkan SK. et al. Physical activity and risk of venous thromboembolism. The Tromso study. Haematologica 2010; 95: 2088-2094.
  • 44 van Stralen KJ, Doggen CJ, Lumley T. et al. The relationship between exercise and risk of venous thrombosis in elderly people. J Am Geriatr Soc 2008; 56: 517-522.
  • 45 Tsai AW, Cushman M, Rosamond WD. et al. Cardiovascular risk factors and venous thromboembolism incidence: the longitudinal investigation of thromboembolism etiology. Arch Intern Med 2002; 162: 1182-1189.
  • 46 Jacobsen BK, Knutsen SF, Knutsen R. The Tromso Heart Study: comparison of information from a short food frequency questionnaire with a dietary history survey. Scand J Soc Med 1987; 15: 41-47.