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Epidemiology

Interaction of smoking and dietary habits modifying the risk of coronary heart disease in women: results from a case–control study

European Journal of Clinical Nutrition volume 72, pages 1673–1681 (2018)Cite this article

Subjects

Abstract

Background/objectives

Smoking is a strong risk factor for coronary heart disease particularly in women. The risk may be aggravated by dietary habits, though.

Subjects/methods

The Coronary Risk for Atherosclerosis Study (CORA) compares dietary, lifestyle, biochemical, and clinical factors in 200 consecutive pre- and postmenopausal women with incident coronary heart disease to those of 255 age-matched population-based controls. A mixed logistic regression model was used to assess the possible interactions between smoking habits and dietary patterns.

Results

Each increase of 100 kcal energy intake per day was positively associated with coronary risk (OR 1.10, 95% CI 1.03–1.17; p = 0.006). Doubling the intake of alcohol and vegetables was negatively related with coronary risk (alcohol: OR 0.61, 95% CI 0.50–0.73; p < 0.001; vegetables: OR 0.50, 95% CI 0.032–0.080; p = 0.003). In contrast, doubling the intake of meat was associated with an increase of coronary risk, but only in smoking women (OR 2.61, 95%CI 1.58–4.29; p < 0.001). In smoking women a high meat-over-vegetable-ratio indicated an even higher risk (ratio of 2.0: OR 5.77, 95% CI 2.13–15.67; p < 0.001), while a low meat-over-vegetable-ratio did not have a significant impact on coronary risk (ratio of 0.5: OR 1.28, 95% CI 0,78–2.09).

Conclusions

This explorative analysis of the CORA-study indicates that a high intake of meat is significantly associated with an increase in coronary risk particularly in smoking women, and may account for part of the unadjusted risk of smoking.

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Acknowledgements

We are indebted to all participants of the study for their collaboration. This work was supported by the '′Stifterverband für die deutsche Wissenschaft’’ (unrestricted grant).

Author contributions

BCZ suggested the study, recruited, and acquired all data and wrote the paper. EV was responsible for the statistical analysis. AH contributed to the idea and concept of the statistical analysis. EW contributed to the concept of the study and made critical revision of the manuscript.

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Authors and Affiliations

  1. Preventive Medicine and Nutrition, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Birgit-Christiane Zyriax

  2. Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Eik Vettorazzi

  3. Department of General and Interventional Cardiology, Preventive Medicine, University Heart Center, Hamburg, Germany

    Ahmad Hamuda & Eberhard Windler

Authors
  1. Birgit-Christiane Zyriax
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  2. Eik Vettorazzi
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  3. Ahmad Hamuda
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  4. Eberhard Windler
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Corresponding author

Correspondence to Birgit-Christiane Zyriax.

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The authors declare that they have no conflict of interest.

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Zyriax, BC., Vettorazzi , E., Hamuda, A. et al. Interaction of smoking and dietary habits modifying the risk of coronary heart disease in women: results from a case–control study. Eur J Clin Nutr 72, 1673–1681 (2018). https://doi.org/10.1038/s41430-018-0099-9

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