Original Communication
European Journal of Clinical Nutrition (2005) 59, 196–204. doi:10.1038/sj.ejcn.1602058 Published online 29 September 2004
Phylloquinone intake as a marker for coronary heart disease risk but not stroke in women
Guarantor: Alice H Lichtenstein
Contributors: ATE contributed to the development of analysis plan, interpretation of the results, writing and revision of the manuscript and conducted the statistical analyses. AHL, SLB, FBH and PFJ contributed to the development of the analysis plan, interpretation of the results and writing of the manuscript. JAEM, KMR and MJS contributed to the data collection, interpretation of the results, and writing of the manuscript.
Disclaimers: Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the view of the US Dept of Agriculture.
A T Erkkilä1,2, S L Booth1, F B Hu3,5, P F Jacques1, J E Manson4,5,6, K M Rexrode6, M J Stampfer3,4,5 and A H Lichtenstein1
- 1Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
- 2Department of Clinical Nutrition, University of Kuopio, Kuopio, Finland
- 3Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
- 4Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
- 5Channing Laboratory, Boston, MA, USA
- 6Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
Correspondence: A Erkkilä, Department of Clinical Nutrition, University of Kuopio, PO Box 1627, 70211 Kuopio, Finland. E-mail: arja.erkkila@uku.fi
Received 22 March 2004; Revised 29 June 2004; Accepted 10 August 2004; Published online 29 September 2004.
Abstract
Objective: To examine the feasibility of using phylloquinone intake as a marker for coronary heart disease (CHD) and stroke risk in women.
Design and setting: Nurses' Health Study, a prospective cohort study during 1984–2000. Dietary data were collected in 1984, 1986, 1990, and 1994 using a validated semiquantitative food frequency questionnaire.
Subjects: A total of 72 874 female nurses, aged 38–65 y, without previously diagnosed angina, myocardial infarction (MI), stroke, or cancer at baseline.
Main outcome measures: Incidence of nonfatal MI, CHD deaths, total CHD events, ischemic, and total strokes.
Results: There were 1679 CHD events (1201 nonfatal) and 1009 strokes (567 ischemic). After adjustment for age and lifestyle factors associated with cardiovascular disease risk, the multivariate relative risks (RR) (95% CI) of total CHD from the lowest to the highest quintile category of phylloquinone intake were 1 (reference), 0.80 (0.69–0.94), 0.86 (0.74–1.00), 0.77 (0.66–0.99), and 0.79 (0.68–0.92), P for trend=0.01. Further adjustment for dietary intakes of saturated fat, polyunsaturated fat, trans fatty acids, eicosapentaenoic, and docosahexaenoic acids, cereal fiber, and folate attenuated the association (RR comparing extreme quintiles 0.84 [0.71–1.00], P for trend=0.12). Incidence rates of total or ischemic strokes were not associated with phylloquinone intake.
Conclusion: The data suggest that high phylloquinone intake may be a marker for low CHD risk. Dietary and lifestyle patterns associated with phylloquinone intakes, rather than intake of the nutrient itself, might account for all or part of the weak association.
Sponsorship: US Department of Agriculture, National Institute of Health and Academy of Finland.
Keywords:
phylloquinone, vitamin K, coronary artery disease, stroke, women
