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Dietary patterns, subclinical inflammation, incident coronary heart disease and mortality in middle-aged men from the MONICA/KORA Augsburg cohort study

European Journal of Clinical Nutrition volume 65, pages 800–807 (2011)Cite this article

Subjects

Abstract

Background/Objectives:

We aimed to identify dietary patterns associated with inflammatory markers and to examine their impact on the incidence of coronary heart disease (CHD) and all-cause mortality, as subclinical inflammation is a risk factor for these outcomes.

Subjects/Methods:

The study population comprised 981 middle-aged men participating in the first or third ‘MONItoring of Trends and Determinants in CArdiovascular Diseases’ (MONICA) Augsburg surveys who completed 7-day dietary records. Subjects were followed up until 2002 for CHD and until 2007 for mortality. Dietary patterns were derived using reduced rank regression (RRR) with C-reactive protein, interleukin (IL)-6 and IL-18 as responses. Alternatively, partial least squares and principal components regression were used.

Results:

A high score of the RRR-derived pattern was characterised by high intakes of meat, soft drinks and beer and low intakes of vegetables, fresh fruit, chocolates, cake, pastries, wholemeal bread, cereals, muesli, curd, condensed milk, cream, butter, nuts, sweet bread spread and tea. This score was associated with a higher risk for CHD (hazard ratio=1.33, 95% confidence interval: 1.06–1.67, P=0.013) and mortality (hazard ratio=1.34, 1.17–1.53, P<0.001) after multivariable adjustment. However, for CHD and CHD mortality the significant association disappeared after further adjustment for smoking status; for all-cause mortality it was attenuated but remained significant (hazard ratio=1.16, 1.00–1.33, P=0.046). Patterns derived from the other methods resembled the RRR pattern showing similar results regarding disease outcomes.

Conclusions:

Participants exhibiting higher dietary pattern scores had higher levels of inflammatory markers and higher risk for CHD and all-cause mortality, however, smoking was an important confounder, especially for CHD outcomes.

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Acknowledgements

We thank all members of the Institute of Epidemiology at the Helmholtz-Zentrum München and the field staff in Augsburg involved in the planning and conduct of the MONICA/KORA Augsburg studies. Furthermore, we thank Gerlinde Trischler (University of Ulm) and Gabi Gornitzka, Ulrike Poschen, and Karin Röhrig (all from the German Diabetes Center, Düsseldorf) for technical assistance and Andrea Schneider for excellent data management. Finally, we express our appreciation to all study participants. The MONICA/KORA Augsburg cohort study was funded by the Helmholtz Zentrum München and supported by grants from the Federal Ministry of Education and Research, Berlin. This study was supported by research grants from the German Research Foundation, Bonn, (TH-784/2-1 and TH-784/2-2) and by additional funds provided by the University of Ulm, the German Diabetes Center, Düsseldorf, the Federal Ministry of Health, the Ministry of Innovation, Science, Research and Technology of the state North Rhine Westphalia.

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Authors and Affiliations

  1. Department of Epidemiology, Institute of Epidemiology II, Helmholtz-Zentrum München, German Research Center for Environmental Health, Munich, Germany

    J Meyer & B Thorand

  2. Department of Epidemiology, Institute of Epidemiology, Helmholtz-Zentrum München, German Research Center for Environmental Health, Munich, Germany

    A Döring

  3. Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany

    C Herder & M Roden

  4. Department of Metabolic Diseases, Heinrich Heine University Düsseldorf, Düsseldorf, Germany

    M Roden

  5. Department of Internal Medicine II-Cardiology, University Hospital Ulm, Ulm Medical Center, Ulm, Germany

    W Koenig

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Correspondence to B Thorand.

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Meyer, J., Döring, A., Herder, C. et al. Dietary patterns, subclinical inflammation, incident coronary heart disease and mortality in middle-aged men from the MONICA/KORA Augsburg cohort study. Eur J Clin Nutr 65, 800–807 (2011). https://doi.org/10.1038/ejcn.2011.37

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