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Dietary patterns and risk of nonfatal acute myocardial infarction in Costa Rican adults

European Journal of Clinical Nutrition volume 60, pages 770–777 (2006)Cite this article

Abstract

Objective:

To investigate the association between dietary patterns and risk of a first nonfatal acute myocardial infarction (MI) in Costa Rican adults.

Design:

Population-based case–control study.

Subjects:

A total of 496 incident MI cases and 518 population-based randomly selected controls matched to the cases by age (±5 years), gender, and county of residence. Subjects were interviewed with a validated food frequency questionnaire. Dietary patterns were identified by factor analysis. Odds ratios (OR) and 95% confidence intervals (CI) were obtained using multivariate conditional logistic regression adjusted for several recognized risk factors for MI.

Results:

Two diet patterns were identified, ‘vegetable’ characterized by increased intake of vegetables and fruits, and ‘staple’, characterized by an increased use of palm oil for cooking, and intake of refined grains (mostly white rice and white bread), legumes, coffee, added sugar, and red meat. Compared to the lowest quintile of the staple diet pattern, the highest quintile was associated with an increased risk of MI (OR: 3.70, 95% CI: 2.30–5.97). Adjusting for potential confounders did not change the results (OR: 3.53, 95% CI: 1.98–6.31). Consistently, an increasing staple pattern score was associated with lower HDL cholesterol (P for trend <0.02) and α-linolenic acid in adipose tissue (P for trend <0.0001). The vegetable pattern was not associated with MI.

Conclusions:

The staple dietary pattern of Costa Rican adults is associated with low plasma HDL cholesterol, low α-linolenic acid in adipose tissue, and increased risk of MI.

Sponsorship:

This study was funded by grants HL 60692 and HL 49086 from the US National Institutes of Health.

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Acknowledgements

We thank Xinia Siles for the direction of data collection and fieldwork operations in Costa Rica.

Author information

Authors and Affiliations

  1. Escuela de Nutrición Humana, Universidad de Costa Rica, San Pedro de Montes de Oca, Costa Rica

    J A Martínez-Ortiz

  2. Department of Nutrition, Harvard School of Public Health, Boston, MA, USA

    T T Fung, A Baylin, F B Hu & H Campos

  3. Centro Centroamericano de Población, Universidad de Costa Rica, San Pedro de Montes de Oca, Costa Rica

    H Campos

Authors
  1. J A Martínez-Ortiz
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  2. T T Fung
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  3. A Baylin
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  4. F B Hu
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  5. H Campos
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Corresponding author

Correspondence to H Campos.

Additional information

Guarantor: H Campos.

Contributors: JAMO conceived and planned the study, performed the statistical analysis, and wrote the manuscript. JAMO, TTF, AB, FBH, and HC participated in the data analysis, interpretation and critical revision of the manuscript. HC designed, conducted, and supervised the project.

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Martínez-Ortiz, J., Fung, T., Baylin, A. et al. Dietary patterns and risk of nonfatal acute myocardial infarction in Costa Rican adults. Eur J Clin Nutr 60, 770–777 (2006). https://doi.org/10.1038/sj.ejcn.1602381

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  • DOI: https://doi.org/10.1038/sj.ejcn.1602381

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