In a recent study published in the European Journal of Nutrition, scientists investigate the association between diet and cardiometabolic multimorbidity risk among British men between the ages of 60 and 79. To this end, consuming more seafood and fish was linked to a lower risk of first cardiometabolic disease transitioning to cardiometabolic multimorbidity.
Study: Prospective associations between diet quality, dietary components, and risk of cardiometabolic multimorbidity in older British men. Image Credit: fizkes / Shutterstock.com
How diet affects heart health
Cardiometabolic multimorbidity is the co-occurrence of multiple cardiometabolic diseases such as type 2 diabetes, myocardial infarction, and stroke. Since age is one of the risk factors for cardiometabolic diseases, the global prevalence of cardiometabolic multimorbidity is increasing with the aging population.
Other factors, including healthcare costs, impaired quality of life, medical treatments, and the risk of mortality, are additive for each cardiometabolic disease during multimorbidity. The occurrence of one cardiometabolic condition can also increase the potential risk of another cardiometabolic disease.
Evidence from various studies has indicated that dietary quality and components are associated with the risk of individual cardiometabolic diseases. High-quality diets such as the Mediterranean diet have been linked to a lower risk of acute myocardial infarction, type 2 diabetes, and unspecified stroke.
An increased intake of vegetables, fruits, whole grains, and seafood has also been linked to a lower risk of stroke and, coronary heart disease, type 2 diabetes, and stroke. However, few studies have examined the association between diet and the incidence of cardiometabolic multimorbidity.
About the study
In the present study, scientists used a cohort of men who were registered in the British Regional Heart Study conducted between 1978 and 1980. A 20-year follow-up on a subset of the participants was also performed between 1998 and 2000.
Baseline data was gathered using a questionnaire that collected information on sociodemographic factors, general lifestyles, medications, and health. A food frequency questionnaire and physical examinations were also used to gather data.
The study excluded individuals with diagnosed type 2 diabetes and a history of stroke or myocardial infarction at baseline, as well as those for whom demographic data or dietary information was unavailable. The food frequency questionnaire used in the study was designed for the World Health Organization to monitor the determinants and trends of cardiovascular disease and was validated for the British population.
The elderly dietary index (EDI) was calculated using data from the food frequency questionnaire. Consumption frequency was used to assign a score on a four-point scale, with a score of one indicating the least adherence to nutritional recommendations and a score of four indicating the healthiest levels of food intake frequencies for each food group.
Events of stroke, myocardial infarction, type 2 diabetes, and death were followed up among the participants. Reviews and reports from the general practitioner were used to ascertain non-fatal cardiometabolic diseases, while National Health Service records on death information were used to determine fatal strokes and myocardial infarctions.
Baseline information obtained using the questionnaire on factors such as smoking behavior, physical activity levels, use of lipid-lowering medications, and alcohol intake was used to determine covariates.
Study findings
No significant associations were observed between dietary patterns, quality, or composition and the risk of cardiometabolic multimorbidity among older male British adults. However, increased seafood and fish consumption were linked to a lower risk of the first cardiometabolic disease progressing to a cardiometabolic multimorbidity.
The insignificant association between diet and the risk of cardiometabolic multimorbidity could be due to various factors. For example, the low number of cardiometabolic multimorbidity cases in the cohort and physiological changes among older adults may have led to weaker associations between cardiovascular disease and risk factors such as cholesterol levels and blood pressure.
Additionally, the study design involved calculating the risk estimate of cardiometabolic multimorbidity from the first myocardial infarction event among participants who survived the first event. Thus, the cardiometabolic multimorbidity risk estimate may not have considered participants in lower EDDI quartiles who might not have survived the first myocardial infarction event.
Conclusions
No significant associations were observed between EDI and the risk of cardiometabolic multimorbidity among older British males.
Nevertheless, the consumption of seafood and fish one to two days each week was inversely associated with the risk of cardiometabolic multimorbidity. Further analyses using multi-state models suggest that seafood and fish consumption protects against first cardiometabolic disease transitioning to cardiometabolic multimorbidity.
Journal reference:
- Wang, Q., Schmidt, A. F., Lennon, L. T., et al. (2023). Prospective associations between diet quality, dietary components, and risk of cardiometabolic multimorbidity in older British men. European Journal of Nutrition. doi:10.1007/s0039402303193x
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