Dietary indices of atherogenicity and thrombogenicity and ischaemic heart disease risk: the Caerphilly Prospective Study

Abstract

The aim of the study was to investigate whether proposed dietary scores of atherogenicity and thrombogenicity predict ischaemic heart disease (IHD) risk in a community sample of men aged 45–59 years. Dietary scores were calculated from consumption of various fatty acids, estimated from 7 d weighed intake data obtained from 665 men. Investigation of associations with blood lipids, lipoproteins and haemostatic factors revealed positive associations with low-density-lipoprotein cholesterol ( P < 0·05) and white cell count ( P < 0·05), and a negative association with antithrombin III ( P = 0·05), after taking into account the effects of age, body mass index and smoking. During a 5-year follow-up period, there were twenty-one new IHD events among the 512 men in whom there was no evidence of IHD at baseline. Men with higher atherogenicity or thrombogenicity scores at baseline tended to have a higher risk of subsequent IHD. The trend was consistent but not statistically significant. A similar trend was observed for total saturates, and an inverse trend for total polyunsaturates, expressed as a percentage of total fatty acids. It is, therefore, concluded that proposed dietary indices of atherogenicity and thrombogenicity may be weak predictors of IHD risk, but that these scores are unlikely to be substantially better predictors than more simple approaches such as intakes of total saturates. To enhance the predictive ability, more complex formulas which take into account other dietary factors as well as fatty acid intakes would probably be required.