Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-05T10:50:09.304Z Has data issue: false hasContentIssue false
  • English
  • Français

Dietary intake of folate equivalents and risk of myocardial infarction in the European Prospective Investigation into Cancer and Nutrition (EPIC)–Potsdam study

Published online by Cambridge University Press:  02 January 2007

Dagmar Drogan ,
Kerstin Klipstein-Grobusch ,
Jutta Dierkes ,
Cornelia Weikert  and
Heiner Boeing
Dagmar Drogan
Affiliation:
German Institute of Human Nutrition Potsdam-Rehbruecke, Department of Epidemiology, Arthur-Scheunert-Allee 114–116, D-14558 Nuthetal, Germany
Kerstin Klipstein-Grobusch*
Affiliation:
German Institute of Human Nutrition Potsdam-Rehbruecke, Department of Epidemiology, Arthur-Scheunert-Allee 114–116, D-14558 Nuthetal, Germany
Jutta Dierkes
Affiliation:
Otto-von-Guericke University, Department of Clinical Chemistry and Pathobiochemistry, Magdeburg, Germany
Cornelia Weikert
Affiliation:
German Institute of Human Nutrition Potsdam-Rehbruecke, Department of Epidemiology, Arthur-Scheunert-Allee 114–116, D-14558 Nuthetal, Germany
Heiner Boeing
Affiliation:
German Institute of Human Nutrition Potsdam-Rehbruecke, Department of Epidemiology, Arthur-Scheunert-Allee 114–116, D-14558 Nuthetal, Germany
*
*Corresponding author: Email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective

To assess the relationship between intake of dietary folate equivalents and risk of myocardial infarction in a German cohort.

Design

Intake of dietary folate equivalents was assessed by a validated food-frequency questionnaire. Cox proportional hazard models were used to evaluate the association between intake of dietary folate equivalents and risk of myocardial infarction.

Setting

The European Prospective Investigation into Cancer and Nutrition (EPIC)–Potsdam cohort, Germany.

Subjects

Subjects were 22 245 apparently healthy non-users of vitamin supplements aged 35–64 years.

Results

During 4.6 years of follow-up, 129 incident cases of myocardial infarction were identified. Compared with intake below the median (103 μg), higher intake of dietary folate equivalents was associated with a multivariate-adjusted hazard ratio (HR) of 0.57 (95% confidence interval (CI) 0.36–0.91). The inverse association of folate intake and myocardial infarction risk was stronger in participants with an ethanol intake equal to or above the sex-specific median (HR = 0.37, 95% CI 0.18–0.79) and attenuated in those with a low ethanol intake (HR = 0.67, 95% CI 0.37–1.22).

Conclusion

An increased intake of dietary folate equivalents was observed to be associated with decreased risk of myocardial infarction in a German study population, pointing towards the importance of folate intake with respect to primary prevention of myocardial infarction.

Keywords

Myocardial infarctionFolic acidAlcohol drinkingSmokingProspective study
Type
Research Article
Information
Public Health Nutrition , Volume 9 , Issue 4 , June 2006 , pp. 465 - 471
Copyright
Copyright © The Authors 2006

References

1Scott, JM, Weir, DG. Folic acid, homocysteine and one-carbon metabolism: a review of the essential biochemistry. Journal of Cardiovascular Risk 1998; 5: 223–7.CrossRefGoogle ScholarPubMed
2Homocysteine Studies Collaboration. Homocysteine and risk of ischemic heart disease and stroke: a meta-analysis. Journal of the American Medical Association 2002; 288: 2015–22.CrossRefGoogle Scholar
3De Bree, A, Verschuren, WM, Kromhout, D, Kluijtmans, LA, Blom, HJ. Homocysteine determinants and the evidence to what extent homocysteine determines the risk of coronary heart disease. Pharmacological Reviews 2002; 54: 599–618.CrossRefGoogle ScholarPubMed
4Morrison, HI, Schaubel, D, Desmeules, M, Wigle, DT. Serum folate and risk of fatal coronary heart disease. Journal of the American Medical Association 1996; 275: 1893–6.CrossRefGoogle ScholarPubMed
5Folsom, AR, Nieto, FJ, McGovern, PG, Tsai, MY, Malinow, MR, Eckfeldt, JH, et al. Prospective study of coronary heart disease incidence in relation to fasting total homocysteine, related genetic polymorphisms, and B vitamins: the Atherosclerosis Risk in Communities (ARIC) study. Circulation 1998; 98: 204–10.CrossRefGoogle Scholar
6Rimm, EB, Willett, WC, Hu, FB, Sampson, L, Colditz, GA, Manson, JE, et al. Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. Journal of the American Medical Association 1998; 279: 359–64.CrossRefGoogle ScholarPubMed
7Bazzano, LA, He, J, Ogden, LG, Loria, C, Vupputuri, S, Myers, L, et al. Dietary intake of folate and risk of stroke in US men and women: NHANES I Epidemiologic Follow-up Study. National Health and Nutrition Examination Survey. Stroke 2002; 33: 1183–8.CrossRefGoogle ScholarPubMed
8Jiang, R, Hu, FB, Giovannucci, EL, Rimm, EB, Stampfer, MJ, Spiegelman, D, et al. Joint association of alcohol and folate intake with risk of major chronic disease in women. American Journal of Epidemiology 2003; 158: 760–71.CrossRefGoogle ScholarPubMed
9Voutilainen, S, Rissanen, TH, Virtanen, J, Lakka, TA, Salonen, JT. Low dietary folate intake is associated with an excess incidence of acute coronary events: The Kuopio Ischemic Heart Disease Risk Factor Study. Circulation 2001; 103: 2674–80.CrossRefGoogle ScholarPubMed
10Halsted, CH, Villanueva, JA, Devlin, AM, Chandler, CJ. Metabolic interactions of alcohol and folate. Journal of Nutrition 2002; 132: 2367S–72S.CrossRefGoogle ScholarPubMed
11Deutsche Gesellschaft für Ernährung. Referenzwerte für die Nährstoffzufuhr. Frankfurt am Main: Umschau/Braus, 2000.Google Scholar
12Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, DC: National Academy Press, 1998.Google Scholar
13Beitz, R, Mensink, GB, Fischer, B, Thamm, M. Vitamins – dietary intake and intake from dietary supplements in Germany. European Journal of Clinical Nutrition 2002; 56: 539–45.CrossRefGoogle ScholarPubMed
14Boeing, H, Korfmann, A, Bergmann, MM. Recruitment procedures of EPIC–Germany. European Investigation into Cancer and Nutrition. Annals of Nutrition & Metabolism 1999; 43: 205–15.CrossRefGoogle ScholarPubMed
15Klipstein-Grobusch, K, Georg, T, Boeing, H. Interviewer variability in anthropometric measurements and estimates of body composition. International Journal of Epidemiology 1997; 26(Suppl. 1): S174–80.CrossRefGoogle ScholarPubMed
16Schulze, MB, Kroke, A, Bergmann, MM, Boeing, H. Differences of blood pressure estimates between consecutive measurements on one occasion: implications for inter-study comparability of epidemiologic studies. European Journal of Epidemiology 2000; 16: 891–8.CrossRefGoogle ScholarPubMed
17Chalmers, J, MacMahon, S, Mancia, G, Whitworth, J, Beilin, L, Hansson, L, et al. World Health Organization-International Society of Hypertension guidelines for the management of hypertension. Guidelines sub-committee of the World Health Organization. Clinical and Experimental Hypertension 1999; 21: 1009–60.Google ScholarPubMed
18Bohlscheid-Thomas, S, Hoting, I, Boeing, H, Wahrendorf, J. Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the German part of the EPIC project. European Prospective Investigation into Cancer and Nutrition. International Journal of Epidemiology 1997; 26: S59–70.CrossRefGoogle Scholar
19Bohlscheid-Thomas, S, Hoting, I, Boeing, H, Wahrendorf, J. Reproducibility and relative validity of energy and macro-nutrient intake of a food frequency questionnaire developed for the German part of the EPIC project. European Prospective Investigation into Cancer and Nutrition. International Journal of Epidemiology 1997; 26: S71–81.CrossRefGoogle Scholar
20Boeing, H, Bohlscheid-Thomas, S, Voss, S, Schneeweiss, S, Wahrendorf, J. The relative validity of vitamin intakes derived from a food frequency questionnaire compared to 24-hour recalls and biological measurements: results from the EPIC pilot study in Germany. European Prospective Investigation into Cancer and Nutrition. International Journal of Epidemiology 1997; 26: S82–90.CrossRefGoogle Scholar
21Kroke, A, Bergmann, MM, Lotze, G, Jeckel, A, Klipstein-Grobusch, K, Boeing, H. Measures of quality control in the German component of the EPIC study. European Prospective Investigation into Cancer and Nutrition. Annals of Nutrition & Metabolism 1999; 43: 216–24.CrossRefGoogle Scholar
22Dehne, LI, Klemm, C, Henseler, G, Hermann-Kunz, E. The German food code and nutrient data base (BLS II.2). European Journal of Epidemiology 1999; 15: 355–9.CrossRefGoogle ScholarPubMed
23World Health Organization (WHO). International Statistical Classification of Diseases and Related Health Problems. Geneva: WHO, 1992.Google Scholar
24Koehler, KM, Baumgartner, RN, Garry, PJ, Allen, RH, Stabler, SP, Rimm, EB. Association of folate intake and serum homo-cysteine in elderly persons according to vitamin supplementation and alcohol use. American Journal of Clinical Nutrition 2001; 73: 628–37.CrossRefGoogle Scholar
25Grundy, SM, Pasternak, R, Greenland, P, Smith, S Jr, Fuster, V. Assessment of cardiovascular risk by use of multiple-risk-factor assessment equations: a statement for healthcare professionals from the American Heart Association and the American College of Cardiology. Circulation 1999; 100: 1481–92.CrossRefGoogle ScholarPubMed
26Klipstein-Grobusch, K, Kroke, A, Voss, S, Boeing, H. [Influence of lifestyle on the use of supplements in the Brandenburg nutrition and cancer study]. Zeitschrift fur Ernahrungswis-senschaft 1998; 37: 38–46.CrossRefGoogle ScholarPubMed