Diet and risk of ischemic heart disease in India.
BACKGROUND
Ischemic heart disease (IHD) is a leading cause of death in India. Dietary changes could reduce risk, but few studies have addressed the association between diet and IHD risk in India.


OBJECTIVE
The goal was to address the association between diet and IHD risk among Indians in New Delhi (northern India) and Bangalore (southern India).


METHODS
We collected data from 350 cases of acute myocardial infarction and 700 controls matched on the basis of age, sex, and hospital as part of a hospital-based case-control study in 8 hospitals. Long-term dietary intake was assessed by using food-frequency questionnaires developed for New Delhi and Bangalore. We used conditional logistic regression to control for the matching factors and other predictors of risk.


RESULTS
We observed a significant and dose-dependent inverse association between vegetable intake and IHD risk. The inverse association was stronger for green leafy vegetables; in multivariate analysis, persons consuming a median of 3.5 servings/wk had a 67% lower relative risk (RR: 0.33; 95% CI: 0.17, 0.64; P for trend = 0.0001) than did those consuming 0.5 servings/wk. Controlling for other dietary covariates did not alter the association. Cereal intake was also associated with a lower risk. Use of mustard oil, which is rich in alpha-linolenic acid, was associated with a lower risk than was use of sunflower oil [for use in cooking: RR: 0.49 (95% CI: 0.24, 0.99); for use in frying, RR: 0.29 (95% CI: 0.13, 0.64)].


CONCLUSIONS
Diets rich in vegetables and use of mustard oil could contribute to the lower risk of IHD among Indians.
Rastogi
Tanuja
T
Department of Nutrition, Harvard School of Public Health, Boston, USA. trastogi@post.harvard.edu
Reddy
K Srinath
KS
Vaz
Mario
M
Spiegelman
Donna
D
Prabhakaran
D
D
Willett
Walter C
WC
Stampfer
Meir J
MJ
Ascherio
Alberto
A
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D003625:Data Collection; D004032:Diet; D005260:Female; D006753:Hospital Records; D006801:Humans; D007194:India; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control; D012307:Risk Factors; D014675:Vegetables