Male cardiovascular mortality and dietary markers in 25 population samples of 16 countries.
OBJECTIVE
To examine associations between various dietary markers and mortality from ischemic heart disease (IHD) and stroke.


METHODS
A multi-center cross-sectional study, involved 25 co-operative study centers in 16 countries.


METHODS
In the report, data for males (n = 2462), aged 48-56 years, from 25 centers were included. Various dietary markers were measured from individual's blood and 24-h urine samples. Age-standardized male mortality rates for IHD and stroke were collected for the region encompassing each study center. Ecological cross-center associations between dietary markers and the mortality were analyzed using univariate and multivariate analysis techniques.


RESULTS
Bivariate correlation analyses showed that IHD mortality was associated positively with body mass index (BMI), serum total cholesterol (TC), urinary potassium (K) and serum phospholipid palmitic acid, and negatively with urinary taurine, sodium (Na) and Na/K (potassium) ratio, n-3 polyunsaturated (n-3PU) fatty acids and polyunsaturated-to-saturated (P/S) fatty acid ratio. Stroke mortality was associated positively with Na and Na/K ratio and phospholipid arachidonic acid (AA), and negatively with TC and K. Stepwise linear regression analyses indicated that 59% of the variance in IHD mortality could be explained by the variance in taurine and P/S ratio and that 57% of stroke mortality could be explained by Na/K ratio and phospholipid AA.


CONCLUSIONS
Although ecological associations do not necessarily imply causality, and the present findings are limited to male samples only, the study extends our understanding of dietary markers in relation to worldwide IHD and stroke mortality rates, and indicates useful avenues for further study on IHD and stroke prevention.
Yamori
Yukio
Y
International Center for Research on Primary Prevention of Cardiovascular Diseases, Kokusaikenju-Bldg, 86-2 Shimobambacho-cho, Jodoji, Sakyo-ku, Kyoto, 606-8413, Japan. yamori@cardiacstudy.com
Liu
Longjian
L
Mizushima
Shunsaku
S
Ikeda
Katsumi
K
Nara
Yasuo
Y
D000367:Age Factors; D000368:Aged; D000569:Americas / Q000453:epidemiology; D000704:Analysis of Variance; D016718:Arachidonic Acid / Q000097:blood; D001208:Asia / Q000453:epidemiology; D001315:Australia / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood / Q000652:urine; D002784:Cholesterol / Q000097:blood / Q000652:urine; D003430:Cross-Sectional Studies; D004032:Diet; D005060:Europe / Q000453:epidemiology; D005227:Fatty Acids / Q000097:blood; D015525:Fatty Acids, Omega-3 / Q000097:blood; D043371:Fatty Acids, Omega-6 / Q000097:blood; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000378:metabolism* / Q000401:mortality* / Q000652:urine; D009520:New Zealand / Q000453:epidemiology; D019308:Palmitic Acid / Q000097:blood; D011188:Potassium / Q000652:urine; D012044:Regression Analysis; D012964:Sodium / Q000652:urine; D020521:Stroke / Q000097:blood / Q000378:metabolism* / Q000401:mortality* / Q000652:urine; D013654:Taurine / Q000652:urine
D015415:Biomarkers; D005227:Fatty Acids; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D013654:Taurine; D016718:Arachidonic Acid; D019308:Palmitic Acid; D002784:Cholesterol; D012964:Sodium; D011188:Potassium