title: Greater fish, fruit, and vegetable intakes are related to lower incidence of venous thromboembolism: the Longitudinal Investigation of Thromboembolism Etiology.
abstract: BACKGROUND
  Little is known about the role of dietary intake in the development of deep vein thrombosis or pulmonary embolus (venous thromboembolism [VTE]). Homocysteine, factor VIII, and von Willebrand factor levels, risk factors for VTE, are influenced by dietary intake. We tested the hypothesis that foods rich in B vitamins and omega-3 fatty acids are negatively associated and meat intake is positively associated with incidence of VTE.
  
  
  RESULTS
  In a prospective study over 12 years, 14,962 middle-aged adults participating in the Atherosclerosis Risk in Communities study were followed up for incident VTE. All hospitalizations were identified, and 196 VTEs were validated by chart review. A food frequency questionnaire assessed dietary intake at baseline and year 6. In separate proportional hazards regression analyses, risk of developing VTE was computed across quintiles of selected nutrients, major food groups, and the Western diet pattern, with adjustment for demographic and lifestyle factors, body mass index, and diabetes. Hazard ratios and 95% confidence intervals of VTE incidence across quintiles of fruit and vegetable intake were 1.0 (reference), 0.73 (0.48 to 1.11), 0.57 (0.37 to 0.90), 0.47 (0.29 to 0.77), and 0.59 (0.36 to 0.99) (P(trend)=0.03). Eating fish 1 or more times per week was associated with 30% to 45% lower incidence of VTE for quintiles 2 to 5 compared with quintile 1, suggestive of a threshold effect. Hazard ratios of VTE across quintiles of red and processed meat intake were 1.0, 1.24 (0.78 to 1.98), 1.21 (0.74 to 1.98), 1.09 (0.64 to 1.87), and 2.01 (1.15 to 3.53) (P(trend)=0.02). Hazard ratios were attenuated only slightly after adjustment for factors VIIc and VIIIc and von Willebrand factor.
  
  
  CONCLUSIONS
  A diet including more plant food and fish and less red and processed meat is associated with a lower incidence of VTE.
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S Second St, Suite 300, Minneapolis, MN 55454, USA. steffen@epi.umn.edu
authors.forename: Lyn M
authors.initials: LM
authors.lastname: Steffen
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Folsom
authors.forename: Mary
authors.initials: M
authors.lastname: Cushman
authors.forename: David R
authors.initials: DR
authors.lastname: Jacobs
authors.forename: Wayne D
authors.initials: WD
authors.lastname: Rosamond
mesh_terms: D000328:Adult; D000818:Animals; D015331:Cohort Studies; D004032:Diet; D004034:Diet Surveys; D005260:Female; D005399:Fishes; D005500:Follow-Up Studies; D005638:Fruit; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000178:diet therapy / Q000453:epidemiology / Q000517:prevention & control; D013923:Thromboembolism / Q000178:diet therapy* / Q000453:epidemiology* / Q000517:prevention & control; D014675:Vegetables; D020246:Venous Thrombosis / Q000178:diet therapy / Q000453:epidemiology / Q000517:prevention & control