title: Adherence to the Southern European Atlantic Diet and occurrence of nonfatal acute myocardial infarction.
abstract: BACKGROUND
  The Southern European Atlantic Diet (SEAD) is the traditional diet in northern Portugal and Galicia, a region in northwest Spain.
  
  
  OBJECTIVE
  The objective was to examine the association between adherence to the SEAD and the occurrence of nonfatal acute myocardial infarction (AMI).
  
  
  METHODS
  This was a population-based case-control study in Porto, Portugal. Cases were patients aged > or =18 y who were hospitalized with an incident AMI (n = 820), and controls were individuals without AMI selected at random from the resident population of the participating hospitals' catchment area (n = 2196). A validated food-frequency questionnaire was administered in face-to-face interviews to assess dietary intake in the previous year. We developed an SEAD adherence index with 9 key components: fresh fish excluding cod, cod, red meat and pork products, dairy products, legumes and vegetables, vegetable soup, potatoes, whole-grain bread, and wine. A score of 1 or 0 was assigned to each food consumed and reflected consumption that was higher or lower, respectively, than the sex-specific median in controls.
  
  
  RESULTS
  After adjustment for the main confounders, a 1-point increment in the SEAD score was associated with a 10% reduced odds of AMI [odds ratio (OR): 0.90; 95% CI: 0.85, 0.96]. In comparison with individuals in the lower quartile of the SEAD index (lowest adherence), those in the upper quartile had a 33% lower likelihood of experiencing an AMI (OR: 0.67; 95% CI: 0.51, 0.88; P for trend = 0.003). An SEAD index calculated by reverse scoring for red meat and pork products and potatoes led to an even stronger inverse association between the SEAD and AMI (OR for the upper compared with the lower quartile of SEAD index: 0.40; 95% CI: 0.30, 0.52; P for trend < 0.001).
  
  
  CONCLUSIONS
  Adherence to the SEAD was associated with lower odds of nonfatal AMI. However, some but not all food components of the SEAD may contribute to the very low coronary mortality in northern Portugal and Galicia.
authors.affiliation: Department of Hygiene, University of Porto Medical School, Porto, Portugal. acmatos@med.up.pt
authors.forename: Andreia
authors.initials: A
authors.lastname: Oliveira
authors.forename: Carla
authors.initials: C
authors.lastname: Lopes
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez-Artalejo
mesh_terms: D000818:Animals; D001939:Bread; D016022:Case-Control Studies; D004035:Diet Therapy; D005399:Fishes; D006801:Humans; D008019:Life Style; D008460:Meat; D009203:Myocardial Infarction / Q000453:epidemiology*; D010349:Patient Compliance; D013030:Spain / Q000453:epidemiology; D014675:Vegetables; D014920:Wine