title: Diet and myocardial infarction: a nested case-control study in a cohort of elderly subjects in a Mediterranean area of southern Italy.
abstract: OBJECTIVE
  We evaluated the incidence of myocardial infarction (MI) in a population of Southern Italy and the relationship of dietary macronutrients with incident MI.
  
  
  RESULTS
  The ONCONUT cohort included 5632 subjects followed-up, over 50 years, recruited in 1992. At baseline, they completed a validated semi-quantitative food frequency questionnaire and gave details of their medical history. After 5years they were traced by their family physician, who found 108 incident MI. Ninety-seven of them and 194 controls, sampled from the noncases at baseline and paired for diabetes to the cases, entered this nested case-control study. MI rate per 1000 person-years was 9.6 in males and 3.7 in females. In non-diabetics, saturated fat were associated with MI directly (odds ratio (OR): tertile 2 vs. 1 = 2.32, tertile 3 vs. 1 = 2.82; chi-square for trend, p = 0.03) and polyunsaturated fats inversely (OR: tertile 2 vs. 1 = 0.80, tertile 3 vs. 1 = 0.37; chi-square for trend, p = 0.05), while in diabetics, starchy carbohydrates (OR: tertile 2 vs. 1 = 1.51, tertile 3 vs. 1 = 6.73; chi-square for trend, p = 0.01) and glycaemic index (OR: tertile 2 vs. 1 = 2.74, tertile 3 vs. 1 = 5.34; chi-square for trend, p = 0.01) were associated directly with MI.
  
  
  CONCLUSIONS
  MI incidence in this population was lower than that found in northern countries. In non-diabetics, saturated fats were associated directly and polyunsaturated fat inversely with MI; in diabetics, starchy carbohydrates and high-glycaemic-index foods were associated directly with MI.
authors.affiliation: Department of Geriatrics and Rare Diseases, University of Bari, Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Pierucci
authors.forename: G
authors.initials: G
authors.lastname: Misciagna
authors.forename: M T
authors.initials: MT
authors.lastname: Ventura
authors.forename: R
authors.initials: R
authors.lastname: Inguaggiato
authors.forename: A M
authors.initials: AM
authors.lastname: Cisternino
authors.forename: V M B
authors.initials: VM
authors.lastname: Guerra
authors.forename: P
authors.initials: P
authors.lastname: Suppressa
authors.forename: F
authors.initials: F
authors.lastname: Resta
authors.forename: C
authors.initials: C
authors.lastname: Sabbà
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D048909:Diabetes Complications / Q000453:epidemiology*; D004032:Diet; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000009:adverse effects; D004041:Dietary Fats / Q000008:administration & dosage; D005231:Fatty Acids, Unsaturated / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D038321:Glycemic Index; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D019083:Mediterranean Region / Q000453:epidemiology; D008875:Middle Aged; D009043:Motor Activity; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000209:etiology; D016017:Odds Ratio; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D005231:Fatty Acids, Unsaturated