title: Lifestyle including dietary habits and changes in coronary artery calcium score: a retrospective cohort study.
abstract: BACKGROUND
  General diet and lifestyle are considered to have an effect on levels of atherosclerosis but previous studies have shown inconsistent results. The aim of this study was to investigate whether macronutrient intake, physical activity and depressive symptoms are associated with progression of preclinical atherosclerosis in healthy Korean adults.
  
  
  METHODS
  A total of 2623 individuals from Kangbuk Samsung Hospital Health Screening Center in South Korea were enrolled between 2010 and 2012 and had follow-up at 2013. Every participant received a non-enhanced coronary computed tomography (CT) and completed questionnaires for food intake frequency, depression and physical activity levels. The study population was divided into two groups according to CAC progression, namely CAC group (CAC score >0) or non-CAC group (CAC score ≤ 0), and were compared according to macronutrient intake, degree of depressive symptoms and physical activity.
  
  
  RESULTS
  A total of 2175 subjects were eligible for the analysis and among them, 592 subjects had progression of CAC. Total energy, carbohydrate and fat intake showed significant differences between the two groups (p-values of 0.01, 0.021 and 0.016 respectively). However, levels of protein intake did not vary for the two groups (p = 0.286). Depressive symptoms and extent of physical activity were similar between the two groups. Multivariate analysis was conducted with adjustment for possible confounding factors. The hazard ratios for CAC progression were not different according to macronutrient intake, degree of depressive symptoms and physical activity.
  
  
  CONCLUSIONS
  In this large relatively healthy population based observational study, CAC progression showed no significant association with total energy intake, proportion of macronutrient intake, depressive symptom and physical activity.
authors.affiliation: Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, #108, Pyung Dong, Jongro-Ku, Seoul, 110-746 Republic of Korea.
authors.forename: EunSun
authors.initials: E
authors.lastname: Cheong
authors.affiliation: Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, #108, Pyung Dong, Jongro-Ku, Seoul, 110-746 Republic of Korea.
authors.forename: Jong-Young
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, #108, Pyung Dong, Jongro-Ku, Seoul, 110-746 Republic of Korea.
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, #108, Pyung Dong, Jongro-Ku, Seoul, 110-746 Republic of Korea.
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Kang
authors.affiliation: Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, #108, Pyung Dong, Jongro-Ku, Seoul, 110-746 Republic of Korea.
authors.forename: Bum-Soo
authors.initials: BS
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, #108, Pyung Dong, Jongro-Ku, Seoul, 110-746 Republic of Korea.
authors.forename: Byung Jin
authors.initials: BJ
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, #108, Pyung Dong, Jongro-Ku, Seoul, 110-746 Republic of Korea.
authors.forename: Ki-Chul
authors.initials: KC
authors.lastname: Sung
keywords: Coronary artery calcium score; Depression; Dietary habits; Lifestyle; Macronutrient; Physical activity