title: Healthy-eating attitudes and the incidence of cardiovascular disease: the SUN cohort.
abstract: There is an emerging use of brief dietary questionnaires to investigate diet-health relation. We prospectively assess the association between eating attitudes (yes/no) and incident cardiovascular disease (CVD) in 19,138 participants of the Seguimiento Universidad de Navarra (SUN) Cohort. We calculated a baseline healthy-eating attitudes score (in quartiles), positively weighting answers on more fruit, vegetables, fish and fiber and less meat, sweets and pastries, fat, butter, fatty meats and added sugar in drinks. We observed 139 incident cases of CVD. A higher score was associated with a lower risk of CVD [3-5 points Hazard Ratio (HR): 0.38 (95% confidence interval: 0.18-0.81); 6-8 points: 0.57 (0.29-1.12); 9-10 points: 0.31 (0.15-0.67), compared to 0-2 points]. Key contributors were the attitude to increase fruit [HR: 0.59 (0.40-0.87)], vegetables [HR: 0.57 (0.29-1.12)] and fiber intake [HR: 0.69 (0.48-0.98)]. Brief questionnaire on attitudes towards healthy-eating may be a useful tool for the primary prevention of CVD.
authors.affiliation: a Department of Nutrition and Food Sciences and Physiology , School of Pharmacy, University of Navarra , Navarra , Spain.|b Instituto de Investigación Sanitaria de Navarra (IdiSNA) , Pamplona , Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Santiago
authors.affiliation: a Department of Nutrition and Food Sciences and Physiology , School of Pharmacy, University of Navarra , Navarra , Spain.|b Instituto de Investigación Sanitaria de Navarra (IdiSNA) , Pamplona , Spain.|c Department of Preventive Medicine and Public Health, School of Medicine , University of Navarra , Navarra , Spain.|d Biomedical Research Center Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III , Madrid , Spain.
authors.forename: Itziar
authors.initials: I
authors.lastname: Zazpe
authors.affiliation: b Instituto de Investigación Sanitaria de Navarra (IdiSNA) , Pamplona , Spain.|c Department of Preventive Medicine and Public Health, School of Medicine , University of Navarra , Navarra , Spain.|d Biomedical Research Center Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III , Madrid , Spain.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Gea
authors.affiliation: c Department of Preventive Medicine and Public Health, School of Medicine , University of Navarra , Navarra , Spain.
authors.forename: Pedro A
authors.initials: PA
authors.lastname: de la Rosa
authors.affiliation: b Instituto de Investigación Sanitaria de Navarra (IdiSNA) , Pamplona , Spain.|c Department of Preventive Medicine and Public Health, School of Medicine , University of Navarra , Navarra , Spain.|d Biomedical Research Center Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III , Madrid , Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Ruiz-Canela
authors.affiliation: b Instituto de Investigación Sanitaria de Navarra (IdiSNA) , Pamplona , Spain.|c Department of Preventive Medicine and Public Health, School of Medicine , University of Navarra , Navarra , Spain.|d Biomedical Research Center Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III , Madrid , Spain.|e Department of Nutrition , Harvard TH Chan School of Public Health , Boston, MA , USA.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Martínez-González
mesh_terms: D000328:Adult; D001294:Attitude to Health; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000517:prevention & control; D015331:Cohort Studies; D004032:Diet; D000072001:Diet, Healthy / Q000523:psychology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011795:Surveys and Questionnaires
keywords: Eating attitudes; cardiovascular disease; diet; follow-up studies