Associations between Multiple Food Consumption Frequencies and the Incidence of Cardiovascular Disease in High Cardiac Risk Subjects

• Published in: Reviews in cardiovascular medicine Vol. 25; no. 11; p. 412
• Main Authors: Xu, Xiaohui, Hu, Shiyun, Shen, Sijie, Ding, Fang, Shao, Jianlin, Shen, Xiafen, Chen, Tianxu, Xu, Xiaoling, Yan, Jing, Zhu, Yin, Cai, Qiang, Yu, Wei
• Format: Journal Article
• Language: English
• Published: Singapore IMR Press 01.11.2024
• Subjects: cardiovascular disease; cox frailty models; dietary; lasso; nomogram; Original Research; cardiovascular disease; nomogram; Cox frailty models; dietary; LASSO
• ISSN: 1530-6550; 2153-8174; 2153-8174
• DOI: 10.31083/j.rcm2511412

Background: Dietary choices are inextricably linked to the incidence of cardiovascular disease (CVD), whereas an optimal dietary pattern to minimize CVD morbidity in high-risk subjects remains challenging. Methods: We comprehensively assessed the relationship between food consumption frequencies and CVD in 28,979 high-risk subjects. The outcome was defined as the composite of the incidence of major CVD events, including coronary heart disease and stroke. Risk factors associated with CVD were screened through a shrinkage approach, specifically least absolute shrinkage and selection operator (LASSO) regression. Hazard ratios (HRs) for various dietary consumption frequencies were assessed using multivariable Cox frailty models with random intercepts. Results: Increased egg and seafood consumption were associated with a lower risk of CVD (daily vs little, HR 1.70, 95% confidence interval, CI: 0.79–3.64, ptrend = 0.0073 and HR 1.86, 95% CI: 1.24–2.81, ptrend = 0.024, respectively). 6 non-food (age, sex, smoke, location, heart ratio, and systolic blood pressure) and 3 food (fruit, egg, and seafood) related risk factors were included in the nomogram to predict 3 and 5-year incidence of CVD. The concordance indexes of the training and validation cohorts were 0.733 (95% CI: 0.725–0.741) and 0.705 (95% CI: 0.693–0.717), respectively. The nomogram was validated using the calibration and time-dependent receiver operating characteristic curves, demonstrating respectable accuracy and discrimination. Conclusions: Guided by the concept of “food as medicine”, this nomogram could provide dietary guidance and prognostic prediction for high cardiac risk subjects in CVD prevention.