OBJECTIVE: To assess the association of alcohol intake with progression of coronary atherosclerosis. Although moderate drinkers have a lower risk of coronary heart disease than abstainers, the relation of alcohol use and coronary atherosclerosis has not been well studied. METHODS AND RESULTS: In the Stockholm Female Coronary Risk Angiographic Study, we evaluated 103 women, aged 65 years or younger, hospitalized with acute myocardial infarction or unstable angina pectoris who underwent serial quantitative coronary angiography 3-6 months following their index event and repeated an average of 3 years and 3 months (range 2-5 years) later. Individual alcoholic beverage consumption was assessed by a standardized questionnaire. We used mixed model analysis to estimate the effect of alcohol consumption on progression of coronary atherosclerosis, as measured by mean luminal diameter change, controlling for age, smoking, body-mass index, education, physical activity, index cardiac event, menopausal status, diabetes, and history of dyslipidemia. Of the 93 women with complete information on alcohol intake, 14 consumed no alcohol (abstainers), 55 consumed up to 5 g of alcohol per day (light drinkers), and 24 consumed more than 5 g of alcohol per day (moderate drinkers). Coronary atherosclerosis progressed by a multivariate-adjusted average of 0.138 mm (95% confidence interval (CI): 0.027-0.249) among abstainers, 0.137 mm (95% CI: 0.057-0.217) among light drinkers, and -0.054 mm (95% CI: -0.154 to 0.047) among moderate drinkers (P
OBJECTIVE: Smoking is a risk factor for increased carotid artery intima-media thickness (IMT). The apolipoprotein E (apoE) 4 allele has been associated with cardiovascular diseases, but the role of apoE in regard to intima-media thickness (IMT) has remained controversial. The objective was to investigate whether there is some gene-environment interaction between smoking and apoE polymorphism.DESIGN Cross-sectional case-control study. METHODS: IMTs of 511 hypertensive and control men were measured ultrasonographically and the apoE genotypes were determined. Genotypes with the 4 allele were pooled into one group and the genotypes without it into another. RESULTS: A significant interaction between the 4 allele and smoking affecting IMT was observed among the hypertensive smokers, as assessed by analysis of covariance. The mean carotid IMT was significantly greater (1.01 versus 0.90 mm, P = 0.003) in the 4 carriers than in the subjects without 4 among the hypertensive smokers. The number of plaques was also significantly higher. No differences were found in the other subjects (hypertensive non-smokers or controls). Linear regression analysis indicated that the 4 allele was an independent determinant of IMT in the hypertensive smokers but not in the other subjects. The estimated average effect of the 4 allele on the mean IMT in the hypertensive smokers was 0.088 mm (P
The hypothesis that the presence of unnatural trans and cis isomers of unsaturated fatty acids in the maternal diet and in human mothers milk could be responsible for initiating atherosclerosis in utero or in infants is proposed. It is suggested that the key etiological factor involved in the formation of atherosclerotic plaques could be uncontrolled division of smooth muscle cells of the intima resulting from the intracellular excess of linoleic acid and deficiency of its metabolites gamma-linolenic acid and dihomogamma-linolenic acid. This imbalance is brought about by competitive inhibition of the enzyme delta-6-desaturase by unnatural trans and cis unsaturated fatty acids. Delta-6-desaturase is the enzyme responsible for converting linoleic acid to dihomogamma-linolenic acid. The cellular presence of unnatural trans and cis isomers of unsaturated fatty acids would therefore enhance increased levels of linoleic acid and deficiency of its metabolites gamma-linolenic acid and dihomogamma-linolenic acid. It is proposed that prophylaxis against the effects of delta-6-desaturase inhibition could be achieved by the adoption of an Eskimo-like diet containing the essential fatty acid metabolites gamma-linolenic acid and/or dihomogamma-linolenic acid and eicosapentaenoic acid per se in high concentrations.
A dietary survey was conducted in 1980 in connection with the Multicentre Study on Atherosclerosis Precursors in Finnish Children in five urban and 12 rural communes in various parts of Finland. 1,768 children aged 3, 6, 9, 12, 15 and 18 years were interviewed using the 48 hour recall method. Food consumption, and the intakes of energy and 49 nutrients were calculated. The intakes of energy and most nutrients increased in the successive age groups until the age of 15 years. There were only small differences in the diet of children belonging to different social classes. Protein accounted for 14% of total energy intake, fat for 38%, total carbohydrate for 48%, and sucrose for 10%. The ratio of polyunsaturated and saturated fatty acids in the diet (P/S) was 0.24 for the whole material, which is higher than found in previous studies in Finland. The P/S ratio was higher in urban areas and West Finland than in rural areas and in East Finland. The share of fat of energy intake exceeded the recommendation given by the Ministry of Health and the P/S ratio was lower than recommended. The mean daily intakes of energy and vitamins met the recommendations. Of the mineral elements, the intakes of calcium, phosphorus, potassium, magnesium and manganese were abundant. The intakes of iron, copper, zinc, molybdenum and chromium were lower than recommended in most age groups and the intakes of selenium and fluorine in all age groups. The large share of refined foods in the children's diet was the main reason for the low nutrient densities.
Fish oil is rich in the long chain omega-3 (omega-3) polyinsaturated fatty acids (PUFA), Pioneering studies of Dyerberg and Bang primarily originate interests in this way. The low incidence of acute myocardial infarction they verified within the Greenland Eskimos suggested that a high dietary omega-3 PUFA intake due to marine food might protect against coronary heart disease. They showed that the Eskimos had a beneficial lipid pattern and that their balance between pro-aggregatory thromboxanes and anti-aggregatory prostacyclins was shifted towards an anti-thrombotic state. The two major omega-3 fatty acids are decosapentaenoic acid (EPA C 20:5, omega 3), with five double bonds, and docosahexaenoic acid (DHA C 22:6, omega 3), with six double bonds. These fatty acids' significant effects include reduction of plasma triglycerides and lipoprotein levels as well as of platelets thrombogenicity in the microcirculation, which is due to effects on the mediators production derived from arachidonic acid (prostaglandins and leucotrienes), meddling in inflammatory and immune cell function, retarded atherosclerosis development. Experimental studies of atherogenesis and arterial thrombogenesis support the hypothesis that dietary omega-3 PUFA intake may play a leading role in primary or secondary prevention of coronary heart disease.