Adherence to dietary guidelines and cardiovascular disease risk in the EPIC-NL cohort

Struijk, Ellen A.; May, Anne M.; Wezenbeek, Nick L.W.; Fransen, Heidi P.; Soedamah-Muthu, Sabita S.; Geelen, Anouk; Boer, Jolanda M.A.; van der Schouw, Yvonne T.; Bueno-de-Mesquita, H. Bas; Beulens, Joline W.J.

doi:10.1016/j.ijcard.2014.07.017

Cited by 74Nutritional Studies and DietCardiovascular Health and Risk FactorsSodium Intake and Health

Adherence to dietary guidelines and cardiovascular disease risk in the EPIC-NL cohort

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Struijk, Ellen A., May, Anne M., Wezenbeek, Nick L.W., Fransen, Heidi P., Soedamah-Muthu, Sabita S., Geelen, Anouk, Boer, Jolanda M.A., van der Schouw, Yvonne T. +2 more·2014·International Journal of Cardiology

DOI 10.1016/j.ijcard.2014.07.017

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Abstract

Background Global and national dietary guidelines have been created to lower chronic disease risk. The aim of this study was to assess whether greater adherence to the WHO guidelines (Healthy Diet Indicator (HDI)); the Dutch guidelines for a healthy diet (Dutch Healthy Diet-index (DHD-index)); and the Dietary Approaches to Stop Hypertension (DASH) diet was associated with a lower risk of cardiovascular disease (CVD), coronary heart disease (CHD) or stroke.Methods A prospective cohort study was conducted among 33,671 healthy Dutch men and women aged 20-70 years recruited into the EPIC-NL study during 1993-1997. We used Cox regression adjusted for relevant confounders to estimate the hazard ratios per standard deviation increase in score and 95% confidence intervals (CI) of the associations between the dietary guidelines and CVD, CHD and stroke risk.Results After an average follow-up of 12.2 years, 2752 CVD cases were documented, including 1630 CHD cases and 527 stroke cases. We found no association between the HDI (0.98, 95% CI 0.94; 1.02) or DHD-index (0.96, 95% CI 0.92; 1.00) and CVD incidence. Similar results were found for these guidelines and CHD or stroke incidence. Higher adherence to the DASH diet was significantly associated with a lower CVD (0.92, 95% CI 0.89; 0.96), CHD (0.91, 95% CI 0.86; 0.95), and stroke (0.90, 95% CI 0.82; 0.99) risk.Conclusion The HDI and the DHD-index were not associated with CVD risk, while the DASH diet was significantly associated with a lower risk of developing CVD, CHD and stroke.

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Authors: Struijk, E. A., May, A. M., Wezenbeek, N. L. W., Fransen, H. P., Soedamah-Muthu, S. S., Geelen, A., Boer, J. M. A., van der Schouw, Y. T., Bueno-de-Mesquita, H. B., & Beulens, J. W. J.
Affiliations: University Medical Center Utrecht (NL)
Wageningen University & Research (NL)
National Institute for Public Health and the Environment (NL)
Corresponding author: Struijk, Ellen A.
ORCID: Struijk, Ellen A.
May, Anne M.
Wezenbeek, Nick L.W.
Fransen, Heidi P.
Geelen, Anouk
Boer, Jolanda M.A.
Beulens, Joline W.J.
Venue: International Journal of Cardiology
Publisher: Elsevier BV
Published: 2014-09
Volume: 176
Issue: 2
Pages: 354-359
ISSN: 0167-5273 (ISSN-L)
DOI: 10.1016/j.ijcard.2014.07.017
OpenAlex: W2106094706
Cited by: 74
References: 36
Citations by year: 2026: 1 · 2025: 4 · 2024: 1 · 2023: 4 · 2022: 7 · 2021: 9 · 2020: 7 · 2019: 7 · 2018: 15 · 2017: 8 · 2016: 4 · 2015: 5 · 2014: 2
FWCI: 6.27
Type: journal article
Language: en
Open access: green
research.wur.nl
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: International Journal of Cardiology (publishedVersion)
PubMed (publishedVersion)
Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
Socio-Environmental Systems Modeling (acceptedVersion)
Pure Amsterdam UMC (submittedVersion)
Rivm Repository (Netherlands National Institute for Public Health and the Environment) (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Funders: Europe against Cancer” Program of the European Commission (SANCO) (SPC.2002.332, AEP/90/05)
Dutch Ministry of Health (WCRF 98A04, WCRF 2000/30)
Dutch Organization for Health Research and Development (ZonMW)
World Cancer Research Fund (WCRF (40-00812-98-10040)
Dutch research council (NWO-ZonMW
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
Keywords: dietary guidelines adherence, cardiovascular risk, coronary artery disease, stroke, DASH diet, Healthy Diet Indicator, EPIC-NL cohort, healthy eating
MeSH terms: Adult, Aged, Cardiovascular Diseases, Europe, Feeding Behavior, Female, Follow-Up Studies, Humans, Male, Middle Aged, Netherlands, Patient Compliance, Prospective Studies, Risk Factors, Cohort Studies, Nutrition Policy, Young Adult

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Adherence to dietary guidelines and cardiovascular disease risk in the EPIC-NL cohort

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