TY - JOUR

T1 - Impact of diet on ten-year absolute cardiovascular risk in a prospective cohort of 94 321 individuals

T2 - A tool for implementation of healthy diets

AU - Kjeldsen, Emilie W.

AU - Thomassen, Jesper Q.

AU - Rasmussen, Katrine L.

AU - Nordestgaard, Børge G.

AU - Tybjærg-Hansen, Anne

AU - Frikke-Schmidt, Ruth

N1 - Publisher Copyright: © 2022 The Authors

PY - 2022

Y1 - 2022

N2 - Background: An unhealthy diet is a major risk factor for cardiovascular disease attributing to the burden of non-communicable diseases. Current dietary guidelines are not sufficiently implemented and effective strategies to encourage people to change and maintain healthy diets are lacking. We aimed to evaluate the impact of incorporating dietary assessment into ten-year absolute risk charts for atherosclerotic cardiovascular disease (ASCVD). Methods: In the prospective Copenhagen General Population Study including 94 321 individuals, we generated sex-specific ten-year absolute risk scores for ASCVD according to adherence to dietary guidelines, using a short and valid food frequency questionnaire. To account for competing risk, we used the method of Fine-Gray. Findings: Non-adherence to dietary guidelines was associated with an atherogenic lipid and inflammatory profile. Ten-year absolute risk of ASCVD increased with increasing age, increasing systolic blood pressure, and decreasing adherence to dietary guidelines for both sexes. The highest ten-year absolute risk of ASCVD of 38% was observed in men aged 65–69 years who smoked, had very low adherence to dietary guidelines, and a systolic blood pressure between 160 and 179 mmHg. The corresponding value for women was 26%. Risk charts replacing dietary assessment with non-HDL cholesterol yielded similar estimates. Interpretation: Incorporation of a short dietary assessment into ten-year absolute risk charts has the potential to motivate patients to adhere to dietary guideline recommendations. Improved implementation of national dietary guidelines must be a cornerstone for future prevention of cardiovascular disease in both younger and older individuals. Funding: The Lundbeck Foundation (R278-2018-804) and the Danish Heart Foundation.

AB - Background: An unhealthy diet is a major risk factor for cardiovascular disease attributing to the burden of non-communicable diseases. Current dietary guidelines are not sufficiently implemented and effective strategies to encourage people to change and maintain healthy diets are lacking. We aimed to evaluate the impact of incorporating dietary assessment into ten-year absolute risk charts for atherosclerotic cardiovascular disease (ASCVD). Methods: In the prospective Copenhagen General Population Study including 94 321 individuals, we generated sex-specific ten-year absolute risk scores for ASCVD according to adherence to dietary guidelines, using a short and valid food frequency questionnaire. To account for competing risk, we used the method of Fine-Gray. Findings: Non-adherence to dietary guidelines was associated with an atherogenic lipid and inflammatory profile. Ten-year absolute risk of ASCVD increased with increasing age, increasing systolic blood pressure, and decreasing adherence to dietary guidelines for both sexes. The highest ten-year absolute risk of ASCVD of 38% was observed in men aged 65–69 years who smoked, had very low adherence to dietary guidelines, and a systolic blood pressure between 160 and 179 mmHg. The corresponding value for women was 26%. Risk charts replacing dietary assessment with non-HDL cholesterol yielded similar estimates. Interpretation: Incorporation of a short dietary assessment into ten-year absolute risk charts has the potential to motivate patients to adhere to dietary guideline recommendations. Improved implementation of national dietary guidelines must be a cornerstone for future prevention of cardiovascular disease in both younger and older individuals. Funding: The Lundbeck Foundation (R278-2018-804) and the Danish Heart Foundation.

KW - Cardiovascular disease

KW - Cohort study

KW - Diet

KW - Food-based dietary guidelines

KW - Prevention

KW - Risk charts

U2 - 10.1016/j.lanepe.2022.100419

DO - 10.1016/j.lanepe.2022.100419

M3 - Journal article

C2 - 35664050

AN - SCOPUS:85130954228

VL - 19

JO - The Lancet Regional Health - Europe

JF - The Lancet Regional Health - Europe

SN - 2666-7762

M1 - 100419

ER -