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      Family History of Premature Coronary Artery Disease (P-CAD)—A Non-Modifiable Risk Factor? Dietary Patterns of Young Healthy Offspring of P-CAD Patients: A Case-Control Study (MAGNETIC Project)

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          Abstract

          Dietary habits of healthy offspring with a positive family history of premature coronary artery disease (P-CAD) have not been studied so far. The aim of this study was twofold: (1) to identify dietary patterns in a sample of young healthy adults with (cases) and without (controls) family history of P-CAD, and (2) to study the association between dietary patterns and family history of P-CAD. The data came from the MAGNETIC case-control study. The participants were healthy adults aged 18–35 years old, with ( n = 351) and without a family history of P-CAD ( n = 338). Dietary data were collected with food frequency questionnaire FFQ-6. Dietary patterns (DP) were derived using principal component analysis (PCA). The associations between the adherence to DPs and family history of P-CAD were investigated using logistic regression. Two models were created: crude and adjusted for age, sex, smoking status, place of residence, financial situation, education, and physical activity at leisure time. Three DPs were identified: ‘prudent’, ‘westernized traditional’ and ‘dairy, breakfast cereals, and treats’. In both crude and adjusted models, subjects with family history of P-CAD showed higher adherence by 31% and 25% to ‘westernized traditional’ DP (odds ratio (OR) 1.31, 95% confidence interval (95% CI): 1.12–1.53; p < 0.005; per 1 unit of standard deviation (SD) of DP score and adjOR 1.25, 95% CI: 1.06–1.48; p = 0.007; per 1 unit of SD of DP score, respectively). Young healthy adults with family history of P-CAD present unfavorable dietary patterns and are potentially a target group for CAD primary prevention programs.

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          Consistent dietary patterns identified from childhood to adulthood: the cardiovascular risk in Young Finns Study.

          Dietary patterns are useful in nutritional epidemiology, providing a comprehensive alternative to the traditional approach based on single nutrients. The Cardiovascular Risk in Young Finns Study is a prospective cohort study with a 21-year follow-up. At baseline, detailed quantitative information on subjects' food consumption was obtained using a 48 h dietary recall method (n 1768, aged 3-18 years). The interviews were repeated after 6 and 21 years (n 1200 and n 1037, respectively). We conducted a principal component analysis to identify major dietary patterns at each study point. A set of two similar patterns was recognised throughout the study. Pattern 1 was positively correlated with consumption of traditional Finnish foods, such as rye, potatoes, milk, butter, sausages and coffee, and negatively correlated with fruit, berries and dairy products other than milk. Pattern 1 type of diet was more common among male subjects, smokers and those living in rural areas. Pattern 2, predominant among female subjects, non-smokers and in urban areas, was characterised by more health-conscious food choices such as vegetables, legumes and nuts, tea, rye, cheese and other dairy products, and also by consumption of alcoholic beverages. Tracking of the pattern scores was observed, particularly among subjects who were adolescents at baseline. Of those originally belonging to the uppermost quintile of pattern 1 and 2 scores, 41 and 38 % respectively, persisted in the same quintile 21 years later. Our results suggest that food behaviour and concrete food choices are established already in childhood or adolescence and may significantly track into adulthood.
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            Parental cardiovascular disease as a risk factor for cardiovascular disease in middle-aged adults: a prospective study of parents and offspring.

            Whether parental cardiovascular disease confers increased risk independent of other risk factors remains controversial. Prior studies relied on offspring report, without complete validation of parental events. To determine whether parental cardiovascular disease predicts offspring events independent of traditional risk factors, using a prospective design for both parents and offspring, and uniform criteria to validate events. Inception cohort study. Framingham Heart Study, a US population-based epidemiologic cohort begun in 1948 with the offspring cohort established in 1971. All Framingham Offspring Study participants (aged > or =30 years) who were free of cardiovascular disease and both parents in the original Framingham cohort. We examined the association of parental cardiovascular disease with 8-year risk of offspring cardiovascular disease, using pooled logistic regression. Among 2302 men and women (mean age, 44 years), 164 men and 79 women had cardiovascular events during follow-up. Compared with participants with no parental cardiovascular disease, those with at least 1 parent with premature cardiovascular disease (onset age <55 years in father, <65 years in mother) had greater risk for events, with age-adjusted odds ratios of 2.6 (95% confidence interval [CI], 1.7-4.1) for men and 2.3 (95% CI, 1.3-4.3) for women. Multivariable adjustment resulted in odds ratios of 2.0 (95% CI, 1.2-3.1) for men and 1.7 (95% CI, 0.9-3.1) for women. Nonpremature parental cardiovascular disease and parental coronary disease were weaker predictors. Addition of parental information aided in discriminating event rates, notably among offspring with intermediate levels of cholesterol and blood pressure, as well as intermediate predicted multivariable risk. Using validated events, we found that parental cardiovascular disease independently predicted future offspring events in middle-aged adults. Addition of parental information may help clinicians and patients with primary prevention of cardiovascular disease, when treatment decisions may be difficult in patients at intermediate risk based on levels of single or multiple risk factors. These data also support further research into genetic determinants of cardiovascular risk.
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              Statistical approaches for assessing the relative validity of a food-frequency questionnaire: use of correlation coefficients and the kappa statistic.

              To compare different statistical methods for assessing the relative validity of a self-administered, 150-item, semi-quantitative food-frequency questionnaire (FFQ) with 4-day weighed diet records (WR). Subjects completed the Scottish Collaborative Group FFQ and carried out a 4-day WR. Relative agreement between the FFQ and WR for energy-adjusted nutrient intakes was assessed by Pearson and Spearman rank correlation coefficients, the percentages of subjects classified into the same and opposite thirds of intake, and Cohen's weighted kappa. Forty-one men, mean age 36 (range 21-56) years, and 40 women, mean age 33 (range 19-58) years, recruited from different locations in Aberdeen, Scotland. Spearman correlation coefficients tended to be lower than Pearson correlation coefficients, and were above 0.5 for 10 of the 27 nutrients in men and 17 of the 27 nutrients in women. For nutrients with Spearman correlation coefficients above 0.5, the percentage of subjects correctly classified into thirds ranged from 39 to 78%, and weighted kappa values ranged from 0.23 to 0.66. Both Spearman correlation coefficients and weighted kappa values are useful in assessing the relative validity of estimates of nutrient intake by FFQs. Spearman correlation coefficients above 0.5, more than 50% of subjects correctly classified and less than 10% of subjects grossly misclassified into thirds, and weighted kappa values above 0.4 are recommended for nutrients of interest in epidemiological studies.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                12 October 2018
                October 2018
                : 10
                : 10
                : 1488
                Affiliations
                [1 ]2nd Department of Cardiology and Angiology, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie 9, 41-800 Zabrze, Poland
                [2 ]Department of Pharmacology, School of Medicine with the Division of Dentistry in Zabrze, Jordana 38, 41-808 Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; n-pawlas@ 123456wp.pl (N.P.); kamila.osadnik@ 123456onet.pl (K.O.); mateusz.lejawa@ 123456gmail.com (M.L.)
                [3 ]Institute of Occupational Medicine and Environmental Health, Kościelna 13, 40-001 Sosnowiec, Poland
                [4 ]Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Sloneczna 45f, 10-718 Olsztyn, Poland; marta.lonnie@ 123456uwm.edu.pl (M.L.); lidia.wadolowska@ 123456uwm.edu.pl (L.W.)
                [5 ]Genomics Laboratory, Kardio-Med Silesia Science and Technology Park, Marii Skłodowskiej-Curie 10C, 41-800 Zabrze, Poland
                [6 ]3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie 9, 41-800 Zabrze, Poland; kamil_bujak@ 123456o2.pl (K.B.); r.regula@ 123456gmail.com (R.R.); m.gierlotka@ 123456sccs.pl (M.G.); scchs@ 123456sum.edu.pl (L.P.); m.gasior@ 123456op.pl (M.G.)
                [7 ]Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry in Zabrze, Jordana 19, 41-808 Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; martynafronczekk@ 123456vp.pl (M.F.); jstrzelczyk@ 123456sum.edu.pl (J.K.S.)
                [8 ]Department of Environmental Medicine and Epidemiology, School of Medicine with the Division of Dentistry in Zabrze, Jordana 19, 41-808 Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; marcin.gawlita@ 123456wp.pl
                [9 ]Students’ Scientific Society, 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie 9, 41-800 Zabrze, Poland; martagoral5@ 123456wp.pl
                [10 ]Department of Cardiology, University Hospital in Opole, Faculty of Natural Sciences and Technology, Institute of Medicine, University of Opole, W. Witosa 26, 45-401 Opole, Poland
                Author notes
                [* ]Correspondence: tadeusz.osadnik@ 123456sccs.pl ; Tel.: +48-32-373-36-19; Fax: +48-32-273-26-79
                Author information
                https://orcid.org/0000-0002-3202-6972
                https://orcid.org/0000-0002-7551-9371
                https://orcid.org/0000-0002-7257-165X
                https://orcid.org/0000-0002-1228-7534
                http://orcid.org/0000-0001-8571-9935
                https://orcid.org/0000-0002-1951-1981
                Article
                nutrients-10-01488
                10.3390/nu10101488
                6213507
                30322041
                f9076a10-9694-4d54-bcdf-64211d4509f9
                © 2018 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 22 August 2018
                : 30 September 2018
                Categories
                Article

                Nutrition & Dietetics
                dietary patterns,family history,ffq-6,pca,premature coronary artery disease,p-cad

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