Cardiovascular disease is the leading cause of death among residents of the United States. The effect of dietary cholesterol and fat on risk of coronary heart disease (CHD) and stroke has been examined extensively in epidemiologic studies. However, the results from these studies are inconsistent. Furthermore, the association between some other key elements of diet and risk of CHD and stroke have been insufficiently studied in epidemiologic studies. The proposed study will examine prospectively the association between: (1). dietary intake of trans-unsaturated fat and risk of CHD; (2). dietary intake of total, saturated and unsaturated fats and risk of stroke (3). dietary intake of protein (vegetable and animal) and risk of stroke; (4). dietary intake of fiber (total and water-soluble) and risk of CHD and stroke; (5). dietary intake of sodium and potassium and risk of CHD and stroke; (6). dietary intake of vitamin C, carotenoids, vitamin E, and folic acid and risk of CHD and stroke; and (7). specific foods, such as milk, fish, beans, fruits and vegetables and risk of CHD and stroke. In addition, the association of baseline serum vitamin A, vitamin C, and folate to risk of CHD and stroke will be investigated. We plan to use data from the NHANES 1 Epidemiologic Follow-up Study (NHEFS) to test the above hypotheses. The NHEFS is an on-going prospective cohort study being conducted in 14,407 US men and women aged 25 to 74 years by the National Center for Health Statistics (NCHS). The baseline data, including a 24-hour dietary recall and food frequency questionnaire, as well as important cardiovascular risk factors were collected during 1971-75. The follow-up data were collected during 1982 to 1984, 1986, 1987, and 1992. The follow-up data were obtained by means of an interview, medical records from health care facilities, and death certificates for all decedents. In the proposed study, we will: (1). Re-code dietary data and calculate dietary nutrients: The 24-hour dietary recall data from NHEFS will be re-coded. The dietary nutrients will be calculated using the ESHA Nutrient Database. (2). Analyze the relationship of dietary nutrients and specific foods to risk of CHD and stroke: Statistical methods for survival data will be used to explore the relationship between dietary factors and risk of CHD and stroke. The proposed study will provide important information for the development of primary preventive strategies which can be used to reduce the societal burden of CHD and stroke.
