Comparison of Dietary Characteristics of Acute Coronary Syndrome Patients with Normal Subjects

Abstract

The importance of nutrition for the prevention and treatment of coronary heart disease (CHD) has been reported in a large number of studies at the levels of single nutrients, foods, and dietary patterns. However, the association between nutrition and the risk of acute coronary syndrome (ACS) has been less studied. In addition, the studies conducted in Korean subjects are limited. In this study, 91 ACS patients and 63 normal subjects without hypertension, dyslipidemia, diabetes, or the history of cardiovascular disease (CVD) were included. Socio-demographic, lifestyle, and anthropometric characteristics were determined. To compare the differences in dietary nutrient intake between ACS and normal groups, food frequency questionnaire (FFQ) and 2-day 24-hour recall were used. We also examined the differences in food intake between two groups and associations between food intake and the risk of ACS based on grouping of food items listed in FFQ and the intake levels of each food group. The ACS group was significantly older and had higher proportion of male subjects than the normal group. The income level and the percentage of the married were significantly lower in ACS group. The proportion of current smoker and subjects not doing regular exercise were significantly higher in ACS group than normal group. ACS patients had significantly higher waist circumference and there was a significant association between abdominal obesity determined by waist circumference and ACS. Overall, no significant difference in nutrient intake between the ACS and normal group was found from the FFQ and 2-day 24-hour recall among female subjects. However, significant differences in several nutrients intakes were found between male ACS patients and male normal subjects. FFQ analysis results showed that ACS group had significantly higher energy, carbohydrate and protein intakes than the normal group. Cholesterol and unsaturated fatty acids intakes were also significantly higher in the ACS group than the normal group. For dietary intakes of mineral and vitamins, the ACS group consumed significantly higher amount of phosphorus, sodium, iron from animal-source, selenium, vitamin E, vitamin K, vitamin B6, vitamin B12, and niacin compared with the normal group. According to the results from 2-day 24-hour recall, ACS group had significantly higher intakes of fat and protein from plant sources, fiber, calcium from plant source, vitamin E, vitamin B12, and folate, and lower animal-source fat intake than the normal group. ACS's sodium intake was also significantly higher than normal group's intake level. The overall correlation between the FFQ and 2-day 24-hour recall was relatively low (r = 0.163 ~ 0.364). When total amount of intake and the number of servings consumed per day were compared for food groups, ACS patients consumed significantly more sweets, fish, and rice/rice cakes/grains groups compared to the normal people. There were associations between the risk of developing ACS and the intakes of sweets, fish, and fruits group. The intake of sugar-sweetened beverages (SSB) group tended to show association with the risk of ACS. In conclusion, based on the data assessed by FFQ, the ACS patients diets were characterized by higher intakes of total energy, carbohydrate, protein, cholesterol, phosphorus, sodium, and heme iron at the nutrient level and by higher consumption of sweets, fish, and rice/rice cakes/grains at the food group level compared to normal subjects. In sweets, fish, and fruits groups, significant associations between consumption level and ACS risk were found. Specifically, sweets and fish consumption had positive associations with ACS which suggest harmful effects of their consumption on the risk of ACS. On the other hand, fruits consumption showed an inverse association with ACS, which suggests a protective effect of fruits intake on ACS. However, dietary intakes assessed by 24-hour recall showed lack of significant correlation with the dietary intake results from FFQ, which suggested that there might have been dietary changes in ACS patients after the diagnosis of disease.