Objective: To test our hypothesis that lower intakes of previously identified cardioprotective nutrients would be associated with the coronary epidemic in Central and Eastern Europe.
Design: We conducted a survey of coronary mortality in 16 countries and diet in 19 countries.
Subjects/setting: Countries were placed in four groups with different cultural patterns (Central and Eastern Europe, including Russia; Western Europe and the United States; Mediterranean; and Asian).
Main outcome measures: Independent predictors of coronary mortality.
Statistical analyses performed: Means and standard deviations were calculated, and analysis of variance with Bonferroni post hoc tests and backward elimination regression analysis was conducted.
Results: Coronary mortality was highest in Central and Eastern Europe followed by Western Europe and the United States, the Mediterranean countries, and Asia (Japan). The model with folate, fiber, and n-6/n-3 fatty acids explained the majority of variation in coronary mortality (men 86%, women 90%). Most of the variation was explained by folate (men 61%, women 62%). The picture is complicated by the fact that folate, lutein/zeaxanthin, and beta-carotene were highly intercorrelated (r=0.87 to 0.99).
Conclusions: A diet low in foods containing folate and carotenoids (beta-carotene and lutein/zeaxanthin) may be a major contributing factor to increased coronary risk observed in the countries of Central and Eastern Europe.
Contact: Donna Vandergraff, Phone: 765-494-8228, E-mail: vandergraff@purdue.edu
Funded by Folic Acid Council grant from March of Dimes.
