Population dietary-metabolic characteristics and mortality from major cardiovascular disease subtypes: the Seven Contries Study 60-year follow-up

Abstract

Background and aim

During the last few years, the Seven Countries Study of Cardiovascular Diseases (SCS) produced some new analyses dealing with the relationships of a dietary score, the pool of dietary fatty acids and serum cholesterol with major types of cardiovascular disease (CVD) mortality in 10 cohorts of 6 countries made of middle-aged men followed-up for 60 years until extinction. This sparse evidence is condensed here to provide a coherent view.

Methods and results

The Mediterranean Adequacy Index (MAI, a dietary score whose high levels depict the characteristics of the Mediterranean Diet), was highly and significantly associated in an inverse way, at country levels, with the Atherogenicity (ATI) and the Thrombogenicity (THI) indexes that included a series of dietary fatty acids. These indexes were highly and significantly associated in a direct way with country baseline serum cholesterol levels. Countries with high serum cholesterol had largely higher death rates from coronary heart disease (CHD) and lower rates from other heart diseases of uncertain etiology and stroke. The reverse was observed in countries with low serum cholesterol.

Conclusion

The chain of diet, dietary fatty acids and serum cholesterol seems to be responsible in various ways for the different distribution of major CVD mortality subtypes in extincted cohorts.