Major dietary patterns and risk of acute myocardial infarction in young, urban, Pakistani population

Background: Premature coronary artery disease (CAD) is very common in Pakistani people who consume high fat diet and low amounts of fruits and green leafy vegetables. Objective: To investigate the role of diet in the development of premature acute myocardial infarction (AMI) in Pakistani population. Methods: In a case-control study, 203 consecutive cases with first AMI and age below 45 years and 205 gender and age matched healthy controls were recruited. Dietary intake was assessed by using a simple 14-item food frequency questionnaire. Using factor analysis, 3 major dietary patterns- prudent dietary pattern, combination dietary pattern and western dietary pattern were identified. ANOVA and conditional logistic regression were used to predict the association of dietary patterns with AMI. Results: Consumption of prudent diet, characterized by high consumption of legumes, vegetables, wheat, chicken and fruits, is protective against the risk of premature AMI. Compared to the first quartile of lowest intake, the adjusted OR was 0.04 (95% CI, 0.01-0.25) for the fourth quartile (P-value for trend \u3c 0.01). Moderate to high consumption of combination diet, characterized by high intake of eggs, fish, fruits, juices and coffee was associated with decreased risk of AMI. Compared to the first quartile, the adjusted ORs were 0.19 (95% CI, 0.07-0.54) and 0.27 (95% CI, 0.10-0.77) for the third and fourth quartiles, respectively (P-value for trend \u3c 0.001). No association was observed between western diet characterized by high intake of meat, fish and tea with milk and risk of AMI. Conclusions: Moderate consumption of a prudent and a combination dietary pattern is protective against the risk of AMI in a Pakistani population. However, western dietary pattern had no association with AMI in this population. Keywords: Coronary artery disease, dietary patterns, myocardial infarction, risk factor