Case-control study of nonfatal myocardial infarction in relation to selected foods in Japanese men and women.

Most studies of diet and coronary heart disease (CHD) have focused on constituents rather than on whole foods. The present study examined the relationship of selected foods to nonfatal acute myocardial infarction (AMI) in Japan, with special reference to vegetables, fruits, fish, and tofu. A total of 660 cases with their first episode of AMI aged 40-79 years living in Fukuoka City or adjacent areas and 1,277 controls matched for age, sex, and residence were surveyed on lifestyle, including dietary factors. Participation rates were 87% of cases and 52% of controls. Consumption frequencies of 19 food/beverages items and daily amounts of 4 items were ascertained by interview. The final analysis was done with 632 cases and 1,214 controls. Although consumption of vegetables showed no clear association with the risk of AMI, fruit consumption appeared to reduce the risk of AMI in both men and women. The results also suggested that fish consumption was related to a decreased risk of AMI in men, although the trend was not statistically significant. In women only, tofu consumption was inversely related to the risk of AMI; relative risks for eating tofu <2, 2-3, and 4+ times per week were 1.0, 0.8, and 0.5, respectively, after adjustment for non-dietary factors (p for trend = 0.01). Further adjustment for consumption of fruit, fish and tofu did not alter the findings generally. The findings suggest that, in women at least, tofu consumption may be protective against the risk of AMI. Further studies are needed to corroborate the relationship of consumption of fish and fruit to AMI risk in Japanese men and women.