The Scottish Heart Health Study. Dietary intake by food frequency questionnaire and odds ratios for coronary heart disease risk. II. The antioxidant vitamins and fibre.

High serum antioxidant vitamins are increasingly being associated with reduced risk of coronary heart disease (CHD). Previous studies have not addressed the relationship between dietary antioxidant vitamins and risk of CHD although diet is a key factor which modifies blood antioxidant vitamin levels. In prospective studies, high-fibre diets have also been associated with reduced CHD incidence. In this analysis CHD-diagnosed, -undiagnosed and non-CHD controls were selected from 10,359 men and women aged 40-59 who participated in a cross-sectional study of CHD risk factors. Diet was assessed by food frequency questionnaire, odds ratios were adjusted for the classical CHD risk factors (+/- social class) and calculated relative to the first quintile for each vitamin and total fibre. The antioxidant vitamins were further combined in a principal component analysis and the odds ratios for undiagnosed and diagnosed CHD were again calculated. For undiagnosed CHD, risk was significantly lower in the highest quintiles of beta-carotene, fibre and vitamin C, E and A for men, but only lower for fibre in women. Opposite trends were observed in the odds ratios for vitamin C and E and fibre for male-diagnosed CHD which possibly indicates changes in diet as a result of diagnosis. Principal component analysis showed significantly reduced risk of undiagnosed CHD in the top three quintiles for men (odds ratios 0.66, 0.67 and 0.64; P less than 0.05 in each case). A similar trend occurred for women but was non-significant. The results suggest that high dietary intake of the antioxidant vitamins may reduce risk of CHD, particularly in men, and that fibre may be equally cardio-protective in both sexes.