Amalia Mattiello1, Paolo Chiodini2, Maria Santucci de Magistris1, Vittorio Krogh3, Sara Grioni3, Francesca Fasanelli4,5, Paolo Vineis5,6, Calogero Saieva7, Benedetta Bendinelli7, Graziella Frasca8, Maria Concetta Giurdanella8, Salvatore Panico9. 1. Dipartimento di medicina clinica e chirurgia, Università degli Studi di Napoli "Federico II". 2. Dipartimento di salute mentale e fisica e medicina preventiva, Seconda Università di Napoli. 3. Dipartimento di medicina preventiva e predittiva, Unità di epidemiologia e prevenzione, Fondazione IRCSS - Istituto nazionale dei tumori, Milano. 4. SC di epidemiologia dei tumori, AOU Città della salute e della scienza, Centro di Riferimento per l'Epidemiologia e la Prevenzione Oncologica in Piemonte (CPO), Torino. 5. Human Genetics Foundation (HuGeF), Torino. 6. School of Public Health, Imperial College, Londra. 7. SC epidemiologia molecolare e nutrizionale, Istituto per lo studio e prevenzione oncologica (ISPO), Firenze. 8. Registro dei tumori, Dipartimento di prevenzione medica, Azienda sanitaria provinciale (ASP) Ragusa. 9. Dipartimento di medicina clinica e chirurgia, Università degli Studi di Napoli "Federico II". spanico@unina.it.
Abstract
OBJECTIVES: to report and evaluate the evidence produced by the EPIC Italian collaboration (EPICOR Project) on the dietary determinants of cardiovascular diseases in Italy. DESIGN: prospective study carried out in a large Italian population, composed by cohorts recruited in Northern, Central and Southern Italy. SETTING AND PARTICIPANTS: data on dietary habits collected at the baseline observation through standardised questionnaires on 47,749 free-living adults at the time of the recruitment of the study (1993-1998). MAIN OUTCOME MEASURES: major coronary and cerebrovascular events (acute coronary syndrome, PTCA, CABG, ischemic and haemorrhagic stroke, TEA of supraortic vessels) identified at follow-up. The longitudinal analyses here reported have measured risks through the use of multivariate Cox regression models, adjusted for potential confounders. RESULTS: the longitudinal analyses of EPICOR indicate that Mediterranean-oriented dietary habits, measured through specific indicators and the consumption of various typical food, are able to reduce coronary and cerebrovascular risks, and that this protection is possible even nowadays, although many changes in diet have occurred in the last decades in Italy. Habitual consumption of plant origin products, including all foods with low glycemic index, is an advantage for cardiovascular risk. CONCLUSIONS: the EPICOR Project is the largest, long-lasting Italian study on the relationship between diet and cardiovascular diseases. It is also the study with the greater number of observed variables. Its results point out the importance to support preventive programmes and industrial policies able to favour a dietary style inspired to the Italian Mediterranean tradition.
OBJECTIVES: to report and evaluate the evidence produced by the EPIC Italian collaboration (EPICOR Project) on the dietary determinants of cardiovascular diseases in Italy. DESIGN: prospective study carried out in a large Italian population, composed by cohorts recruited in Northern, Central and Southern Italy. SETTING AND PARTICIPANTS: data on dietary habits collected at the baseline observation through standardised questionnaires on 47,749 free-living adults at the time of the recruitment of the study (1993-1998). MAIN OUTCOME MEASURES: major coronary and cerebrovascular events (acute coronary syndrome, PTCA, CABG, ischemic and haemorrhagic stroke, TEA of supraortic vessels) identified at follow-up. The longitudinal analyses here reported have measured risks through the use of multivariate Cox regression models, adjusted for potential confounders. RESULTS: the longitudinal analyses of EPICOR indicate that Mediterranean-oriented dietary habits, measured through specific indicators and the consumption of various typical food, are able to reduce coronary and cerebrovascular risks, and that this protection is possible even nowadays, although many changes in diet have occurred in the last decades in Italy. Habitual consumption of plant origin products, including all foods with low glycemic index, is an advantage for cardiovascular risk. CONCLUSIONS: the EPICOR Project is the largest, long-lasting Italian study on the relationship between diet and cardiovascular diseases. It is also the study with the greater number of observed variables. Its results point out the importance to support preventive programmes and industrial policies able to favour a dietary style inspired to the Italian Mediterranean tradition.