Relationship of dietary intake to subsequent coronary heart disease incidence: The Puerto Rico Heart Health Program.

A study of base-line nutrient intakes of 8218 urban and rural Puerto Rican man aged 45 to 64 years was undertaken in relation to subsequent six year coronary heart disease (CHD) incidence. Urban dietary intakes were significantly higher in total fat and lower in carbohydrate, particularly starch. Average cholesterol intakes were 83 mg/day higher in urban than rural men. Urban serum cholesterol values were significantly higher than rural values. Urban men who developed myocardial infarction or CHD death had significantly lower calorie and carbohydrate intakes i.e., chiefly those derived from rice and legumes. The same association was found in the rural group but failed to reach statistical significance. A very low intake of alcohol was noted in the 73 rural CHD cases. Dietary sucrose intake showed no relationship to CHD incidence. Multivariate analysis, taking relative weight, hematocrit, blood pressure, serum cholesterol, alcohol intake, cigarette smoking, area, and age into account, demonstrated an independent inverse relation of carbohydrate intake from legumes to CHD incidence. The apparent protective effect of complex carbohydrate merits further investigation.