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Relationship of dietary nitrate intake from vegetables with cardiovascular disease mortality: a prospective study in a cohort of older Australians

Journal Article


Abstract


  • Purpose: Short-term trials indicate inorganic nitrate and nitrate-rich vegetables may have vascular health benefits. However, few observational studies have explored the relationship between nitrate intake and long-term cardiovascular disease (CVD) outcomes. The primary aim of this study was to investigate the association of nitrate intake from vegetables with CVD mortality in a sample of older Australians. Methods: A subgroup of participants without diabetes or major CVD at baseline (1992–1994) were included from the Blue Mountains Eye Study, a population-based cohort study of men and women aged ≥ 49 years. Diets were evaluated using a validated food frequency questionnaire at baseline, 5 years and 10 years of follow-up. Vegetable nitrate intake was estimated using a comprehensive vegetable nitrate database. Cox proportional hazard regression was used to explore the association between vegetable nitrate intake and CVD mortality. Results: During 14 years of follow-up, 188/2229 (8.4%) participants died from CVD. In multivariable-adjusted analysis, participants in quartile 2 [69.5–99.6 mg/day; HR 0.53 (95% CI 0.35, 0.82)], quartile 3 [99.7–137.8 mg/day; HR 0.51 (95% CI 0.32, 0.80)], and quartile 4 [> 137.8 mg/day; HR 0.63 (95% CI 0.41, 0.95)] of vegetable nitrate intake had lower hazards for CVD mortality compared to participants in quartile 1 (< 69.5 mg/day). Conclusions: In older Australian men and women, vegetable nitrate intake was inversely associated with CVD mortality, independent of lifestyle and cardiovascular risk factors. These findings confirm a recent report that intake of vegetable nitrate lowers the risk of CVD mortality in older women and extend these findings to older men.

Authors


  •   Liu, Alex (external author)
  •   Bondonno, Catherine (external author)
  •   Russell, Joanna C.
  •   Flood, Vicki M.
  •   Lewis, Joshua (external author)
  •   Croft, Kevin D. (external author)
  •   Woodman, Richard (external author)
  •   Lim, Wai (external author)
  •   Kifley, Annette (external author)
  •   Wong, Germaine (external author)
  •   Mitchell, Paul (external author)
  •   Hodgson, Jonathan (external author)
  •   Blekkenhorst, Lauren (external author)

Publication Date


  • 2018

Citation


  • Liu, A. H., Bondonno, C. P., Russell, J., Flood, V. M., Lewis, J. R., Croft, K. D., Woodman, R. J., Lim, W. H., Kifley, A., Wong, G., Mitchell, P., Hodgson, J. M. & Blekkenhorst, L. C. (2018). Relationship of dietary nitrate intake from vegetables with cardiovascular disease mortality: a prospective study in a cohort of older Australians. European Journal of Nutrition, Online first 1-13.

Scopus Eid


  • 2-s2.0-85053703489

Number Of Pages


  • 12

Start Page


  • 1

End Page


  • 13

Volume


  • Online first

Place Of Publication


  • Germany

Abstract


  • Purpose: Short-term trials indicate inorganic nitrate and nitrate-rich vegetables may have vascular health benefits. However, few observational studies have explored the relationship between nitrate intake and long-term cardiovascular disease (CVD) outcomes. The primary aim of this study was to investigate the association of nitrate intake from vegetables with CVD mortality in a sample of older Australians. Methods: A subgroup of participants without diabetes or major CVD at baseline (1992–1994) were included from the Blue Mountains Eye Study, a population-based cohort study of men and women aged ≥ 49 years. Diets were evaluated using a validated food frequency questionnaire at baseline, 5 years and 10 years of follow-up. Vegetable nitrate intake was estimated using a comprehensive vegetable nitrate database. Cox proportional hazard regression was used to explore the association between vegetable nitrate intake and CVD mortality. Results: During 14 years of follow-up, 188/2229 (8.4%) participants died from CVD. In multivariable-adjusted analysis, participants in quartile 2 [69.5–99.6 mg/day; HR 0.53 (95% CI 0.35, 0.82)], quartile 3 [99.7–137.8 mg/day; HR 0.51 (95% CI 0.32, 0.80)], and quartile 4 [> 137.8 mg/day; HR 0.63 (95% CI 0.41, 0.95)] of vegetable nitrate intake had lower hazards for CVD mortality compared to participants in quartile 1 (< 69.5 mg/day). Conclusions: In older Australian men and women, vegetable nitrate intake was inversely associated with CVD mortality, independent of lifestyle and cardiovascular risk factors. These findings confirm a recent report that intake of vegetable nitrate lowers the risk of CVD mortality in older women and extend these findings to older men.

Authors


  •   Liu, Alex (external author)
  •   Bondonno, Catherine (external author)
  •   Russell, Joanna C.
  •   Flood, Vicki M.
  •   Lewis, Joshua (external author)
  •   Croft, Kevin D. (external author)
  •   Woodman, Richard (external author)
  •   Lim, Wai (external author)
  •   Kifley, Annette (external author)
  •   Wong, Germaine (external author)
  •   Mitchell, Paul (external author)
  •   Hodgson, Jonathan (external author)
  •   Blekkenhorst, Lauren (external author)

Publication Date


  • 2018

Citation


  • Liu, A. H., Bondonno, C. P., Russell, J., Flood, V. M., Lewis, J. R., Croft, K. D., Woodman, R. J., Lim, W. H., Kifley, A., Wong, G., Mitchell, P., Hodgson, J. M. & Blekkenhorst, L. C. (2018). Relationship of dietary nitrate intake from vegetables with cardiovascular disease mortality: a prospective study in a cohort of older Australians. European Journal of Nutrition, Online first 1-13.

Scopus Eid


  • 2-s2.0-85053703489

Number Of Pages


  • 12

Start Page


  • 1

End Page


  • 13

Volume


  • Online first

Place Of Publication


  • Germany