Nutritional Attributes as Predictors of Coronary Heart Disease


Background: Diet is an important modifiable risk factor for coronary heart disease (CHD). However, the influence of some groups of food intake on CHD has shown inconsistent findings. Objectives: This study aimed to identify the relation of the dietary habits, Vitamin D, serum lipids, and anthropometric measures of the participants with CHD. Methods: A retrospective case-control study was conducted at Al-Remal Clinic, Gaza City. The study included 50 cases of symptomatic CHD and 50 controls, chosen by convenience sampling method. Data were collected by direct methods that included measurement of serum levels of lipids and Vitamin D, and indirect methods using a structured interview questionnaire. Results: The mean of servings per day of fruits and vegetables was lower in CHD patients than controls (P = 0.004, and P = 0.001, respectively). Vitamin D deficiency prevailed in CHD patients (odds ratio, 3.78; 95% confidence interval, 1.65 - 8.65). The mean serum level of triglycerides was higher among cases (P = 0.02), while the mean of high-density lipoprotein cholesterol was lower in CHD patients (P = 0.001). Waist circumference (mean) was higher among cases (P = 0.01). Conclusion: Traditional risk factors including unhealthy diet, and Vitamin D deficiency could be associated with the development of CHD.

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Elhissi, J. , Sukkar, D. and El-Sakka, M. (2014) Nutritional Attributes as Predictors of Coronary Heart Disease. Pharmacology & Pharmacy, 5, 1171-1179. doi: 10.4236/pp.2014.513128.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] World Health Organization (2013) Cardiovascular Diseases (CVDs). WHO Media Centre.
[2] Ministry of Health (2012) Health Annual Report Palestine 2011.
[3] Royal College of Physicians (2010) Unstable Angina and NSTEMI: The Early Management of Unstable Angina and Non-ST-Segment-Elevation Myocardial Infarction, London, UK.
[4] Nabel, E.G. and Braunwald, E. (2012) A Tale of Coronary Artery Disease and Myocardial Infarction. The New England Journal of Medicine, 366, 54-63.
[5] Boudi, F.B. (2014) Risk Factors for Coronary Artery Disease.
[6] Olinto, M.T., Gigante, D.P., Horta, B., Silveira, V., Oliveira, I. and Willett, W. (2012) Major Dietary Patterns and Cardiovascular Risk Factors among Young Brazilian Adults. European Journal of Nutrition, 51, 281-291.
[7] World Health Organization (2014) Unhealthy Diet. WHO Global Health Observatory (GHO).
[8] Grundy, S.M., Cleeman, J.I., Bairey Merz, C.N., Brewer Jr., H.B., Clark, L.T., Hunninghake, D.B., et al. (2004) NCEP Report. Implications of Recent Clinical Trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines. Circulation, 110, 227-239.
[9] Natarajan, P., Ray, K.K. and Cannon, C.P. (2010) High-Density Lipoprotein and Coronary Heart Disease. Journal of the American College of Cardiology, 55, 1283-1299.
[10] Pejic, R.N. (2011) Should We Treat Moderately Elevated Triglycerides? American Family Physician, 83, 242-245.
[11] Lavie, C.J., Lee, J.H. and Milani, R.V. (2011) Vitamin D and Cardiovascular Disease, Will It Live up to Its Hype? Journal of American College of Cardiology, 58, 1547-1556.
[12] Holick, M.F. (2014) Sunlight, Ultraviolet Radiation, Vitamin D and Skin Cancer: How Much Sunlight Do We Need? Advances in Experimental Medicine and Biology, 810, 1-16.
[13] Holick, M.F. (2007) Vitamin D Deficiency. The New England Journal of Medicine, 357, 266-281.
[14] Chung, M., Balk, E.M., Brendel, M., Ip, S., Lau, J., Lee, J., et al. (2009) Vitamin D and Calcium: Systematic Review of Health Outcomes. Evidence Report/Technology Assessment No. 183. (Prepared by Tufts Evidence-Based Practice Center under Contract No. 290-2007-10055-I.)
[15] Kunadian, V., Ford, G.A., Bawamia, B., Qiu, W. and Manson, J.E. (2014) Vitamin D Deficiency and Coronary Artery Disease: A Review of the Evidence. American Heart Journal, 167, 283-291.
[16] Office of Dietary Supplements/National Institutes of Health (2014) Vitamin D Fact Sheet for Health Professionals.
[17] World Health Organization (2014) Gaza Strip, Joint Health Sector Assessment Report. Health Cluster in the Occupied Palestinian Territory.
[18] Centers for Disease Control and Prevention, CDC (2011) About BMI for Adults, USA.
[19] American Association for Clinical Chemistry (2013) Lipid Profile: The Test.
[20] Mayo Clinic (2011) Endocrine University: Intensive Technology Training for Clinical Endocrinology Fellows. Endocrinology Update, 6.
[21] Loucks, E.B., Buka, S.L., Rogers, M.L., Liu, T., Kawachi, I., Kubzansky, L.D., Martin, L.T. and Gilman, S.E. (2012) Education and Coronary Heart Disease Risk Associations May Be Affected by Early Life Common Prior Causes: A Propensity Matching Analysis. Annals of Epidemiology, 22, 221-232.
[22] Sadeghi, R., Adnani, N., Erfanifar, A., Gachkar, L. and Maghsoomi, Z. (2013) Premature Coronary Heart Disease and Traditional Risk Factors—Can We Do Better? International Cardiovascular Research Journal, 7, 46-50.
[23] Mirmohammadi, S.J., Taheri, M., Mehrparvar, A.H., Heydari, M., Saadati Kanafi, A. and Mostaghaci, M. (2014) Occupational Stress and Cardiovascular Risk Factors in High-Ranking Government Officials and Office Workers. Iranian Red Crescent Medical Journal, 16, e11747.
[24] American Heart Association (2014) Coronary Artery Disease—Coronary Heart Disease.
[25] Nabi, H., Kivimaki, M., Batty, G.D., Shipley, M.J., Britton, A., Brunner, E.J., et al. (2013) Increased Risk of Coronary Heart Disease among Individuals Reporting Adverse Impact of Stress on Their Health: The Whitehall II Prospective Cohort Study. European Heart Journal, 34, 2697-2705.
[26] Kuklina, E.V., Yoon, P.W. and Keenan, N.L. (2010) Prevalence of Coronary Heart Disease Risk Factors and Screening for High Cholesterol Levels among Young Adults, United States, 1999-2006. Annals of Family Medicine, 8, 327-333.
[27] Reddy, K.S. and Katan, M.B. (2004) Diet, Nutrition and the Prevention of Hypertension and Cardiovascular Diseases. Public Health Nutrition, 7, 167-186.
[28] Nguyen, N.T., Nguyen, X.M., Wooldridge, J.B., Slone, J.A. and Lane, J.S. (2010) Association of Obesity with Risk of Coronary Heart Disease: Findings from the National Health and Nutrition Examination Survey, 1999-2006. Surgery for Obesity and Related Diseases, 6, 465-469.
[29] Logue, J., Murray, H.M., Welsh, P., Shepherd, J., Packard, C., Macfarlane, P., et al. (2011) Obesity Is Associated with Fatal Coronary Heart Disease Independently of Traditional Risk Factors and Deprivation. Heart, 97, 564-568. PMid:21324888
[30] Siadat, Z.D., Kiani, K., Sadeghi, M., Shariat, A.S., Farajzadegan, Z. and Kheirmand, M. (2012) Association of Vitamin D Deficiency and Coronary Artery Disease with Cardiovascular Risk Factors. Journal of Research in Medical Sciences, 17, 1052-1055.
[31] Anderson, J.L., May, H.T., Horne, B.D., Bair, T.L., Hall, N.L., Carlquist, J.F., Lappé, D.L. and Muhlestein, J.B. (2010) Relation of Vitamin D Deficiency to Cardiovascular Risk Factors, Disease Status, and Incident Events in a General Healthcare Population. American Journal of Cardiology, 106, 963-968.
[32] Syal, S.K., Kapoor, A., Bhatia, E., Sinha, A., Kumar, S., Tewari, S., Garg, N. and Goel, P.K. (2012) Vitamin D Deficiency, Coronary Artery Disease, and Endothelial Dysfunction: Observations from a Coronary Angiographic Study in Indian Patients. The Journal of Invasive Cardiology, 24, 385-389.
[33] Ramly, M., Ming, M.F., Chinna, K., Suboh, S. and Pendek, R. (2014) Effect of Vitamin D Supplementation on Cardiometabolic Risks and Health-Related Quality of Life among Urban Premenopausal Women in a Tropical Country—A Randomized Controlled Trial. PLoS ONE, 9, e110476.
[34] Rice, B.H. (2014) Dairy and Cardiovascular Disease: A Review of Recent Observational Research. Current Nutrition Reports, 15, 130-138.
[35] Crichton, G.E. and Elias, M.F. (2014) Dairy Food Intake and Cardiovascular Health: The Maine-Syracuse Study. Advances in Dairy Research, 2, 112.
[36] Avalos, E.E., Barrett-Connor, E., Kritz-Silverstein, D., Wingard, D.L., Bergstrom, J.N. and Al-Delaimy, W.K. (2013) Is Dairy Product Consumption Associated with the Incidence of CHD? Public Health Nutrition, 16, 2055-2063.
[37] Crowe, F.L., Roddam, A.W., Key, T.J., Appleby, P.N., Overvad, K., Jakobsen, M.U., et al. (2011) Fruit and Vegetable Intake and Mortality from Ischaemic Heart Disease: Results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart Study. European Heart Journal, 32, 1235-1243.
[38] Bhupathiraju, S.N., Wedick, N.M., Pan, A., Manson, J.E., Rexrode, K.M., Willett, W.C., Rimm, E.B. and Hu, F.B. (2013) Quantity and Variety in Fruit and Vegetable Intake and Risk of Coronary Heart Disease. American Journal of Clinical Nutrition, 98, 1514-1523.
[39] Estruch, R., Ros, E., Salas-Salvadó, J., Covas, M.I., Corella, D., Arós, F., et al. (2013) Primary Prevention of Cardiovascular Disease with a Mediterranean Diet. The New England Journal of Medicine, 368, 1279-1290.
[40] Fulgoni, V.L., Dreher, M. and Davenport, A.J. (2013) Avocado Consumption Is Associated with Better Diet Quality and Nutrient Intake, and Lower Metabolic Syndrome Risk in US Adults: Results from the National Health and Nutrition Examination Survey (NHANES) 2001-2008. Nutrition Journal, 12, 1.
[41] Virtanen, J.K., Mursu, J., Tuomainen, T.P. and Voutilainen, S. (2014) Atherosclerosis/Lipoproteins, Dietary Fatty Acids and Risk of Coronary Heart Disease in Men. The Kuopio Ischemic Heart Disease Risk Factor Study. Arteriosclerosis, Thrombosis, and Vascular Biology, 34, 2679-2687.
[42] Moghadam, E.F., Tadevosyan, A., Kimiagar, M. and Chamari, M. (2012) An Assessment of Dietary Intake Associated with the Coronary Heart Disease among Adults in Yerevan, Armenia. Life Science Journal, 9, 865-870.

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