British Journal of Nutrition

Full Papers

Dietary patterns, food groups and myocardial infarction: a case–control study

Michael S. K. Lockhearta1, Lyn M. Steffena1, Hege Møklebust Rebnorda2, Ragnhild Lekven Fimreitea2, Jetmund Ringstada3, Dag S. Thellea4, Jan I. Pedersena2 and David R. Jacobs Jra1a2 c1

a1 Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd Street, Suite 300, Minneapolis, MN 55454, USA

a2 Department of Nutrition, University of Oslo, Oslo, Norway

a3 Department of Infectious Diseases, Østfold Central Hospital, Fredrikstad, Norway

a4 Sahlgrenska University Hospital in Gothenberg, Gothenberg, Sweden


Certain dietary patterns may be related to the risk of CVD. We hypothesised that a plant-centred dietary pattern would be associated with a reduced risk of first myocardial infarction (MI). A case–control study of Norwegian men and postmenopausal women (age 45–75 years) was performed. A FFQ was administered, generally within 3 d after incident MI (n 106 cases). Controls (n 105) were frequency matched on sex, age and geographic location. On the FFQ, 190 items were categorised into thirty-five food groups and an a priori healthy diet pattern score was created. We estimated OR using logistic regression with adjustment for energy intake, family history of heart disease, marital status, current smoking, education and age. Among food groups, the risk of MI was significantly higher per sd of butter and margarine (OR 1·66 (95 % CI 1·12, 2·46)), and lower per sd of tomatoes (OR 0·53 (95 % CI 0·35, 0·79)), high-fat fish (OR 0·57 (95 % CI 0·38, 0·86)), wine (OR 0·58 (95 % CI 0·41, 0·83)), salad (OR 0·59 (95 % CI 0·40, 0·87)), wholegrain breakfast cereals (OR 0·64 (95 % CI 0·45, 0·90)), cruciferous vegetables (OR 0·66 (95 % CI 0·47, 0·93)) and non-hydrogenated vegetable oil (OR 0·68 (95 % CI 0·49, 0·95)). An abundance of cases were found to have a low a priori healthy diet pattern score. A dietary pattern emphasising nutrient-rich plant foods and high-fat fish and low in trans fatty acids was associated with decreased risk of MI among Norwegians.

(Received July 18 2006)

(Revised January 26 2007)

(Accepted January 31 2007)


c1 *Corresponding author: Dr David R. Jacobs Jr, fax +1 612 624 0315, email


Abbreviations: MI, myocardial infarction