How much does a woman's diet affect her risk of coronary heart disease (CHD)?




Arch Intern Med

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There has been so much awareness of the role that breast cancer plays in the lives of women over the past decade that heart disease, the number one killer of women, has not been given the attention needed to alert more women to attend to their particular level of risk. According to the American Heart Association, cardiovascular diseases “claim more female lives every year than the next 16 causes of death combined, and almost twice as many as all forms of cancer. More than 250,000 women die each year of coronary heart disease, compared to 46,000 deaths from breast cancer.”1
There are many risk factors for heart disease including smoking, obesity, physical inactivity, cholesterol and other lipids, and diabetes. In addition to education on risk factors, there have been many studies on prevention of heart disease through lifestyle changes involving exercise and diet. One such study reviewed the dietary habits of over 60,000 women. This study utilized dietary information from a food frequency questionnaire developed in 1984 that was associated with the Nurses' Health Study. The associations between dietary patterns and CHD risk among 69,017 women aged 38 to 63 years, without history of major chronic diseases were examined and the researchers were able to gather valuable information regarding diet and health factors.
In the study, two major dietary patterns were identified, "prudent" and "Western." Higher intakes of fruits, vegetables, legumes, fish, poultry, and whole grains were characteristic for the "prudent" diet. Whereas the "Western" included higher intakes of red and processed meats, sweets and desserts, french fries, and refined grains. Between 1984 and 1996, 821 cases of CHD were documented. Coronary risk factors were adjusted for in calculating the results. Comparing the highest with the lowest quintile, the prudent diet was associated with a relative risk of 0.76. The same comparison for the Western diet resulted in a relative risk of 1.46. Participants who were both in the highest prudent diet quintile and lowest Western diet quintile had an even lower relative risk of 0.64 compared with those with the opposite pattern profile. Based on these results, the authors were able to conclude that a "diet high in fruits, vegetables, whole grains, legumes, poultry, and fish and low in refined grains, potatoes, and red and processed meats may lower risk of CHD" for women.2


1. National Heart, Lung, and Blood Institute's (NHLBI). Women and Heart Disease. 2000.
2. Fung TT. Dietary patterns and the risk of coronary heart disease in women. Arch Intern Med. Aug 2001;161(15):1857-62.