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.
Keywords
Cardiovascular disease, Mortality, Nitrate, Vegetables, Coronary heart disease, Stroke
Document Type
Journal Article
Date of Publication
2018
Volume
58
Publication Title
European Journal of Nutrition
Publisher
Springer Nature
School
School of Medical and Health Sciences
RAS ID
27462
Funding Information
The analysis of this study was supported by a National Health and Medical Research Council (NHMRC) of Australia project Grant 1084922. The salaries of JRL and JMH were supported by NHMRC of Australia Fellowships.
Funding received from the National Health and Medical Research Council (NHMRC)
1084922
Administering Institution
Edith Cowan University
First Page
2741
Content Type
Full object
Last Page
2753
Recommended Citation
Liu, A. H., Bondonno, C. P., Russell, J., Flood, V. M., Lewis, J. R., Croft, K. D., ... & Blekkenhorst, L. (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, 58(17) 2741 - 2753.
Comments
This is a post-peer-review, pre-copyedit version of an article published in European Journal of Nutrition. The final authenticated version is available online at: http://dx.doi.org/10.1007/s00394-018-1823-x
Liu, A. H., Bondonno, C. P., Russell, J., Flood, V. M., Lewis, J. R., Croft, K. D., ... & Blekkenhorst, L. (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, 58(17) 2741 - 2753.
Available here.