Biomarker-calibrated energy and protein consumption and cardiovascular disease risk among postmenopausal women

Ross L. Prentice, Ying Huang, Lewis H. Kuller, Lesley F. Tinker, Linda Van Horn, Marcia L. Stefanick, Gloria Sarto, Judith Ockene, Karen Johnson

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41 Citations (Scopus)

Abstract

Background: Nutritional epidemiology cohort studies primarily use food frequency questionnaires (FFQs). In part because FFQs are more reliable for nutrient densities than for absolute nutrient consumption, reports from association studies typically present only nutrient density measures in relation to disease risk. Methods: We used objective biomarkers to correct FFQ assessments for measurement error, and examined absolute energy and protein consumption in relation to cardiovascular disease incidence. FFQs and subsequent physician-adjudicated cardiovascular disease incidence were assessed for 80,370 postmenopausal women in the age range 50-79 years at enrollment in the comparison group of the Dietary Modification Trial or the prospective Observational Study in the Women's Health Initiative. Urinary recovery biomarkers of energy and protein were obtained from a subsample of 544 women, with concurrent FFQ information. Results: After biomarker correction, energy consumption was positively associated with coronary heart disease incidence (hazard ratio = 1.18; 95% confidence interval = 1.04-1.33, for 20% consumption increment) and protein density was inversely associated (0.85 [0.75-0.97]). The positive energy association appeared to be mediated by body fat accumulation. Ischemic stroke incidence was inversely associated with energy and protein consumption, but not with protein density. Conclusions: A positive association between energy and coronary heart disease risk can be attributed to body mass accumulation. Ischemic stroke risk is inversely associated with energy and protein consumption, possibly due to correlations between consumption and physical activity.

Original languageEnglish (US)
Pages (from-to)170-179
Number of pages10
JournalEpidemiology
Volume22
Issue number2
DOIs
StatePublished - Mar 1 2011

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Cardiovascular Diseases
Biomarkers
Food
Proteins
Incidence
Coronary Disease
Stroke
Diet Therapy
Women's Health
Observational Studies
Adipose Tissue
Epidemiology
Cohort Studies
Surveys and Questionnaires
Prospective Studies
Confidence Intervals
Exercise
Physicians

All Science Journal Classification (ASJC) codes

  • Epidemiology

Cite this

Biomarker-calibrated energy and protein consumption and cardiovascular disease risk among postmenopausal women. / Prentice, Ross L.; Huang, Ying; Kuller, Lewis H.; Tinker, Lesley F.; Horn, Linda Van; Stefanick, Marcia L.; Sarto, Gloria; Ockene, Judith; Johnson, Karen.

In: Epidemiology, Vol. 22, No. 2, 01.03.2011, p. 170-179.

Research output: Contribution to journalArticle

Prentice, RL, Huang, Y, Kuller, LH, Tinker, LF, Horn, LV, Stefanick, ML, Sarto, G, Ockene, J & Johnson, K 2011, 'Biomarker-calibrated energy and protein consumption and cardiovascular disease risk among postmenopausal women', Epidemiology, vol. 22, no. 2, pp. 170-179. https://doi.org/10.1097/EDE.0b013e31820839bc
Prentice, Ross L. ; Huang, Ying ; Kuller, Lewis H. ; Tinker, Lesley F. ; Horn, Linda Van ; Stefanick, Marcia L. ; Sarto, Gloria ; Ockene, Judith ; Johnson, Karen. / Biomarker-calibrated energy and protein consumption and cardiovascular disease risk among postmenopausal women. In: Epidemiology. 2011 ; Vol. 22, No. 2. pp. 170-179.
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