Relationship of dietary intake to hospital admission for coronary heart and vascular disease: the NHANES II national probability study.

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Abstract
After excluding 2,908 subjects (25% of the cohort) whose diets had changed, possibly as a consequence of disease discovery, in 8,679 individuals from the NHANES II national probability study, our specific aim was to determine which nutritional factors were significant independent contributors to overnight hospitalization with coronary heart and vascular disease (CHD). Covariance adjustments were made for multiple sociodemographic, educational, geographic factors, total cholesterol, high-density lipoprotein cholesterol (HDL-C), race, age, sex, and relative ponderosity (obesity). After these adjustments, linoleic acid (p = 0.049) and alcohol (p = 0.017) were independently inversely associated with CHD hospitalizations; cigarette smoking (p = 0.054) was positively associated. Relative risk for CHD hospitalization was 1.0 for linoleate 0-6 g/day, 0.72 for 6-11.59 g/day, and 0.49 for > or = 11.6 g/day, p < or = 0.01. Relative risk for CHD hospitalization was 1.0 for no coffee intake, 0.6 for regular coffee, 1.8 for regular coffee plus decaffeinated coffee, 2.6 for decaffeinated coffee, and 5.2 when decaffeinated coffee was drunk by virtue of physicians' advice, p < or = 0.001. Unlike our extensive exclusions (25% of the cohort) for diet change, we did not exclude any subjects on the basis of self-directed or physician-recommended changes in smoking habits of initiation of decaffeinated coffee use, following, or as a consequence of disease discovery. We speculate that the relationship of decaffeinated coffee to CHD reflects behavior change after CHD hospitalization. Dietary cholesterol (p = 0.038) was an independent positive predictor of serum total cholesterol.(ABSTRACT TRUNCATED AT 250 WORDS)