Healthy eating behaviors may be associated with lower risk of premature coronary artery disease: A multi-center case-control study

BACKGROUND: Despite some evidence on individual eating habits in relation to cardiovascular disease, little is known about the combination of common eating habits in relation to premature coronary artery disease (PCAD). OBJECTIVE: We investigated the association between a combined eating habits score (EHS) and PCAD risk. METHODS: In this case-control study, 2022 patients with PCAD and 1063 healthy control were recruited. Women aged between 18 and 70 and men aged between 18 and 60 years were eligible. PCAD was defined as 75% or more stenosis in a single coronary artery disease or at least 50% in the left main coronary artery. Eating habits were assessed through interview and higher scores represent healthier behaviors. RESULTS: Participants in the fourth quartile of EHS had 22% lower risk of PCAD than those in the first quartile (95% CI: 0.61, 0.99; P = 0.024). Not adding salt at the table (OR = 0.80, 95% CI: 0.66, 0.97; P = 0.023), low-salt meals (OR = 0.75, 95% CI: 0.57, 0.99; P = 0.022), and slow eating (OR = 0.42, 95% CI: 0.24, 0.71; P < 0.001) were associated with lower risk of PCAD while more water drinking (OR = 1.56, 95% CI: 1.07, 2.27; P = 0.013), and increased meal frequency (OR = 1.85, 95% CI: 1.09, 3.13; P = 0.025) were linked with increased risk of PCAD. CONCLUSION: Healthy eating behaviors score, particularly low salt intake and slow eating were associated with lower risk of PCAD. However, higher meal frequency and more water drinking were associated with increased risk of PCAD. Well-designed prospective cohort studies are required.