Diet and coronary heart disease: a case-control study in Athens, Greece

We conducted a case-control study in Athens, Greece, between January 1990 and April 1991 to examine the association between diet and coronary heart disease. The case series comprised 329 patients with electrocardiographically confirmed first coronary infarct or a first positive coronary arteriogram, or both, who were admitted to a major teaching hospital during a 16-month period. Controls were 570 patients admitted to the same hospital for minor conditions believed to be unrelated to nutrition. Total energy intake was inversely associated with coronary heart disease risk, a quintile energy increase corresponding to a relative risk of 0.96. After controlling for total energy intake, dietary fat was positively related to coronary heart disease, and total carbohydrates were negatively related to coronary heart disease, the nutrient-specific relative risks for a quintile increase being 1.19 (95% confidence interval = 0.96-1.48) and 0.81 (95% confidence interval = 0.67-0.97), respectively. Major fat components (saturated, monounsaturated, and polyunsaturated fat) did not appear to have differential risk implications for coronary heart disease; however, cooking with margarine was associated with an increased relative risk (1.87; 95% confidence interval = 0.82-4.28). Dietary proteins, cholesterol, and vitamin C were not associated with coronary heart disease.