TABLE 4.
HRs (95% CIs) of ischemic heart disease mortality across quintiles of major food sources of carbohydrate and fiber1
| Quintiles of intake |
||||||||
| 1 (low) | 2 | 3 | 4 | 5 (high) | P-trend | Per serving increase (d) | ||
| Rice | ||||||||
| Men (n) | 4148 | 3941 | 4286 | 4415 | 6711 | — | — | |
| Median (range) intake (servings/d) | 2.35 (0, 2.97) | 3.40 (2.97, 3.75) | 4.10 (3.75, 4.43) | 4.80 (4.43, 5.24) | 6.74 (5.24, 10.26) | — | — | |
| Age-adjusted HR2 | 1.00 | 0.98 (0.78, 1.23) | 0.96 (0.77, 1.20) | 1.00 (0.81, 1.25) | 1.07 (0.88, 1.31) | 0.40 | 1.02 (0.98, 1.05) | |
| Multivariable HR3 | 1.00 | 0.95 (0.75, 1.19) | 0.92 (0.74, 1.15) | 0.95 (0.76, 1.19) | 1.00 (0.82, 1.22) | 0.84 | 1.00 (0.97, 1.04) | |
| Additional adjustment for diet4 | 1.00 | 0.96 (0.76, 1.20) | 0.95 (0.75, 1.20) | 0.98 (0.77, 1.25) | 1.02 (0.79, 1.31) | 0.97 | 1.00 (0.95, 1.06) | |
| Women (n) | 6545 | 6753 | 6408 | 6279 | 3983 | — | — | |
| Median (range) intake (servings/d) | 2.40 (0, 2.97) | 3.39 (2.97, 3.75) | 4.08 (3.75, 4.43) | 4.80 (4.43, 5.24) | 5.77 (5.24, 9.68) | — | — | |
| Age-adjusted HR2 | 1.00 | 1.14 (0.85, 1.54) | 1.40 (1.05, 1.87) | 1.28 (0.96, 1.72) | 1.55 (1.15, 2.08) | <0.01 | 1.09 (1.03, 1.16) | |
| Multivariable HR3 | 1.00 | 1.11 (0.82, 1.50) | 1.31 (0.98, 1.76) | 1.22 (0.91, 1.64) | 1.42 (1.06, 1.91) | 0.03 | 1.07 (1.01, 1.14) | |
| Additional adjustment for diet4 | 1.00 | 1.07 (0.79, 1.45) | 1.20 (0.88, 1.63) | 1.07 (0.77, 1.48) | 1.10 (0.77, 1.58) | 0.99 | 1.00 (0.92, 1.08) | |
| Noodles | ||||||||
| Men (n) | 5905 | 4348 | 4106 | 4344 | 4798 | — | — | |
| Median (range) intake (servings/d) | 0.11 (0, 0.24) | 0.31 (0.24, 0.39) | 0.47 (0.39, 0.55) | 0.66 (0.55, 0.81) | 1.08 (0.81, 4.41) | — | — | |
| Age-adjusted HR2 | 1.00 | 0.99 (0.81, 1.20) | 1.10 (0.90, 1.34) | 1.21 (1.00, 1.47) | 1.40 (1.17, 1.69) | <0.01 | 1.38 (1.20, 1.59) | |
| Multivariable HR3 | 1.00 | 0.96 (0.79, 1.17) | 1.06 (0.87, 1.29) | 1.16 (0.95, 1.41) | 1.28 (1.07, 1.55) | <0.01 | 1.28 (1.11, 1.47) | |
| Additional adjustment for diet4 | 1.00 | 0.96 (0.79, 1.18) | 1.07 (0.87, 1.31) | 1.19 (0.96, 1.46) | 1.32 (1.07, 1.62) | <0.01 | 1.30 (1.11, 1.53) | |
| Women (n) | 4788 | 6346 | 6588 | 6350 | 5896 | — | — | |
| Median (range) intake (servings/d) | 0.15 (0, 0.24) | 0.32 (0.24, 0.39) | 0.46 (0.39, 0.55) | 0.65 (0.55, 0.81) | 1.07 (0.81, 4.20) | — | — | |
| Age-adjusted HR2 | 1.00 | 1.03 (0.79, 1.34) | 0.98 (0.74, 1.28) | 1.20 (0.92, 1.57) | 1.50 (1.15, 1.96) | <0.01 | 1.48 (1.21, 1.82) | |
| Multivariable HR3 | 1.00 | 1.04 (0.80, 1.35) | 0.96 (0.73, 1.27) | 1.15 (0.88, 1.51) | 1.39 (1.07, 1.82) | <0.01 | 1.38 (1.12, 1.69) | |
| Additional adjustment for diet4 | 1.00 | 1.01 (0.77, 1.33) | 0.95 (0.71, 1.27) | 1.14 (0.86, 1.53) | 1.38 (1.02, 1.85) | 0.01 | 1.38 (1.09, 1.75) | |
| Vegetables | ||||||||
| Men (n) | 6897 | 4914 | 4140 | 3873 | 3677 | — | — | |
| Median (range) intake (servings/d) | 0.45 (0, 0.62) | 0.72 (0.62, 0.81) | 0.90 (0.81, 1.01) | 1.13 (1.01, 1.29) | 1.57 (1.29, 8.72) | — | — | |
| Age-adjusted HR2 | 1.00 | 0.88 (0.74, 1.04) | 0.77 (0.63, 0.92) | 0.85 (0.70, 1.03) | 0.76 (0.62, 0.94) | 0.01 | 0.82 (0.71, 0.95) | |
| Multivariable HR3 | 1.00 | 0.92 (0.78, 1.09) | 0.82 (0.68, 0.99) | 0.89 (0.74, 1.08) | 0.83 (0.67, 1.03) | 0.06 | 0.87 (0.75, 1.00) | |
| Additional adjustment for diet4 | 1.00 | 0.92 (0.78, 1.10) | 0.80 (0.66, 0.98) | 0.87 (0.71, 1.07) | 0.84 (0.67, 1.05) | 0.11 | 0.88 (0.75, 1.03) | |
| Women (n) | 3796 | 5780 | 6554 | 6821 | 7017 | — | — | |
| Median (range) intake (servings/d) | 0.51 (0, 0.62) | 0.72 (0.62, 0.81) | 0.91 (0.81, 1.01) | 1.13 (1.01, 1.29) | 1.58 (1.29, 10.40) | — | — | |
| Age-adjusted HR2 | 1.00 | 0.88 (0.69, 1.12) | 0.77 (0.61, 0.99) | 0.76 (0.59, 0.98) | 0.59 (0.45, 0.79) | <0.01 | 0.67 (0.55, 0.82) | |
| Multivariable HR3 | 1.00 | 0.90 (0.71, 1.15) | 0.80 (0.62, 1.02) | 0.80 (0.62, 1.03) | 0.62 (0.47, 0.82) | <0.01 | 0.69 (0.57, 0.85) | |
| Additional adjustment for diet4 | 1.00 | 0.93 (0.73, 1.20) | 0.84 (0.65, 1.08) | 0.86 (0.66, 1.12) | 0.69 (0.51, 0.93) | 0.01 | 0.75 (0.60, 0.93) | |
| Fruit | ||||||||
| Men (n) | 6189 | 4517 | 4218 | 4200 | 4377 | — | — | |
| Median (range) intake (servings/d) | 0.26 (0, 0.56) | 0.73 (0.56, 0.92) | 1.10 (0.92, 1.31) | 1.56 (1.31, 1.91) | 2.54 (1.91, 12.93) | — | — | |
| Age-adjusted HR2 | 1.00 | 0.75 (0.63, 0.90) | 0.68 (0.56, 0.83) | 0.76 (0.63, 0.91) | 0.69 (0.57, 0.83) | <0.01 | 0.86 (0.80, 0.92) | |
| Multivariable HR3 | 1.00 | 0.79 (0.66, 0.95) | 0.76 (0.62, 0.92) | 0.84 (0.69, 1.02) | 0.78 (0.64, 0.95) | <0.01 | 0.90 (0.84, 0.97) | |
| Additional adjustment for diet4 | 1.00 | 0.81 (0.67, 0.97) | 0.78 (0.64, 0.95) | 0.88 (0.72, 1.08) | 0.84 (0.68, 1.04) | 0.04 | 0.92 (0.85, 1.00) | |
| Women (n) | 4504 | 6177 | 6476 | 6494 | 6317 | — | — | |
| Median (range) intake (servings/d) | 0.37 (0, 0.56) | 0.75 (0.56, 0.92) | 1.10 (0.92, 1.31) | 1.55 (1.31, 1.91) | 2.53 (1.91, 11.94) | — | — | |
| Age-adjusted HR2 | 1.00 | 0.77 (0.62, 0.97) | 0.74 (0.58, 0.94) | 0.65 (0.51, 0.84) | 0.56 (0.42, 0.73) | <0.01 | 0.77 (0.69, 0.86) | |
| Multivariable HR3 | 1.00 | 0.82 (0.65, 1.03) | 0.81 (0.63, 1.03) | 0.73 (0.56, 0.94) | 0.62 (0.47, 0.83) | <0.01 | 0.81 (0.73, 0.90) | |
| Additional adjustment for diet4 | 1.00 | 0.85 (0.67, 1.07) | 0.87 (0.68, 1.11) | 0.79 (0.61, 1.04) | 0.71 (0.52, 0.95) | <0.01 | 0.85 (0.76, 0.95) | |
| Bread | 0 | 0 to <1 | ≥1 | — | — | — | — | |
| White bread | ||||||||
| Men (n) | 5281 | 12,894 | 5326 | — | — | — | — | |
| Median (range) intake (slices/d) | 0 (0, 0) | 0.33 (0.02, 0.66) | 1.00 (1.00, 4.00) | — | — | — | — | |
| Age-adjusted HR2 | 1.00 | 1.12 (0.96, 1.31) | 1.03 (0.86, 1.24) | — | — | 0.03 | 0.88 (0.78, 0.99) | |
| Multivariable HR3 | 1.00 | 1.10 (0.94, 1.29) | 1.09 (0.90, 1.31) | — | — | 0.18 | 0.92 (0.81, 1.04) | |
| Additional adjustment for diet4 | 1.00 | 1.09 (0.92, 1.29) | 1.12 (0.90, 1.39) | — | — | 0.20 | 0.91 (0.79, 1.05) | |
| Women (n) | 6498 | 17,260 | 6210 | — | — | — | — | |
| Median (range) intake (slices/d) | 0 (0, 0) | 0.33 (0.02, 0.66) | 1.00 (1.00, 4.00) | — | — | — | — | |
| Age-adjusted HR2 | 1.00 | 1.01 (0.84, 1.23) | 0.90 (0.71, 1.14) | — | — | 0.28 | 0.91 (0.76, 1.08) | |
| Multivariable HR3 | 1.00 | 1.00 (0.83, 1.21) | 0.89 (0.70, 1.13) | — | — | 0.30 | 0.91 (0.76, 1.09) | |
| Additional adjustment for diet4 | 1.00 | 0.91 (0.74, 1.11) | 0.79 (0.60, 1.04) | — | — | 0.11 | 0.84 (0.68, 1.04) | |
| Whole-wheat bread | — | — | — | — | ||||
| Men (n) | 18,348 | 4071 | 1082 | — | — | — | — | |
| Median (range) intake (slices/d) | 0 (0, 0) | 0.33 (0.02, 0.66) | 1.00 (1.00, 4.00) | — | — | — | — | |
| Age-adjusted HR2 | 1.00 | 0.83 (0.70, 0.99) | 0.72 (0.53, 0.98) | — | — | 0.03 | 0.78 (0.63, 0.98) | |
| Multivariable HR3 | 1.00 | 0.90 (0.75, 1.07) | 0.83 (0.60, 1.13) | — | — | 0.31 | 0.89 (0.71, 1.11) | |
| Additional adjustment for diet4 | 1.00 | 0.93 (0.77, 1.12) | 0.94 (0.66, 1.33) | 0.95 | 0.99 (0.78, 1.27) | |||
| Women (n) | 22,384 | 6245 | 1339 | — | — | — | — | |
| Median (range) intake (slices/d) | 0 (0, 0) | 0.33 (0.02, 0.66) | 1.00 (1.00, 4.00) | — | — | — | — | |
| Age-adjusted HR2 | 1.00 | 0.83 (0.67, 1.03) | 0.48 (0.29, 0.80) | — | — | <0.01 | 0.53 (0.36, 0.78) | |
| Multivariable HR3 | 1.00 | 0.90 (0.72, 1.13) | 0.53 (0.31, 0.88) | — | — | 0.01 | 0.60 (0.40, 0.88) | |
| Additional adjustment for diet4 | 1.00 | 0.93 (0.74, 1.17) | 0.51 (0.30, 0.89) | — | — | 0.01 | 0.58 (0.38, 0.89) | |
1
Data were analyzed by using Cox proportional hazards regression. P-interactions by sex in fully adjusted models were as follows: rice, 0.018; noodles, 0.709; vegetables, 0.017; fruit, 0.019; white bread, 0.954; and whole-wheat bread, 0.085.
2
Adjusted for age, year of interview, father's dialect, and total energy intake.
3
Additional adjustment for cigarette smoking, alcohol consumption, physical activity, sleep duration, education level, BMI, history of hypertension, and, for women only, menopausal status and hormone-replacement therapy use.
4
Multivariable model with additional adjustment for the ratio of polyunsaturated to saturated fat and consumption of rice, noodles, vegetables, fruit, fish, red meat, poultry, eggs, legumes, soy protein, white bread, and whole-wheat bread.