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To analyse the association between macronutrient intake and body mass index (BMI).
A series of hospital-based case–control studies.
Selected teaching and general hospitals in several Italian regions.
A total of 6619 subjects from the comparison groups of the case–control studies were included in the analysis.
We obtained data from a validated 78-item food-frequency questionnaire submitted between 1991 and 2002. For various macronutrients, the partial regression coefficient (variation of BMI (kg m− 2) per 100 kcal increment of energy intake) was derived from multiple linear regression models, after allowance for age, study centre, education, smoking habits, number of eating episodes and mutual adjustment for macronutrients.
BMI was directly associated with protein intake among women only (β = 0.68) and with unsaturated fats in both genders (for monounsaturated fats β = 0.27 for men and 0.26 for women; for polyunsaturated fats β = 0.27 for men and 0.54 for women), and inversely related to carbohydrates (β = − 0.05 for men and − 0.21 for women) and number of eating episodes in both genders (β = − 0.42 for men and − 0.61 for women) and to saturated fats among women only (β = − 0.57).
These results confirm and provide convincing evidence that, after allowance for selected covariates including total energy intake, a protein-rich diet is not inversely related to BMI, and a carbohydrate-rich diet is not directly related to BMI.
The relation between several measures of body iron and atherosclerotic disease, particularly acute myocardial infarction (AMI), is debated. This is of specific interest since iron is frequently included in supplementation and fortification of foods. We assessed the relation between dietary iron intake and the risk of non-fatal AMI.
Case–control study. The information was collected by interviewers using a food-frequency questionnaire tested for validity and reproducibility. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were obtained by multiple unconditional logistic regression models, including terms for energy and alcohol intakea, as well as for sociodemographic factors, tobacco and other major recognised risk factors for AMI.
Milan, Italy, between 1995 and 1999.
Cases were 507 patients, below age 79 years, with a first episode of non-fatal AMI, and controls were 478 patients admitted to hospital for a wide spectrum of acute conditions unrelated to known or potential AMI risk factors.
Compared with patients in the lowest tertile of total iron intake, the OR was 0.48 (95% CI 0.29–0.82) for those in the highest tertile. The corresponding value for haem iron was 0.71 (95% CI 0.48–1.06), for non-haem, non-alcohol iron was 0.80 (95% CI 0.51–1.24) and for iron derived from alcoholic beverages was 0.60 (95% CI 0.40–0.90). Sex-specific OR for total iron intake were not heterogeneous.
In this Italian population dietary iron intake was inversely related to AMI risk. This inverse association may depend on other nutrients present in the major sources of iron in the Italian diet.
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