Acta Nat. Sci.   |  e-ISSN: 2718-0638

Original article | Acta Natura et Scientia 2022, Vol. 3(2) 189-202

Relationship Between the Risk of Coronary Heart Disease and Nutritional Status of Adult

Sümeyye Güzel & Alev Keser

pp. 189 - 202   |  DOI:   |  Manu. Number: MANU-2211-05-0001.R1

Published online: December 09, 2022  |   Number of Views: 46  |  Number of Download: 387


Cardiovascular diseases (CVD) have the highest prevalence among non-communicable diseases so prevention from CVD is very important. The aim of this study was to determine the risk of cardiovascular events in adults over the next 10 years with the Framingham Risk Score (FRS) and to evaluate the relationship between this risk and the nutritional patterns of individuals. This study was conducted with a total of 238 individuals (78 males, 160 females) aged between 30-64 years. Energy, micro and macronutrients intake levels of the participants according to FRS and gender were determined by taking a daily food consumption record with a 24-hour retrospective reminder method. Participants’ ten-year coronary disease risk was assessed with FRS which was classified as low risk (<10%), moderate risk (10-20%), and high risk (>20%). While 44.9% of the men had moderate/high coronary disease risk, all of women had low risk. Energy, many macronutrients and micronutrients intake levels of men with low risk of coronary heart diseases (CHD) were higher than women. FRS values of all individuals participating in the research were related to energy, carbohydrate (g, %), protein (g), total fat (%), mono-unsaturated fatty acid/MUFA (g), poly-unsaturated fatty acid/PUFA (%), riboflavin, sodium, and zinc. Of these parameters, total fat and PUFA were negatively correlated, while the others were positively correlated. The parameter that most affected the FRS value was carbohydrate (g). These results clearly demonstrate the relationship between nutrition and CVD risk. Therefore, identifying individuals with medium/high FRS and taking nutritional initiatives are important in reducing the CVD prevalence and health costs.

Keywords: Coronary heart diseases, Framingham Risk Score, Macronutrients, Micronutrients, Nutrition

How to Cite this Article?

APA 6th edition
Guzel, S. & Keser, A. (2022). Relationship Between the Risk of Coronary Heart Disease and Nutritional Status of Adult . Acta Natura et Scientia, 3(2), 189-202. doi: 10.29329/actanatsci.2022.352.10

Guzel, S. and Keser, A. (2022). Relationship Between the Risk of Coronary Heart Disease and Nutritional Status of Adult . Acta Natura et Scientia, 3(2), pp. 189-202.

Chicago 16th edition
Guzel, Sumeyye and Alev Keser (2022). "Relationship Between the Risk of Coronary Heart Disease and Nutritional Status of Adult ". Acta Natura et Scientia 3 (2):189-202. doi:10.29329/actanatsci.2022.352.10.

  1. Adriouch, S., Julia, C., Kesse-Guyot, E., Ducrot, P., Péneau, S., Méjean, C., Assmann, K. E., Deschasaux, M., Hercberg, S., Touvier, M., & Fezeu, L. K. (2017). Association between a dietary quality index based on the food standard agency nutrient profiling system and cardiovascular disease risk among French adults. International Journal of Cardiology, 234, 22–27. [Google Scholar] [Crossref] 
  2. Bazzano, L. A., Hu, T., Reynolds, K., Yao, L., Bunol, C., Liu, Y., Chen, C. S., Klag, M. J., Whelton, P. K., & He, J. (2014). Effects of low-carbohydrate and low-fat diets: A randomized trial. Annals of Internal Medicine, 161(5), 309–318. [Google Scholar] [Crossref] 
  3. Bhupathiraju, S. N., & Tucker, K. L. (2011). Greater variety in fruit and vegetable intake is associated with lower inflammation in Puerto Rican adults. American Journal of Clinical Nutrition, 93(1), 37–46. [Google Scholar] [Crossref] 
  4. Buttar, H. S., Li, T., & Ravi, N. (2005). Prevention of cardiovascular diseases: Role of exercise, dietary interventions, obesity and smoking cessation. Experimental and Clinical Cardiology, 10(4), 229–249. [Google Scholar]
  5. Cangemi, R., Pignatelli, P., Carnevale, R., Corazza, G. R., Pastori, D., Farcomeni, A., Basili, S., Davì, G., Ferro, D., Hiatt, W. R., Licata, G., Lip, G. Y. H., Loffredo, L., Mannucci, P. M., Vestri, A., & Violi, F. (2013). Cholesterol-adjusted vitamin e serum levels are associated with cardiovascular events in patients with non-valvular atrial fibrillation. International Journal of Cardiology, 168(4), 3241–3247. [Google Scholar] [Crossref] 
  6. CDC. (2019). Know Your Risk for Heart Disease. Retrieved on October 3, 2022, from [Google Scholar]
  7. Dehghan, M., Mente, A., Zhang, X., Swaminathan, S., Li, W., Mohan, V., Iqbal, R., Kumar, R., Wentzel-Viljoen, E., Rosengren, A., Amma, L. I., Avezum, A., Chifamba, J., Diaz, R., Khatib, R., Lear, S., Lopez-Jaramillo, P., Liu, X., Gupta, R., Mohammadifard, N., Gao, N., Oguz, A., Ramli, A. S., Seron, P., Sun, Y., Szuba, A., Tsolekile, L., Wielgosz, A., Yusuf, R., Yusufali, A. H., Teo, K. K., Rangarajan, S., Dagenais, G., Bangdiwala, S. I., Islam, S., Anand, S. S., Yusuf, S., & Prospective Urban Rural Epidemiology (PURE) study investigators. (2017). Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): A prospective cohort study. The Lancet, 390(10107), 2050–2062. [Google Scholar] [Crossref] 
  8. Fang, X., Wang, K., Han, D., He, X., Wei, J., Zhao, L., Imam, M. U., Ping, Z., Li, Y., Xu, Y., Min, J., & Wang, F. (2016). Dietary magnesium intake and the risk of cardiovascular disease, type 2 diabetes, and all-cause mortality: A dose-response meta-analysis of prospective cohort studies. BMC Medicine, 14(1), 210. [Google Scholar] [Crossref] 
  9. Gunashekar, D. R., Singh, R. B., Niaz, M. A., Shewale, A. R., Takahashi, T., Chauhan, A. K., & Singh, R. P. (2017). Dietary fiber and risk of cardiovascular diseases. In R. A. Samaan (Ed.), Dietary Fiber for the Prevention of Cardiovascular Disease: Fiber’s Interaction between Gut Micoflora, Sugar Metabolism, Weight Control and Cardiovascular Health (pp. 91–120). Elsevier Inc. [Google Scholar] [Crossref] 
  10. Hariri, N., Darafshi Ghahroudi, S., Nasseri, E., Bondarianzadeh, D., Houshyar-Rad, A., & Zayeri, F. (2017). Evaluation of the Alternative Healthy Eating Index as a predictor of 10-year cardiovascular disease risk in a group of Iranian employees. Journal of Human Nutrition and Dietetics, 30(4), 499–505. [Google Scholar] [Crossref] 
  11. Heart Foundation. (2019). Fats, Oils and Heart Health. Retrieved on October 3, 2022, from [Google Scholar]
  12. Horigan, G., McNulty, H., Ward, M., Strain, J. J. J., Purvis, J., & Scott, J. M. (2010). Riboflavin lowers blood pressure in cardiovascular disease patients homozygous for the 677C→T polymorphism in MTHFR. Journal of Hypertension, 28(3), 478–486. [Google Scholar] [Crossref] 
  13. Hu, F. B., Stampfer, M. J., Rimm, E., Ascherio, A., Rosner, B. A., Spiegelman, D., & Willett, W. C. (1999). Dietary fat and coronary heart disease: A comparison of approaches for adjusting for total energy intake and modeling repeated dietary measurements. American Journal of Epidemiology, 149(6), 531–540. [Google Scholar] [Crossref] 
  14. Kannel, W. B., McGee, D., & Gordon, T. (1976). A general cardiovascular risk profile: The Framingham study. The American Journal of Cardiology, 38(1), 46–51. [Google Scholar] [Crossref] 
  15. Kieboom, B. C. T., Niemeijer, M. N., Leening, M. J. G., van den Berg, M. E., Franco, O. H., Deckers, J. W., Hofman, A., Zietse, R., Stricker, B. H., & Hoorn, E. J. (2016). Serum magnesium and the risk of death from coronary heart disease and sudden cardiac death. Journal of the American Heart Association, 5(1), e002707. [Google Scholar] [Crossref] 
  16. Lai, Y. H., Leu, H. B., Yeh, W. T., Chang, H. Y., & Pan, W. H. (2015). Low-normal serum potassium is associated with an increased risk of cardiovascular and all-cause death in community-based elderly. Journal of the Formosan Medical Association, 114(6), 517–525. [Google Scholar] [Crossref] 
  17. Lairon, D., Arnault, N., Bertrais, S., Planells, R., Clero, E., Hercberg, S., & Boutron-Ruault, M. C. (2005). Dietary fiber intake and risk factors for cardiovascular disease in French adults. American Journal of Clinical Nutrition, 82(6), 1185–1194. [Google Scholar] [Crossref] 
  18. Lavigne, P. M., & Karas, R. H. (2013). The current state of niacin in cardiovascular disease prevention: A systematic review and meta-regression. Journal of the American College of Cardiology, 61(4), 440–446. [Google Scholar] [Crossref] 
  19. Mazidi, M., Nematy, M., Heidari-Bakavoli, A. R., Namadchian, Z., Ghayour-Mobarhan, M., & Ferns, G. A. (2017). The relationship between dietary intake and other cardiovascular risk factors with blood pressure in individuals without a history of a cardiovascular event: Evidence based study with 5670 subjects. Diabetes and Metabolic Syndrome: Clinical Research and Reviews, 11(1), 65–71. [Google Scholar] [Crossref] 
  20. Meseri, R., Ucku, R., & Unal, B. (2014). Waist:height ratio: A superior index in estimating cardiovascular risks in Turkish adults. Public Health Nutrition, 17(10), 2246–2252. [Google Scholar] [Crossref] 
  21. Micha, R., Peñalvo, J. L., Cudhea, F., Imamura, F., Rehm, C. D., & Mozaffarian, D. (2017). Association between dietary factors and mortality from heart disease, stroke, and type 2 diabetes in the United States. Journal of the American Medical Association, 317(9), 912–924. [Google Scholar] [Crossref] 
  22. Mohammadifard, N., Humphries, K. H., Gotay, C., Mena-Sánchez, G., Salas-Salvadó, J., Esmaillzadeh, A., Ignaszewski, A., & Sarrafzadegan, N. (2019). Trace minerals intake: Risks and benefits for cardiovascular health. Critical Reviews in Food Science and Nutrition, 59(8), 1334–1346. [Google Scholar] [Crossref] 
  23. National Research Council. (1986). Nutrient Adequacy: Assessment Using Food Consumption Surveys. In Nutrient Adequacy: Assessment Using Food Consumption Surveys. National Academies Press. [Google Scholar] [Crossref] 
  24. NIH. (2001). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Retrieved on October 3, 2022, from [Google Scholar]
  25. NIH. (2013). Assessing Cardiovascular Risk: Systematic Evidence Review from the Risk Assessment Work Group. Retrieved on October 3, 2022, from [Google Scholar]
  26. Núñez-Córdoba, J. M., & Martínez-González, M. A. (2011). Antioxidant Vitamins and Cardiovascular Disease. Current Topics in Medicinal Chemistry, 11(14), 1861–1869. [Google Scholar] [Crossref] 
  27. Rakıcıoğlu, N., Tek, N., Ayaz, A., & Pekcan, G. (2009). Food and Food Photo Catalog: Measure and Quantities (1st Ed.). Ata Ofset. [Google Scholar]
  28. Ravera, A., Carubelli, V., Sciatti, E., Bonadei, I., Gorga, E., Cani, D., Vizzardi, E., Metra, M., & Lombardi, C. (2016). Nutrition and cardiovascular disease: Finding the perfect recipe for cardiovascular health. Nutrients, 8(6), 363. [Google Scholar] [Crossref] 
  29. Setayeshgar, S., Whiting, S. J., Pahwa, P., & Vatanparast, H. (2015). Predicted 10-year risk of cardiovascular disease among Canadian adults using modified Framingham risk score in association with dietary intake. Applied Physiology, Nutrition and Metabolism, 40(10), 1068–1074. [Google Scholar] [Crossref] 
  30. Sieri, S., Krogh, V., Berrino, F., Evangelista, A., Agnoli, C., Brighenti, F., Pellegrini, N., Palli, D., Masala, G., Sacerdote, C., Veglia, F., Tumino, R., Frasca, G., Grioni, S., Pala, V., Mattiello, A., Chiodini, P., & Panico, S. (2010). Dietary glycemic load and index and risk of coronary heart disease in a large Italian cohort: The EPICOR study. Archives of Internal Medicine, 170(7), 640–647. [Google Scholar] [Crossref] 
  31. Similä, M. E., Kontto, J. P., Männistö, S., Valsta, L. M., & Virtamo, J. (2013). Glycaemic index, carbohydrate substitution for fat and risk of CHD in men. The British Journal of Nutrition, 110(9), 1704–1711. [Google Scholar] [Crossref] 
  32. Sohn, C., Kim, J., & Bae, W. (2012). The Framingham risk score, diet, and inflammatory markers in Korean men with metabolic syndrome. Nutrition Research and Practice, 6(3), 246–253. [Google Scholar] [Crossref] 
  33. Tekkeşin, N., Cumhur, K., & Ökmen, A. Ş. (2011). Investigation of Framingham Risk Factors in Turkish adults. Journal of Clinical and Experimental Investigations, 2(1), 42–49. [Google Scholar] [Crossref] 
  34. Virtanen, J. K., Mursu, J., Tuomainen, T. P., & Voutilainen, S. (2014). Dietary fatty acids and risk of coronary heart disease in men the kuopio ischemic heart disease risk factor study. Arteriosclerosis, Thrombosis, and Vascular Biology, 34(12), 2679–2687. [Google Scholar] [Crossref] 
  35. Weber, C., Erl, W., Weber, K., & Weber, P. C. (1996). Increased adhesiveness of isolated monocytes to endothelium is prevented by vitamin C intake in smokers. Circulation, 93(8), 1488–1492. [Google Scholar] [Crossref] 
  36. WHO. (2021). Noncommunicable diseases. Retrieved on October 3, 2022, from [Google Scholar]
  37. Xu, J., Eilat-Adar, S., Loria, C., Goldbourt, U., Howard, B. V., Fabsitz, R. R., Zephier, E. M., Mattil, C., & Lee, E. T. (2006). Dietary fat intake and risk of coronary heart disease: The Strong Heart Study. American Journal of Clinical Nutrition, 84(4), 894–902. [Google Scholar] [Crossref]