Relationship of dietary nitrate intake from vegetables with cardiovascular disease mortality: a prospective study in a cohort of older Australians

Alex Liu, Catherine Bondonno, Russell Joanna, Victoria Flood, Joshua Lewis, Kevin Croft, Richard Woodman, Wai Lim, Annette Kifley, Germaine Wong, Paul mitchell, Jonathan Hodgson, Lauren Blekkenhorst

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    8 Citations (Scopus)

    Abstract

    Purpose: Short-term trials indicate inorganic nitrate and nitrate-rich vegetables may have vascular health benefits. However, few observational studies have explored the relationship between nitrate intake and long-term cardiovascular disease (CVD) outcomes. The primary aim of this study was to investigate the association of nitrate intake from vegetables with CVD mortality in a sample of older Australians. Methods: A subgroup of participants without diabetes or major CVD at baseline (1992–1994) were included from the Blue Mountains Eye Study, a population-based cohort study of men and women aged ≥ 49 years. Diets were evaluated using a validated food frequency questionnaire at baseline, 5 years and 10 years of follow-up. Vegetable nitrate intake was estimated using a comprehensive vegetable nitrate database. Cox proportional hazard regression was used to explore the association between vegetable nitrate intake and CVD mortality. Results: During 14 years of follow-up, 188/2229 (8.4%) participants died from CVD. In multivariable-adjusted analysis, participants in quartile 2 [69.5–99.6 mg/day; HR 0.53 (95% CI 0.35, 0.82)], quartile 3 [99.7–137.8 mg/day; HR 0.51 (95% CI 0.32, 0.80)], and quartile 4 [> 137.8 mg/day; HR 0.63 (95% CI 0.41, 0.95)] of vegetable nitrate intake had lower hazards for CVD mortality compared to participants in quartile 1 (< 69.5 mg/day). Conclusions: In older Australian men and women, vegetable nitrate intake was inversely associated with CVD mortality, independent of lifestyle and cardiovascular risk factors. These findings confirm a recent report that intake of vegetable nitrate lowers the risk of CVD mortality in older women and extend these findings to older men.

    Original languageEnglish
    Pages (from-to)2741-2753
    Number of pages13
    JournalEuropean Journal of Nutrition
    VolumeSep20
    Issue number7
    DOIs
    Publication statusPublished - 2018

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    Liu, A., Bondonno, C., Joanna, R., Flood, V., Lewis, J., Croft, K., Woodman, R., Lim, W., Kifley, A., Wong, G., mitchell, P., Hodgson, J., & Blekkenhorst, L. (2018). Relationship of dietary nitrate intake from vegetables with cardiovascular disease mortality: a prospective study in a cohort of older Australians. European Journal of Nutrition, Sep20(7), 2741-2753. https://doi.org/10.1007/s00394-018-1823-x