Circulation, Vol 89, 969-974, Copyright © 1994 by American Heart Association
A Ascherio, WC Willett, EB Rimm, EL Giovannucci and MJ Stampfer
BACKGROUND: We prospectively studied iron intake in relation to the
incidence of coronary disease in a 4-year follow-up of 44,933 men (with no
previous history of cardiovascular disease) aged 40 to 75 years in 1986 who
completed a food frequency questionnaire at baseline. METHODS AND RESULTS:
We documented 844 incident cases of coronary disease (249 nonfatal
myocardial infarctions, 137 coronary disease fatalities, and 458 bypass
operations or angioplasties). After adjustment for established risk
factors, there was no significant association between total iron intake and
risk of coronary heart disease. Men in the highest quintile of total intake
(median, 37 mg/d) had a relative risk (RR) of fatal coronary disease or
nonfatal myocardial infarction of 0.73 (95% confidence intervals [CI],
0.51, 1.06) compared with men in the lowest quintile of intake (median, 11
mg/d). Dietary intake of heme iron--mainly from red meat--also was not
significantly associated with risk of coronary heart disease. However,
incidence of fatal coronary disease or nonfatal myocardial infarction was
higher among men in the top quintile of heme iron intake compared with men
in the lowest quintile (RR, 1.42; 95% CI, 1.02, 1.98). This association
remained after adjustment for dietary cholesterol and fats. Heme iron but
not total iron intake was positively correlated with serum ferritin among
123 members of the cohort who participated in a validation study.
CONCLUSIONS: These results do not support the hypothesis that dietary iron
in general increases coronary risk in men; they are consistent, however,
with an increased risk of myocardial infarction among men with higher
intake of heme iron, which is itself positively associated with iron
stores.
ARTICLES
Dietary iron intake and risk of coronary disease among men
Department of Epidemiology, Harvard School of Public Health, Boston, MA.
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