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Lignan Intake and Risk of Coronary Heart Disease
Quick Takes
- Lignan intake is inversely associated with CHD risk.
- Diets high in lignans include plant-based foods such as seeds, whole grains, fruits, vegetables, wine, tea, and coffee.
- There is a nonlinear association for total lignan, matairesinol, and secoisolariciresinol, with a plateau in risk reduction at intakes above approximately 300 mg/d, 10 mg/d, and 100 mg/d of intake, respectively.
Study Questions:
Is lignan intake associated with coronary heart disease (CHD) risk?
Methods:
Data from 214,108 men and women participants enrolled in three US prospective cohorts (Nurses’ Health Study I and II, and Health Professionals Follow-up Study) were used for the present analysis. All participants were free of cardiovascular disease or cancer at baseline. Diet was assessed using a validated food frequency questionnaire every 2-4 years starting at baseline. Lignans, the main exposure of interest, are polyphenolic substances that are produced by plant cells. Dietary lignans, including matairesinol, secoisolariciresinol, pinoresinol, and lariciresinol, are primarily from intake of plant-based foods, especially seeds, whole grains, fruits, vegetables, wine, tea, and coffee.
Results:
Over 5,517,225 person-years of follow-up, a total of 10,244 CHD events were identified, including 6,283 nonfatal myocardial infarction and 3,961 fatal CHD cases. Across all cohorts, total lignan intake was associated with older age and a more favorable health and lifestyle profile (including lower body mass index, less hypertension, and less dyslipidemia). After adjustment for traditional risk factors, comparing the top and bottom quintiles of intake, the pooled hazard ratios of CHD were 0.85 (95% confidence interval [CI], 0.79-0.92) for total lignans, 0.76 (95% CI, 0.71-0.82) for matairesinol, 0.87 (95% CI, 0.81-0.93) for secoisolariciresinol, 0.89 (95% CI, 0.83-0.95) for pinoresinol, and 0.89 (95% CI, 0.83-0.95) for lariciresinol (all p values for trend ≤ 0.003). Nonlinear relationships were found for total lignan, matairesinol, and secoisolariciresinol. The risk reduction plateaued at intakes above approximately 300 mg/d, 10 mg/d, and 100 mg/d, respectively (p < 0.01 for all nonlinearity). The inverse associations for total lignan intake appeared to be more apparent among participants with higher total fiber intake (p = 0.04 for interaction). Lignan intake was more strongly associated with plasma concentrations of enterolactone when fiber intake was higher.
Conclusions:
The investigators concluded that increased long-term intake of lignans was associated with a significantly lower risk of total CHD in both men and women. Possible synergistic effects may exist between lignan and fiber intake in relation to CHD risk reduction, possibly through enhancing the production of enterolignans.
Perspective:
These data support recommendations for a diet high in plant-based foods such as seeds, whole grains, fruits, and vegetables.
Clinical Topics: Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Dyslipidemia, Prevention, Diet, Hypertension
Keywords: Body Mass Index, Coffee, Coronary Disease, Diet, Dyslipidemias, Fruit, Hypertension, Life Style, Lignans, Myocardial Infarction, Plant Cells, Plasma, Primary Prevention, Risk Reduction Behavior, Tea, Vegetables, Wine
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