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Nutr Metab Cardiovasc Dis. 2015 Jan;25(1):24-35. doi: 10.1016/j.numecd.2014.09.002. Epub 2014 Sep 30.

Dietary intake of heme iron and risk of cardiovascular disease: a dose-response meta-analysis of prospective cohort studies.

Author information

1
Department of Nutrition, Research Center for Nutrition and Health, Institute of Nutrition and Food Safety, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China; The First Affiliated Hospital, Institute for Translational Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China.
2
Department of Nutrition, Research Center for Nutrition and Health, Institute of Nutrition and Food Safety, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China.
3
Department of Epidemiology & Biostatistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China.
4
The First Affiliated Hospital, Institute for Translational Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, Zhejiang 310058, China.
5
Departments of Epidemiology and Medicine, Brown University, Providence, RI 02912, USA.
6
Department of Nutrition, Research Center for Nutrition and Health, Institute of Nutrition and Food Safety, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, Zhejiang 310058, China. Electronic address: fwang@zju.edu.cn.

Abstract

BACKGROUND AND AIMS:

Iron is thought to play a fundamentally important role in the development of cardiovascular disease (CVD). This meta-analysis was performed to investigate the dose-response association between dietary intake of iron (including heme and non-heme iron) and the risk of CVD.

METHODS AND RESULTS:

We performed a search of the PubMed and Embase databases for prospective cohort studies of the association between dietary iron intake and CVD risk. Thirteen articles comprising 252,164 participants and 15,040 CVD cases were eligible for inclusion. Heme iron intake was associated significantly with increased risk of cardiovascular disease, and the pooled relative risk (RR) for each 1 mg/day increment was 1.07 (95% confidence interval: 1.01 to 1.14, I² = 59.7%). We also found evidence of a curvilinear association (P < 0.05 for non-linearity). In contrast, we found no association between CVD risk and dietary non-heme (0.98, 0.96 to 1.01, I² = 15.8%) or total iron (1.00, 0.94 to 1.06, I² = 30.4%). Subgroup analyses revealed that the association between heme iron intake and CVD risk was stronger among non-fatal cases (1.19, 1.07-1.33) and American patients (1.31, 1.11-1.56).

CONCLUSIONS:

Higher dietary intake of heme iron is associated with an increased risk of cardiovascular disease, whereas no association was found between CVD and non-heme iron intake or total iron intake. These findings may have important public health implications with respect to preventing cardiovascular disease.

KEYWORDS:

Cardiovascular disease; Dose–response; Heme iron; Meta-analysis

PMID:
25439662
DOI:
10.1016/j.numecd.2014.09.002
[Indexed for MEDLINE]

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